GOP clears major hurdle to reshape health care but runs into taller one,
GOP senators aim to do bill independent of House version
WASHINGTON — House Republicans journeyed to the White House on Thursday for a health care victory lap in the Rose Garden, but Senate Republicans were in no mood for celebration.
Instead, they sent an unmistakable message: When it comes to health care, they’re going to do their own thing.
“I think there will be essentially a Senate bill,” explained Sen. Roy Blunt, R-Mo., the fourth-ranking Senate Republican.
Now that the House has narrowly passed legislation overhauling the nation’s health care system, it is headed to the Senate.
Republican senators are signaling that their strategy will be rooted in effectively crafting their own replacement for the Affordable Care Act. It remains to be seen how closely that measure will resemble the one that narrowly passed the House on Thursday.
A small group of GOP senators met Thursday morning in the office of Senate Majority Leader Mitch McConnell, R-Ky., to begin outlining their health care priorities, said Sen. John Cornyn, RTexas. But Cornyn would not commit to a timeline for a Senate vote, saying: “When we get 51 senators, we’ll vote.”
Republicans hold a 52 to 48 advantage over Democrats in the upper chamber, leaving GOP leaders with a narrower margin for error than in the House, where infighting among Republican lawmakers nearly derailed the push on multiple occasions.
In a sign of the frustration that some Republican senators already have with the House bill, Sen. Lindsey Graham, R-S.C., posted a skeptical note on Twitter Thursday: “A bill -- finalized yesterday, has not been scored, amendments not allowed, and 3 hours final debate -- should be viewed with caution.”
Senate Republicans have opted to use a maneuver known as reconciliation to try to pass the bill with a simple majority, instead of having to clear the 60-vote threshold that is required for most legislation. In the current balance of power, that would require Democratic votes. But even getting to a simple majority will be no small task.
GOP senators from states that have expanded Medicaid under the Affordable Care Act, such as Sen. Rob Portman of Ohio and Shelley Moore Capito of West Virginia have voiced concerns about rollbacks to that program in the House bill.
“Absolutely,” replied Capito, when asked if she still has worries.
Meanwhile, a trio of conservative senators — Ted Cruz, R-Texas, Mike Lee, R-Utah, and Rand Paul, R-Ky. — earlier this year pushed for a more aggressive repeal of the health-care law than many of their colleagues favored.
“I think that the House Freedom Caucus was able to make the bill a lot less bad,” Paul said. “I think there’s still some fundamental problems that I have with it.”
Sens. Bill Cassidy, R-La., and Susan Collins, RMaine, have already introduced an alternative plan, giving lawmakers a second measure to look at should talks fall apart over the current bill.
Then there are the procedural hoops that Senate Republicans will need to clear, which could steer them to strip away some of the House bill’s signature provisions.
The measure’s original version, introduced in March by Speaker Paul Ryan, R-Wis., already contained elements at risk of being struck out in the Senate under budget reconciliation rules that allow tax and spending changes but not broader policy changes.
That proposal initially left many of the ACA’s insurance regulations alone — with the goal of ensuring it would pass muster with the Senate parliamentarian, a nonpartisan officer who decides on what may go in a reconciliation bill — but not all of them.
The version of the bill the House passed undercuts the ACA’s insurance regulations even more, by giving states a path to opt out of federal requirements for insurers to cover certain “essential” health benefits — and to allow them to charge sick people the same premiums as healthy people.
Members of the House voted on their bill before they received a score from the nonpartisan Congressional Budget Office, which measures how much the legislation would cost and how many people stand to lose coverage.
Senate budget rules require a CBO score that proves the legislation will not increase the deficit after 10 years.
The Senate parliamentarian can’t even start reviewing the AHCA without a score from the CBO, which is expected to take weeks.
“I sincerely hope the Senate won’t mimic the House and try to rush it through without hearings or debate or analysis,” said Senate Minority Leader Chuck Schumer, D-N.Y.