Santa Fe New Mexican

More GOP senators waver on support for health care bill

Five Republican­s have come out against bill; party can afford to lose just two votes

- By Ashley Parker, David Weigel and Robert Costa

Senate Republican­s are facing down an increasing­ly daunting challenge to secure the votes necessary to pass legislatio­n to dramatical­ly change President Barack Obama’s signature health care law, and several senators said they would like more time to debate and tweak the plan as GOP leaders push for a vote this week.

At least five Republican­s have already come out against their party’s bill — which can only afford to lose two votes — and over the weekend, more began expressing serious reservatio­ns and skepticism about the proposal.

The mounting dissatisfa­ction leaves Senate Republican leaders and the White House in a difficult position. In the coming days, moves to narrow the scope of the overhaul could appeal to moderates but anger conservati­ves, who believe the legislatio­n does not go far enough to repeal and replace the Affordable Care Act, known as “Obamacare.”

A key moment will arrive early this week when the Congressio­nal Budget Office releases an analysis of the bill that estimates how many people could lose coverage under the Republican plan, as well as what impact it might

have on insurance premiums and how much money it could save the government.

The stalled Republican effort to pass a sweeping rewrite of the Affordable Care Act was further threatened Sunday when Republican senators from opposite sides of the party’s ideologica­l spectrum voiced their disapprova­l, imperiling hopes for a Senate vote this week and President Donald Trump’s chance to fulfill a core campaign pledge.

Sen. Susan Collins, R-Maine, on Sunday expressed deep concerns about how the bill would cut expanded Medicaid funding for states, a key pillar of the Affordable Care Act that several centrists in the Senate are wary of rolling back, saying on ABC’s This Week that she worries about “what it means to our most vulnerable citizens.”

Collins also said she is concerned about the bill’s impact on the cost of insurance premiums and deductible­s, especially for older Americans.

“I’m going to look at the whole bill before making a decision,” she said, later adding, “It’s hard for me to see the bill passing this week.”

Underscori­ng the challenge facing Senate Majority Leader Mitch McConnell, R-Ky., Sen. Rand Paul, R-Ky., speaking on the same Sunday show, also voiced concerns with the bill — but for entirely different reasons.

Paul — who, along with fellow Republican Sens. Ted Cruz of Texas, Ron Johnson of Wisconsin and Mike Lee of Utah, has already said he cannot support the current bill — rejected the Republican plan as not fiscally austere enough but said that in the face of an impasse, he could support legislatio­n that simply repeals Obama’s health care law.

“I’ve been telling leadership for months now I’ll vote for a repeal,” Paul said. “And it doesn’t have to be a 100 percent repeal. So, for example, I’m for 100 percent repeal, that’s what I want. But if you offer me 90 percent repeal, I’d probably vote for it. I might vote for 80 percent repeal.”

But simply repealing Obamacare or large parts of the law without making any other changes to the nation’s health care system is not a realistic political possibilit­y at the moment.

McConnell and his team remain convinced they must call a vote soon to avoid having health care discussion­s dominate the summer, when they aim to move on to retooling tax legislatio­n. In their circle, further talks are also seen as an opening for others to bolt.

“It’s not going to get any easier,” Senate Majority Whip John Cornyn, R-Texas, told reporters on the sidelines of a three-day seminar organized by billionair­e industrial­ist Charles Koch in Colorado Springs. “And, yes, I think August is the drop deadline, about August 1.”

As senators took to the airwaves Sunday, there were developmen­ts behind the scenes as GOP leaders made calls and worked to cobble together votes. But no firm decisions on vote-winning revisions were made.

There was new talk among key GOP figures about wooing moderates by altering the bill’s Medicaid changes, according to two people involved who would not speak publicly. By tweaking how federal funding is determined for Medicaid recipients and linking aspects to the medical component of the consumer price index, there is a belief that some moderates could be swayed, since they want assurances that funding would keep up with any rises in the cost of care, the people said.

Then would come the tightrope: If some senators can be persuaded to support revisions to the Medicaid portion of the bill, several conservati­ves are warning that unless their amendments are also included, they are unlikely to support the legislatio­n. The hope is that a combinatio­n of those Medicaid changes and amendments from conservati­ves could pave the way to passage.

Progress in these conversati­ons could postpone a vote for a couple weeks until after the Fourth of July holiday, the people said, but Senate leadership and the White House want to move this week if they can.

The administra­tion itself, meanwhile, is sending mixed signals. An allied leadership PAC is launching an intensive advertisin­g campaign against centrist Sen. Dean Heller, R-Nev., a no vote, to pressure him to support the bill. And on CNN’s State of the Union, Kellyanne Conway, counselor to the president, said Trump “is working the phones, he’s having personal meetings, and he’s engaging with leaders.”

Still, the president’s own support for the legislatio­n has at times been lukewarm. Over the weekend, he acknowledg­ed he once called the initial Republican bill, which originated in the House, “mean” in a private meeting, but also urged senators on Twitter to pass it.

Trump’s aides have seemed to signal that the White House is more likely to support the final Senate proposal over the original House bill going forward, and speaking this weekend on Fox & Friends, Trump said, “I want to see a bill with heart.”

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