Senate takes up narrow repeal bill

House speaker tries to ease senators’ concerns over what happens next.

WASHINGTON — Buoyed by a signal from House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell introduced a pared-down health care bill late Thursday that he hoped would keep alive Republican ambitions to repeal so-called “Obamacare.” McConnell is calling his bill the Health Care Freedom Act, but among his colleagues it’s

known as “skinny repeal.” It’s not intended to become law, but to open a path for a House-Senate conference committee to try to work out comprehensive legislation Congress can pass and send to President Donald Trump.

The bill would repeal the unpopular Affordable Care Act provision that requires most peo

ple to have health insurance or risk a fine from the IRS. A similar requirement on larger employers would be suspended for eight years.

Additionally itwould deny funding to Planned Parenthood, and

suspend for three years a tax on medical device manufacturers. It would allow states to seek waivers from consumer protections in the Obama-era law, and increase the amount that individuals could contribute to tax-sheltered health savings accounts for medical expenses.

Ryan opened a path for McConnell earlier Thursday evening by signaling a willingness to negoti-

ate a more comprehensive bill with the Senate. Some Republican senators had been concerned that the House would simply pass the “skinny bill” and send it to Trump. That would have sent a shock wave through health insurance markets, spiking premiums.

Ryan sent senators a statement saying that if “moving forward” requires talks with the Senate, the House would be “willing” to do so. His words received varied responses from three GOP senators who’d insisted on

a clear commitment from Ryan.

“Not sufficient,” said Sen. John McCain of Arizona, who returned to the Capitol Tuesday to provide a pivotal vote that allowed the Senate to begin debating the health care bill, a paramount priority for Trump and the GOP. The 80-year-old McCain had been home in Arizona trying to decide on treatment options for brain cancer.

But Sen. Lindsey Graham of South Carolina, who initially said “not yet” when asked if he was ready to vote for the scaled-back Senate bill, later told reporters that Ryan had assured him and others in a phone conversation

that the House would hold talks with the Senate.

“I feel comfortable personally. I know Paul; he’s a man of his word,” said Graham.

“Let’s see how everything turns out here, guys,” Sen. Ron Johnson of Wisconsin told reporters.

It appeared McConnell might have just enough votes in his slender 52-member majority to pass the bill.

It would be the third attempt in the past two weeks. A comprehensive bill failed on the Senate floor, and a straight-up repeal failed too, so McConnell and his top lieutenants turned toward the “skinny” bill, a lowest-common-denominator

solution, with the goal of getting something, anything, out of the Senate.

That would be the ticket to negotiations with the House, which passed its own legislation in May.

But that plan caused consternation among GOP senators after rumors began to surface that the House might just pass the “skinny bill,” call it a day and move on to other issues like tax reform after frittering away the first six months of Trump’s presidency on unsuccessful efforts over health care.

Even if Ryan’s reassurance proves enough to move the bill forward, there were other potential barriers.

The Senate parliamentarian advised that the waiver language violates chamber rules, meaning Democrats could block it. And plans to eliminate the Obama law’s tax on medical devices nught have to be abandoned because Republicans need that money for their package.

Businesses also remained wary of the bill. An insurance company lobby group, America’s Health Insurance Plans, wrote to Senate leaders Thursday saying that ending Obama’s requirement that people buy insurance without strengthening insurance markets would produce “higher premiums, fewer choices for consumers

and fewer people covered next year.”

And a bipartisan group of governors including John Kasich of Ohio and Brian Sandoval of Nevada also announced their opposition.

On their own, the changes in the skinny bill could roil insurance markets. Yet the scenario at hand, with senators trying to pass something while hoping it does not clear the House or become law, was highly unusual.

“We’re in the twilight zone of legislating,” said Democratic Sen. Claire McCaskill of Missouri.

AP Sen. John McCain, R-Ariz., said he would oppose the latest Republican plan without assurances from the House that it would become the basis for negotiations between the two chambers on a better measure.

ASSOCIATED PRESS Rep. Mark Meadows, R-N.C., chairman of the conservative House Freedom Caucus, said he thinks there is little support in the House for the “skinny repeal” plan the Senate is considering now.

AP Sen. Susan Collins, R-Maine, voted against the first two health care plans the Senate considered this week, a repeal-only proposal and one that would have repealed the current law and replaced it with a GOP alternative.