Trump touts Republicans’ latest health care legislation

President Donald Trump on Wednesday endorsed the latest effort by Senate Republicans to advance a health care bill, calling it legislation that would fulfill the party’s promise to repeal and replace the Patient Protection and Affordable Care Act.

But later in the day, Trump said the Republicans’ effort remains two or three votes short, forecasting days of lobbying ahead of a deadline looming next week.

The legislation by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina would repeal major pillars of former President Barack Obama’s health law, replacing them with block grants to states to let the states design their own programs.

Senate Majority Leader Mitch McConnell, R-Ky., is trying to round up 50 votes to pass the legislation before Sept. 30, when special rules preventing a Democratic filibuster will expire. If they got to 50 votes, Vice President Mike Pence would provide the tie-breaker vote.

The majority leader’s “intention” is to have the legislation on the Senate floor next week, McConnell’s office announced in a statement Wednesday.

Sen. Dick Durbin of Illinois, the Senate’s second-ranking Democrat, told reporters that McConnell’s statement is “an indication he believes he has the votes” and there is alarm among Democrats.

Trump told reporters covering the U.N. General Assembly meeting in New York: “We think this has a very good chance; Obamacare is only getting worse. At some point, the Senate is going to be forced to make a deal.”

“We’re at 47 or 48 already, senators, and a lot of others are looking at it very positively,” he said.

In two tweets Wednesday morning, the president urged Senate Republicans to support the measure.

“I hope Republican Senators will vote for GrahamCassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!” Trump tweeted.

In his second message, he took a swipe at Sen. Rand Paul, R-Ky., who has criticized the measure as insufficient.

“Rand Paul is a friend of mine but he is such a negative force when it comes to fixing healthcare,” Trump wrote. “Graham-Cassidy Bill is GREAT! Ends Ocare!”

Shortly after the president’s tweets, Paul responded with his own tweets, renewing his criticism of the bill.

“#GrahamCassidy is amnesty for Obamacare. It keeps it, it does not repeal it,” Paul wrote. “I will keep working with the President for real repeal.”

In a Senate split 52-48 between the Republican and Democratic caucuses, McConnell has little room for error. In addition to Paul, moderate Republican Sen. Susan Collins of Maine is also seen as a likely “no” vote.

With Democrats unanimously opposed, McConnell cannot afford to lose even one more Republican senator. The focus is on Sens. John McCain of Arizona and Lisa Murkowski of Alaska, both of whom opposed earlier versions of repeal legislation.

Graham on Wednesday appealed for support from fellow senators for his GOP health care bill despite “all its imperfections.”

“We’re going to vote,” Graham told broadcaster Sean Hannity. “Everybody will be held accountable.”

Graham made his comments in an overheard cellphone call in front of a passenger at Reagan National Airport before he boarded a flight. They were earlier misinterpreted by The Associated Press as being delivered to a fellow senator. Graham’s office did not dispute that interpretation when asked about the comments and did not say who was on the call with the senator. It turned out to be Hannity.

Graham said Republicans have for years been tripped up by their inability to offer a credible alternative to the Affordable Care Act. He said he thinks that alternative now exists with his bill and that it can prevail against tough odds with the help of Trump.

But one leading Republican, Sen. Charles Grassley of Iowa, expressed pessimism about the Republicans’ efforts to round up the votes.

In an interview Wednesday with reporters from him home state, Grassley said: “I think we’re one or two votes short, and I don’t see those other votes coming. And I hope I’m wrong.”

“Republicans campaigned on this so often that we have a responsibility to carry out what you said in the campaign. And that’s pretty much as much of a reason as the substance of the bill” to support it, Grassley said.

One of the key points of contention in the bill is whether it protects people with existing health problems.

Under the legislation, states would have wide latitude in creating their own health systems and requirements and would be able to seek waivers from certain mandates, including those related to coverage for people with existing conditions.

The bill does say that coverage must remain “adequate and affordable” for those with existing conditions. But because those terms are not defined, critics fear that insurers could raise prices beyond many people’s ability to pay.

Cassidy on Wednesday defended the bill against criticism from late-night TV host Jimmy Kimmel, who jumped into the debate after his son was born with a congenital heart defect in April.

“I am sorry he does not understand,” Cassidy said of Kimmel on CNN, arguing that his bill would protect people with existing conditions, a claim that leading health advocacy groups dispute. “I think the price will actually be lower.”

On his ABC television show Tuesday night, Kimmel said “this guy Bill Cassidy just lied right to my face,” referring to Cassidy’s promises to Kimmel and others that his health bill would pass the “Jimmy Kimmel test.”