The Atlanta Journal-Constitution

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» Republican­s struggle for consensus on health care,

- By Erica Werner and Alan Fram

WASHINGTON — Republican divisions over health care multiplied Monday as President Donald Trump pressured GOP senators to act quickly, and Vice President Mike Pence suggested they might have to revert to a straightfo­rward “Obamacare” repeal if they can’t agree on an alternativ­e.

Consensus on a replacemen­t seemed more remote than ever as senators returned to the Capitol from a Fourth of July recess. Some lawmakers spent the break facing critics of Senate Majority Leader Mitch McConnell’s bill, or voicing criticism of their own. But Sen. John Cornyn of Texas, the No. 2 Republican, told reporters that a revised bill would be unveiled this week, and “the goal continues to be to” vote next week.

McConnell abruptly postponed a vote last month, lacking GOP support for legislatio­n he wrote largely in secret.

To succeed, the new legislatio­n will have to address the concerns of conservati­ves like Mike Lee of Utah and Ted Cruz of Texas, who want a more full-blown repeal, and moderates like Susan Collins of Maine and Lisa Murkowski of Alaska, who want essentiall­y the opposite, a more generous bill.

McConnell has little room for error as he tries to pass a bill with 50 GOP votes, and Pence as the tie-breaker, in a Senate split 52-48 between Republican­s and Democrats. Some GOP senators are questionin­g McConnell’s partisan approach, and the majority leader himself acknowledg­ed to a home-state audience in Kentucky last week that if he can’t get the job done with Republican­s alone, he’ll have to turn to Democrats to shore up the market for individual insurance buyers.

Collins, referring to President Barack Obama’s Affordable Care Act, passed in 2010 without a single Republican vote, told reporters: “I believe that we should not repeat the mistake that President Obama made in passing major legislatio­n with no support from the other party.”

The Republican Party has been campaignin­g against Obama’s law ever since, but having ridden the issue to control of the House, Senate and the White House, they’re finding it nearly impossible to coalesce around an alternativ­e.

Underscori­ng the divisions within the GOP, and an occasional communicat­ions vacuum between the White House and the Senate, Pence appeared on conservati­ve host Rush Limbaugh’s radio show to rule out working with Democrats.

“The president’s made it very clear. We believe if they can’t pass this carefully crafted repeal and replace bill, do those two things simultaneo­usly, we ought to just repeal only,” and then turn to replacemen­t legislatio­n later on, Pence said, although Trump has at times dangled the prospect of working with Democrats.

Few Republican­s on Capitol Hill believe a repeal bill could pass Congress without a replacemen­t.

The vice president made his comments after Trump himself began his day with a tweet aimed at McConnell and his Republican­s: “I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!”

Congress is beginning a three-week sprint toward its traditiona­l five-week August recess, which some lawmakers have suggested should be shortened or even canceled if they can’t get health care done first, though that’s unlikely to happen.

The House managed to pass health care legislatio­n in May after plentiful struggles of its own to reach agreement. Both the House and Senate bills eliminate Obamacare’s mandates for people to buy insurance and individual­s to provide it, gradually undo an expansion of Medicaid and reduce the size of the federal-state health care program for the poor and disabled. The measures would cut taxes for the wealthy.

Both bills would result in more than 20 million people kicked off insurance rolls over the next decade, numbers that have spooked lawmakers eyeing re-election.

Around 80 demonstrat­ors opposed to the legislatio­n were arrested around the Capitol complex Monday, U.S. Capitol Police said.

As McConnell reworks his bill, Cruz, R-Texas, has proposed letting insurers sell any policies they’d like, as long as they also sell one that covers a list of services like mater- nity care that Obama’s law requires. The Cruz amendment was alienating senators like Collins amid concerns it would lead to unaffordab­le prices for people with pre-existing medical conditions because younger, healthier customers wouldn’t be sharing their costs.

But Pence endorsed Cruz’s plan on Limbaugh’s show, saying: “Rush, that’s what freedom looks like, isn’t it?”

Also Monday a study found that the number of uninsured adults has grown by 2 million this year, underscori­ng that recent coverage gains have begun to erode.

The Gallup-Sharecare Well-Being Index found that the uninsured rate among adults was 11.7 percent in the second three months of this year, compared with a record

of 10.9 percent at the end of last year. The reduction could reflect rising premiums and dwindling choices in the insurance markets created under Obama and could also flow from Trump administra­tion actions and comments about withholdin­g support for the law.

 ?? J. SCOTT APPLEWHITE / ASSOCIATED PRESS ?? A demonstrat­or is taken into custody by U.S. Capitol Police as activists protest against the Republican health care bill outside the offices of Sen. Jeff Flake, R-Ariz., and Sen. Ted Cruz, R-Texas, Monday in Washington.
J. SCOTT APPLEWHITE / ASSOCIATED PRESS A demonstrat­or is taken into custody by U.S. Capitol Police as activists protest against the Republican health care bill outside the offices of Sen. Jeff Flake, R-Ariz., and Sen. Ted Cruz, R-Texas, Monday in Washington.

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