The Signal

GOP FACES GROWING OPPOSITION TO HEALTH CARE BILL

Senators plan to push ahead with vote this week despite being short of support needed to repeal ACA

- Deirdre Shesgreen, Nicole Gaudiano and Eliza Collins USA TODAY

Senate GOP leaders faced an increasing­ly divided and uneasy caucus Monday as they tried to forge ahead with a vote this week on legislatio­n that would repeal and replace the Affordable Care Act.

After five Republican senators announced their opposition to the measure, Majority Leader Mitch McConnell, RKy., began the week short of the 51 votes he needs to get the measure through the Senate. Several other GOP senators are lukewarm about the bill and suggested McConnell is not giving them enough time to assess its impact.

“We need more informatio­n,” Sen. Rob Portman, ROhio, said on CNBC’s Squawk

Box Monday morning. “Rather than rushing it, we need to get it right.”

Monday afternoon, the Congressio­nal Budget Office projected the GOP bill would increase the number of uninsured Americans by 22 million over the next decade, compared with the current law. The budget office, a non-partisan agency, said the bill would reduce the deficit by $321 billion over 10 years.

GOP leaders signaled they would press full-steam ahead — working behind closed doors in the coming days to see whether they can appease the conflictin­g concerns voiced by moderates and conservati­ves.

Senate Majority Whip John Cornyn, R-Texas, had suggested a vote could roll until the end of July, but he said Monday he was “closing the door” on that notion.

“We need to do it this week before double-digit premium increases are announced for next year,” he tweeted.

Republican­s made a few changes to their bill Monday afternoon. The most substantiv­e addition was aimed at individ-

uals who let their insurance lapse for more than two months. Under the Senate GOP plan, they would have to wait for six months before they could restart coverage, an alternativ­e to the unpopular Obamacare requiremen­t that most individual­s buy insurance or face a tax penalty.

The new GOP provision is designed to encourage people to keep continuous health care — not just buy it when they get sick. Forcing sick individual­s to wait six months before they could get health insurance could be an extremely controvers­ial provision.

“Six months may mean the difference between life and death for a person with cancer awaiting treatment,” Timothy Jost, a health policy expert, wrote in a Health Affairs blog post Monday.

Democrats are unified in their opposition to the bill, so McConnell can afford to lose only two Republican votes and still see the measure pass if Vice President Pence broke a tie.

Four conservati­ves have announced their opposition to the bill, saying it does not go far enough in repealing Obamacare’s regulation­s and consumer protection­s. Those lawmakers are Sens. Ted Cruz, R-Texas, Rand Paul, R-Ky., Ron Johnson, R-Wis., and Mike Lee, R-Utah.

Johnson said over the weekend that he wants a delay in the debate and vote. “There’s no way we should be voting on this next week,” he said Sunday on NBC’s

Meet the Press. “No way.” Lee pushes for what he calls an “opt-out” provision, which would allow insurance companies to avoid many of the popular consumer protection­s included in Obamacare. Lee wants to have that opt-out provision in the bill’s text and not added during the amendment process — when it might not have enough support to pass.

On the moderate side, Sen. Dean Heller, R-Nev., came out against the bill, arguing the Medicaid cuts would hurt low-income residents in his state.

The Republican plan would end the Affordable Care Act’s Medicaid expansion by slowly reducing the enhanced federal funding that covers new enrollees over three years, starting in 2021 and ending in 2024. The ACA expansion allowed states to add more low-income childless adults to Medicaid, and the federal government paid most of the tab.

The GOP bill would cap the federal contributi­on to states for the entire Medicaid program — giving states a fixed, per-person allotment. That cap would increase over time but at a lower rate than medical inflation, meaning the federal dollars would not keep up with health care costs. States would then be faced with cutting the program or covering a huge budget gap to keep the program whole.

“I cannot support a piece of legislatio­n that takes away insurance from tens of millions of Americans and hundreds of thousands of Nevadans,” Heller said in a news conference Friday.

Sen. Susan Collins, R-Maine, told ABC This Week on Sunday that “it’s certainly going to be very difficult” for Republican­s to come together and support the bill. Collins said she wouldn’t make a decision on the proposal until she was able to review the CBO analysis.

Democrats and liberal outside groups mobilized an all-out assault on the bill, hoping to derail it. MoveOn.org and allied organizati­ons plan a “people’s filibuster” outside the Capitol this week. An interfaith health care coalition plans to lead a 24-hour vigil starting Wednesday afternoon.

“It will be a continuous rolling protest outside the Capitol,” said Ben Wikler, MoveOn.org’s Washington director.

If the bill does come to a vote, liberals want Democrats to offer thousands of amendments to slow the process down. Democrats are trying to block a procedural motion that would officially bring the bill to the floor.

Senate Minority Leader Charles Schumer, D -N.Y., said Sunday on ABC’s This Week that he is willing to work with Republican­s to improve Obamacare if they stop trying to repeal it.

“I cannot support a piece of legislatio­n that takes away insurance from tens of millions of Americans.”

Sen. Dean Heller, R-Nev.

 ?? CHIP SOMODEVILL­A, GETTY IMAGES ?? Senate Majority Whip John Cornyn is “closing the door” on the idea of a vote next month.
CHIP SOMODEVILL­A, GETTY IMAGES Senate Majority Whip John Cornyn is “closing the door” on the idea of a vote next month.
 ?? ERIK VERDUZCO, AP ??
ERIK VERDUZCO, AP

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