Uproot care law, Trump exhorts
GOP bill for vote is still a mystery
WASHINGTON — President Donald Trump browbeat Republican opponents of his party’s reeling health care bill Monday, asserting that his predecessor’s signature overhaul has meant “death” and saying the Senate’s planned vote is their chance to keep their pledge to repeal it.
Senate Majority Leader Mitch McConnell said he’d call a pivotal vote today on beginning debate on the legislation. He said he’s “made a commitment to the people I represent” to undo President Barack Obama’s health care overhaul, in what seemed a pointed reminder to Republican senators that they’ve made the same vow.
McConnell, R-Ky., did not describe precisely what version of the GOP legislation senators would be voting on. That omission has caused confusion and frustration among some Republican senators, though others have said they expect McConnell to clarify that by the time voting begins.
At the White House, Trump lambasted Democrats who helped enact the 2010 health care law and now uniformly oppose the GOP attempt to scrap and rewrite it.
“They run out and say, ‘Death, death, death,’” Trump said, with a backdrop of families that he said have encountered problems getting affordable, reliable medical coverage because of Obama’s statute. “Well, Obamacare is death. That’s the one that’s death.
“Every Republican running for office promised immediate relief from this disastrous law, but so far, Senate Republicans have not done their job in ending the Obamacare nightmare,” the president added.
Trump even jokingly threatened to fire his health secretary if the vote fails.
“Hopefully he’s going to get the votes tomorrow to start our path toward killing this horrible thing known as Obamacare,” Trump said Monday at a national gathering of Boy Scouts in West Virginia, before turning to Tom Price, the secretary of health and human services.
“By the way, you going to get the votes? He better get them,” Trump said, adding, “Otherwise, I’ll say: Tom, you’re fired.”
Trump, who campaigned on a promise to immediately roll back the health law and enact a better system, said GOP senators’ constituents would exact a price for inaction — “you’ll see that at the voter booth, believe me” — and hinted that any Republican who did not support the bid to open debate on an as-yet-determined health bill would be painted as complicit in preserving a health law passed on the basis of “a big, fat, ugly lie.”
Some Democrats have said the GOP repeal effort would lead to death for patients who lose coverage. The nonpartisan Congressional Budget Office has said various versions of the legislation would mean more than 20 million Americans would become uninsured by 2026.
Trump focused much of his remarks on GOP senators. McConnell is nursing a slim 52-48 majority and the possible absence of Arizona Sen. John McCain, who’s battling cancer, which would mean two GOP defections would sink the measure. McCain’s office announced Monday that he would return to Washington today.
“For Senate Republicans, this is their chance to keep their promise. Over and over again, they said, ‘Repeal and replace, repeal and replace.’ But they can now keep their promise,” Trump said.
At least a dozen Republican senators have publicly opposed or criticized the legislation, more than enough to kill it. That’s forced McConnell to step back twice from anticipated votes and to revise his bill in hopes of mollifying unhappy moderates and conservatives.
McConnell’s legislation would uproot much of Obama’s law, eliminating its tax penalties on people not buying policies, cutting the Medicaid health care program for the poor and providing less generous health care subsidies for consumers.
He’s revised it once and then said he’d push a vote on legislation simply repealing Obama’s statute. But McConnell and administration officials have also considered additional changes to the repeal-and-replace bill that might attract senators, leaving the focus of today’s vote uncertain.
McConnell is expected to move ahead with a procedural vote to take up the health care bill that narrowly passed the House in May. If that vote is approved, the Senate would begin debating a bill to repeal and replace the Affordable Care Act.
If McConnell can muster 50 votes to begin debate on the House bill, he could quickly move to replace it with an entirely new bill to repeal the Affordable Care Act without a replacement. If that amendment vote fails, he could move to replace the bill that was passed in the House with a health bill that has been worked out in private negotiations among Republican senators.
None of that would happen if senators vote against the motion to proceed.
