USA TODAY US Edition

GOP health bill in trouble after delay

Doubting the bill will pass, some senators are working on another plan

- Eliza Collins and Bartholome­w D. Sullivan USA TODAY

After Senate MaWASHINGT­ON jority Leader Mitch McConnell announced Saturday that he is delaying his plan to consider a bill to replace Obamacare this week, the controvers­ial Republican health care overhaul faces a perilous path forward.

“There are about eight to 10 Republican senators who have serious concerns about this bill,” Sen. Susan Collins, R-Maine, said on CNN’s State of the Union. “So at the end of the day, I don’t know whether it will pass.”

Sen. John McCain, R-Ariz., will be absent from the Senate this week as he recovers from surgery to remove a blood clot, leading McConnell to announce Saturday night that the Senate would defer considerat­ion of the Better Care Act until McCain returns.

But McConnell must now continue building support for the bill.

Republican­s already lost two members on the revised bill — the moderate Collins and Kentucky conservati­ve Sen. Rand Paul, who said they would vote against a procedural motion to bring the bill to the floor — and can’t afford to lose a third. Without McCain’s vote in favor, the bill does not have enough support to pass.

Even if the Senate waits for McCain to return and vote to debate the bill, there are more than a half-dozen lawmakers who could be the critical third “no” vote. And opponents of the bill kept up their drumbeat of criticism on Sunday.

“We should not be making fundamenta­l changes in a vital safety net program ... without having a single hearing to evaluate what the consequenc­es are going to be,” Collins said.

The bill, Collins said, “would impose fundamenta­l, sweeping changes in the Medicaid program and those include deep cuts. That would affect some of the most vulnerable in our society.”

Paul also continued to express his concerns about the bill. “I think the longer the bill’s out there, the more conservati­ve Republican­s are going to discover that it’s not repeal. And the more that everybody’s going to discover that it keeps the fundamenta­l flaw of Obamacare,” he said on CBS’s Face the Nation.

“It keeps the insurance mandates that cause the prices to rise, which chase young, healthy people out of the marketplac­e, and leads to what people call adverse selection, where you have a sicker and sicker insurance pool and the premiums keep rising through the roof,” he said. “For all Republican­s’ complaints about the death spiral of Obamacare, they don’t fix it. They simply subsidize it with taxpayer monies, which I just don’t agree with at all.”

The bill already has drawn opposition from insurance industry trade groups, patients’ advocates, doctors, hospitals and some religious groups. Collins told both ABC’s This Week and CNN’s State of the Union that the bill’s proposed cuts to Medicaid would hurt rural hospitals and nursing homes that are also major employers.

Also on CNN, Health and Human Services Secretary Tom Price said that governors are telling him they need the bill to provide flexibilit­y and justified efforts to lure Alaska’s senators with state-specific provisions unique to their state. He cited Alaska’s landscape — more than 600 municipali­ties that can’t be reached by road — as justifying special accommodat­ions for Alaska.

Yet on NBC’s Meet the Press, Sen. John Cornyn, R-Texas, said the bill contains “no state-specific relief.”

“But what there is,” he said, “is an an attempt to try to accommodat­e the concerns of those states that expanded Medicaid under Obamacare and those that did not — and that’s the hard task ahead of us.”

Still, Cornyn, the Senate Republican whip, expressed optimism that the bill would move forward. A procedural vote to bring the bill to the floor, he said, will occur “as soon as we have a full contingent of senators.”

One key vote lies with Sen. Dean Heller, R-Nev., the most vulnerable GOP senator up for re-election in 2018, in a state Hillary Clinton won during the presidenti­al election. Heller came out against the original version of the bill in a blistering news conference last month, which was something of a tipping point that ultimately led McConnell to abandon a planned vote before the July Fourth recess. One of Heller’s concerns was scaling back funding for the Medicaid expansion. That roll back provision stays the same in the new version.

On Thursday, Heller said he was undecided on the new bill.

Other undecided lawmakers — such as Sens. John Hoeven, RN.D., Rob Portman, R- Ohio, and Shelley Moore Capito, R-W.Va. — said they were holding out final judgement until the nonpartisa­n Congressio­nal Budget Office released its analysis of the new bill, which is expected early this week.

The CBO review of the previous version found that, by 2026, 22 million people would be without health coverage, but the bill would reduce the federal deficit by $321 billion over that same period. The White House has attacked CBO’s credibilit­y, saying its earlier estimates were inaccurate. And it is not clear whether the CBO score will include the Cruz-Lee Amendment.

A conservati­ve amendment by Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, would legalize the sale of deregulate­d insurance plans as long as insurance companies also offered plans that include the coverage mandated under Obamacare. Fans of the amendment say the deregulate­d plans will cost less and give people more options. Critics say older, sicker people will foot higher premiums.

The bill’s chances of passing are so narrow that some Republican­s are working on the side to secure an alternativ­e in case the Senate GOP plan fails — and they’re hoping it’ll be bipartisan.

“For all Republican­s’ complaints about the death spiral of Obamacare, they don’t fix it.” Sen. Rand Paul

 ?? MICHAEL REYNOLDS, EUROPEAN PRESSPHOTO AGENCY ??
MICHAEL REYNOLDS, EUROPEAN PRESSPHOTO AGENCY

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