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Analysis: GOP Senate Health Care Effort at Standstill

McConnell’s plan to resurrect 2015 Obamacare repeal bill expected to fail

Senate Majority Leader Mitch McConnell plans to resurrect a health care bill that President Barrack Obama vetoed in 2015. (Bill Clark/CQ Roll Call file photo)
Senate Majority Leader Mitch McConnell plans to resurrect a health care bill that President Barrack Obama vetoed in 2015. (Bill Clark/CQ Roll Call file photo)

Senate Majority Leader Mitch McConnell lacks the Republican support needed to advance a bill to overhaul the U.S. health insurance system and will instead try hold a vote on a separate measure to repeal the 2010 health care law that Congress passed in 2015 and former President Barack Obama vetoed.

“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful,” McConnell said in a statement late Monday. “In the coming days, the Senate will vote to take up the House bill with the first amendment in order being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Obama: a repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.”

But a return to the bill Obama vetoed, which would end the law’s Medicaid expansion and repeal other portions beginning in two years, is almost certain to fail. The current GOP proposal is considered to be more generous.  

McConnell will still need to clear a procedural hurdle in order to get to a vote on a repeal-only bill. But there appears to be enough GOP opposition to block that motion to proceed.

Should that happen, the Kentucky Republican is expected to then begin work on a bipartisan bill to stabilize the markets, a move he previously said would be necessary should the current GOP effort falter.

“This second failure of Trumpcare is proof positive that the core of this bill is unworkable,” Senate Minority Leader Charles E. Schumer said in a statement Monday. “Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long term stability to the markets and improves our health care system.”

After already losing the support of four GOP senators on the Republican “repeal and replace” plan, McConnell faced the prospect of even more opposition within his party.

A Senate GOP aide said further defections had been likely, but added that it was unclear if that opposition would now be made public. Several Republican lawmakers, including Sens. Lisa Murkowski of Alaska, Rob Portman of Ohio, Dean Heller of Nevada and Shelley Moore Capito of West Virginia, had not yet publicized their positions.

It is also unclear whether the Senate is still scheduled to proceed with McConnell’s plan to delay the chamber’s August recess by two weeks. While there are a number of remaining items on the Senate’s agenda, including addressing the upcoming debt limit and funding the government beyond fiscal 2017, many of those initiatives are said to not yet be ready for consideration on the chamber floor.

A bipartisan approach?

Any attempt at stabilizing the insurance markets is bound to take time. There are serious policy differences between Republicans and Democrats, and top GOP lawmakers have said some sort of regulatory overhaul would be necessary.

“We’re willing to do what we can to shore up the system now, to stabilize it to make health care available to people now, but we want reforms to go along with it,” Senate Majority Whip John Cornyn of Texas said over the weekend. “I don’t think Democrats want to change anything about Obamacare, they just want to throw more money at it.”

Several GOP lawmakers, however, have already expressed their strong desire to begin work with Democrats on a joint effort.

“One of the major problems with Obamacare was that it was written on a strict party-line basis and driven through Congress without a single Republican vote,” Sen. John McCain of Arizona said in a statement Monday evening. “The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.”

A vote on the current Republican draft was delayed from this week as a result of McCain’s health issues.

‘That’s hypothetical’

The GOP’s repeal and replace proposal had included roughly $250 billion in government funding to help insurers. It remains to be seen whether Republicans would be open to including that same level of funding without the corresponding cuts to Medicaid or other policy changes.

When asked about it Monday evening, Sen. David Perdue said, “That’s hypothetical.”

“Right now, there are a lot of combinations of what could be and what might be,” the Georgia Republican told reporters.

A likely vehicle for any stabilization package is the upcoming reauthorization of the Children’s Health Insurance Program, lawmakers and GOP aides say. Work on the renewal of that program, which expires at the end of September, has largely been stalled amid uncertainty surrounding the GOP’s current health care effort. 

One key demand from Democrats will likely be the funding of the 2010 health care law’s so-called cost-sharing subsidies that help reduce out-of-pocket health care costs for low-income people. The GOP has so far resisted funding those payments. 

“With the news that Senate Republican leaders do not have the votes needed to bring their dangerous TrumpCare bill to the Floor to be debated, it is time for them to abandon their failed plan and work with Democrats to address the challenges facing our health care system,” House Democratic Whip Steny H. Hoyer of Maryland said in a statement.