“It’s still fluid,” said Sen. Pat Roberts of Kansas, who added that he wants to support whatever plan emerges because he opposes leaving the Affordable Care Act in place.
Complicating McConnell’s task, Ohio GOP Gov. John Kasich said it would be a mistake for the Senate to move ahead today “and force a one-sided deal that the American people are clearly against.” Kasich’s stance could make it harder for wavering Sen. Rob Portman, R-Ohio, who’s criticized the measure’s Medicaid cuts, to back the legislation.
Yet in one possible sign of progress by leaders, Portman said it’s “not as important to me” to know what bill McConnell would move to if the Senate votes to begin debate.
Kasich panned the bill for a lack of “bipartisanship, transparency or open dialogue.” In a statement, the 2016 GOP presidential contender said Congress should take no action on re-crafting the nation’s health care system until it can “step back from political gamesmanship and come together with a workable, bipartisan plan.”
Yet Portman and other undeclared Republican senators were also being pounded by the White House.
“Republicans have a last chance to do the right thing on Repeal & Replace after years of talking & campaigning on it,” Trump tweeted earlier Monday.
Republican leaders are pressuring their members to go along at least with the procedural step, to bring them closer to delivering on their longtime promise of repealing the Affordable Care Act, which was adopted without any Republican votes.
“It’s hard to believe somebody who has run and won election could go home and face the voters again and say, ‘I’m not even willing to debate it on the floor,’” Sen. John Barrasso of Wyoming, a member of the Republican leadership, said on CBS’ Face the Nation on Sunday.
Barrasso said if the Housepassed bill makes it to the floor, senators could “amend it in various ways and lots of members have different ideas on how it should be best amended. Until the vote is actually on the floor of the Senate, some people may not tell you what they’re actually going to do.”
Rep. Blake Farenthold, R-Texas, speaking on a Corpus Christi, Texas, radio show Monday, said it is “absolutely repugnant” that Republican senators aren’t following through on campaign promises to repeal Obama’s law.
Without naming them, he mentioned “female senators from the Northeast” and said, “If it was a guy from South Texas, I might ask him to step outside and settle this Aaron Burr style,” a reference to the firearms duel in which Burr killed Alexander Hamilton.
Sen. Susan Collins, R-Maine, has opposed the GOP replacement plan. Other Republicans expressing reservations include Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska.
It will be hard to get people who have taken hard stands against McConnell’s plan or portions of it to change their positions, Roberts said.
“It’s awfully difficult when people climb the tree and get out on a limb and say, ‘I’m going to vote no,”’ the Kansas senator said. “For them to skinny back down that tree, that’s tough. And they have to have some very good reasons as to why that’s the case.”
The repeal bill is being considered under special expedited procedures that apply to certain budget-related legislation. These rules limit debate, preclude a filibuster and allow passage with a simple majority vote. However, the rules stipulate that provisions of the bill can be stricken if they would not change federal spending or revenue or if the budgetary effects are “merely incidental” to some policy objective.
The Senate parliamentarian, Elizabeth MacDonough, who serves as a sort of referee, has made a preliminary finding that a number of provisions of the bill appear to violate Senate rules.
These provisions would, for example, cut off federal funds to Planned Parenthood for one year; prohibit the use of federal subsidies to buy insurance that includes coverage for abortions; and require people who have experienced a gap in coverage to wait six months before buying insurance in the individual market.
If a senator objects to any of these provisions, the presiding officer could sustain the objection, following the parliamentarian’s advice. Republicans would then need 60 votes to keep that provision in the bill, and it would be nearly impossible for them to muster those votes on any significant issue.
Information for this article was contributed by Alan Fram and Julie Carr Smyth of The Associated Press; Thomas Kaplan, Julie Hirschfeld Davis, Jennifer Steinhauer and Robert Pear of The New York Times; and Laura Litvan of Bloomberg News.
President Donald Trump speaks about health care Monday in the Blue Room of the White House in Washington.