Health care vote on hold
Opposition among GOP senators forces delay in overhaul of key Obama law
WASHINGTON — Plagued by deep internal divisions within their party and terrible reviews of their plan to repeal Obamacare, Senate Republicans retreated from a vote this week on their proposed health plan, dealing a setback to President Trump and the GOP effort to deliver on a bedrock campaign promise.
Senate Majority Leader Mitch McConnell, R-Ky., postponed action on the bill Tuesday until after the July 4 recess, during which he vowed to work “to get at least 50 people in a comfortable place” to vote for passage.
But that prospect dimmed almost as soon as McConnell
uttered the words. Moderate Republicans, such as Rob Portman of Ohio, Shelly Moore Capito of West Virginia and Terry Moran of Kansas came out in opposition, saying the plan’s proposal to cut deeply into Medicaid would devastate sick people in their states. Susan Collins, R-Maine, had already said she could not vote for the bill.
Another moderate Republican, Sen. Lisa Murkowski of Alaska, welcomed the possibility that the legislation, opposed by the Senate’s 46 Democrats, could eventually be abandoned to open the way for a bipartisan effort to fix the Affordable Care Act, President Barack Obama’s signature 2010 health legislation.
“Absolutely,” she said. “Shouldn’t we all be working together? This is not for Republicans to fix or Democrats to fix, this is for us as Americans to fix.”
McConnell had been pushing for a vote by Friday, but his effort was dealt a significant blow with the release of an analysis of the bill by the nonpartisan Congressional Budget Office. Holding a slim, 52-vote majority, the majority leader can afford to lose just two votes, using Vice President Mike Pence to break a tie.
But the CBO analysis concluded that 22 million more Americans would be without insurance by 2026. Additionally, the analysis said, premiums and deductibles would soar but cover far less. The only obvious beneficiaries, according to the CBO analysis, would be very wealthy individuals and insurance and drug companies, whose taxes had been raised under the Affordable Care Act to pay for an expansion of coverage to the less well off.
Moderate Senate Republicans began to fall away. At the other end of the spectrum, four Republican conservatives — Rand Paul of Kentucky, Mike Lee of Utah, Ted Cruz of Texas and Ron Johnson of Wisconsin — said they could not vote for the bill because it did not go far enough to repeal the current health law.
In delaying the vote, McConnell said he wants to provide more time to make changes to the bill to try to persuade reluctant Republicans to vote for the measure.
“I believe we can get to yes, and we will get to yes,” Cruz said. “We will be vindicating the promise that we made to the voters.”
Late Tuesday, Trump invited Senate Republicans to a meeting in the White House to try to hammer out differences.
“The Senate bill is going to be great,” Trump said, adding that Republicans “are getting very close” to reaching a consensus.
Afterward, McConnell said that failure “is not an option,” and all but ruled out working with Democrats, who, he said, support “none of the reforms we want” to Medicaid and insurance.
Meanwhile, a coalition of patient advocates, doctors and senior citizens’ groups have joined Democrats in pushing for the bill’s defeat.
In a rare joint telephone news conference Tuesday, California’s top Democrats, Gov. Jerry Brown and Sens. Dianne Feinstein and Kamala Harris, urged Republicans to drop their partisan undertaking, warning that the Senate bill would harm Californians of all stripes and devastate the state’s hospitals, among other things.
“It’s the most indefensible bill I’ve actually seen in 24 years in the Senate,” Feinstein said.
“Blue Cross says that this means deductibles of $7,350,” she said. “Now what does that mean? That’s essentially a junk plan that no one who’s low- or middle-income would even buy.”
Brown called it “toxic,” and a “divisive, hateful piece of legislation.”
No state embraced the Affordable Care Act with more gusto than California, and no state would be hit harder by the Senate bill, Harris said.
She called the legislation “nothing short of a disaster.” Between 3 million and 4 million Californians would lose insurance coverage, the California lawmakers said, and the state’s three biggest children’s hospitals might be forced to close because nearly all the children they treat are on Medicaid.
Feinstein said Republicans could be forced to abandon their effort if the Senate bill loses 10 or 12 Republicans and urged constituents to “flood the phones” of wavering GOP senators. “Then we can talk what our priorities are to bring people together and not split them apart,” Feinstein said.
Harris and Feinstein have proposed legislation that would address the major complaints about the current law by plumping up subsidies for middle-class people who now are just above the cut-off point for government help with insurance premiums. “We do recognize what needs to be fixed, repaired and improved,” Harris said.
Democrats held multiple Capitol Hill news conferences led by patient groups who called the legislation a life-ordeath issue. At the same time, conservative groups such as the Club for Growth derided the Senate legislation as “Obamacare-lite.”
Such criticisms are only likely to grow over the long holiday. McConnell, who had crafted the legislation in secrecy, only unveiling it publicly last week, had hoped to avoid such political exposure and move directly into negotiations with House Republicans to meld its similar legislation into a final product that they could pass and send to Trump for his signature before Congress leaves on a monthlong recess in August.
As it stands, Trump and the GOP-led Congress have no landmark legislation to show after six months of unified control of Washington, and show no sign of the unity they will need to pass the tax overhaul that is next on their agenda.
But the health care legislation is hardly dead. House Speaker Paul Ryan, R-Wis., similarly withdrew that chamber’s health bill from the floor last spring, but revived it after negotiations with conservatives and passed it last month.