USA TODAY International Edition
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
WASHINGTON 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.
On Monday, the Congressional Budget Office projected the GOP bill would increase the number of uninsured Americans by 22 million over the next decade, compared with current law. The budget office, a nonpartisan agency, also said the bill would reduce the deficit by $ 321 billion over 10 years.
That analysis came after five Republican senators had already announced their opposition to the measure, leaving Majority Leader Mitch McConnell, R- Ky., 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 they would oppose opening debate on the bill unless McConnell slows down and gives them more time to assess its impact and offer possible changes.
Sen. Susan Collins, R- Maine, said the CBO analysis showed the GOP bill would not fix the flaws in the Affordable Care Act ( ACA). “I will vote no” on the motion to proceed, she tweeted.
“We need more information,” Sen. Rob Portman, R- Ohio, said on CNBC’s Squawk Box Monday morning. “Rather than rushing it, we need to get it right.”
GOP leaders signaled they would press 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 individuals 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 Monday he wanted more time to digest the bill and its potential impact; like Collins, he signaled he could resist even a procedural motion to get the bill on the floor.
“I have a hard time believing I’ll have enough information for me to support a motion to proceed this week,” Johnson told reporters.
Paul also said he would likely oppose the motion to proceed and suggested GOP leaders have ignored his entreaties for changes to the bill that could win him over.
“I’ve said I’m willing to negotiate,” Paul said. “We’ve reached out to them, we’ve got nothing back.”
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 reduc- ing 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.
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.
“I cannot support a piece of legislation that takes away insurance from tens of millions of Americans.” Sen. Dean Heller, R- Nev.