Senate panel on health care is all male

WASHINGTON — The 13 Republican senators who are writing a new bill to repeal and replace much of the Affordable Care Act include the top leadership, three committee chairmen and two of the most conservative members of the Senate.

What the group does not include is a woman — and the moderate Republicans who could determine the bill’s fate.

The decision by Sen. Mitch McConnell of Kentucky, the majority leader, to include himself and his top three lieutenants, as well as Sens. Ted Cruz of Texas and Mike Lee of Utah — but not Sens. Susan Collins of Maine or Lisa Murkowski of Alaska, not to mention the more junior Sens. Deb Fischer of Nebraska or Shelley Moore Capito of West Virginia — has raised eyebrows.

‘‘It matters to have women at the table — and it matters when they aren’t,’’ Democratic Sen. Patty Murray of Washington tweeted.

The omission of Collins has especially surprised health-policy analysts. For several years starting in the late 1980s, Collins was the top insurance regulator in Maine. Early this year she introduced a bill with Sen. Bill Cassidy, R-La., that would give states much more power to reconfigure their health-care systems while also preserving consumer protections in the Affordable Care Act. (Cassidy was also left off the working group.) But conservatives panned their proposal.

Republicans, holding 52 seats in the Senate, can afford to lose only two members of their party on a vote to undo the health-care law. They will not receive any support from Democratic senators or the Senate’s two independents.

Sen. Lamar Alexander of Tennessee, a member of McConnell’s working group, suggested the Senate is largely ignoring the House bill and basically starting afresh.

Collins agreed. ‘‘The Senate is starting from scratch,’’ she said Sunday.

The other senators on the working group include Rob Portman of Ohio.