After what has been an incredibly rocky rollout, Republican leaders have decided to delay a vote on their version of health care reform until after the July 4th recess in what was clearly a defeat for Majority Leader McConnell and the rest of the Republican leadership:
WASHINGTON — Facing intransigent Republican opposition, Senator Mitch McConnell of Kentucky, the Republican leader, announced on Tuesday that he will delay a vote on his legislation to repeal the Affordable Care Act, dealing President Trump an embarrassing setback on a key part of his agenda.
Republican leaders had hoped to take a page from the playbook used to get a bill over the line in the House, appeasing the most conservative members of their conference while pressuring moderates to fall in line with fewer concessions.
But as opposition mounted in both camps, even against a vote just to take up the bill, Mr. McConnell decided he would delay consideration until after the Senate’s weeklong July 4 recess.
“We will not be on the bill this week, but we will still be working to get at least 50 people in a comfortable place,” Mr. McConnell said.
That delay does not guarantee the senators will come together. Opposition groups will mount pressure campaigns on lawmakers in their home states, and policy divisions are deep.
Negotiations on Tuesday that leaders hoped would move senators toward yes only exposed the fissures in the Republican Party. Conservatives were demanding that states be allowed to waive the Affordable Care Act’s prohibition on insurance companies charging sick people more for coverage and are asking for a more expansive waiver system for state regulators. They also wanted more money for tax-free health savings accounts to help people pay for private insurance.
Senators from states that expanded the Medicaid program — and Senator Susan Collins, Republican of Maine — would not brook many of those changes, especially the measure to severely undermine protections for people with pre-existing medical conditions. They wanted more money for mental health benefits for people addicted to opioids and money for states to cover people left behind by the rollback of the Medicaid program in both the House and Senate versions.
Three Republican senators — Ms. Collins, Rand Paul of Kentucky and Ron Johnson of Wisconsin — had announced they would vote against the motion to begin debate that had been scheduled to hit the Senate floor on Wednesday, joining Senator Dean Heller of Nevada, who made the same pledge on Friday.
A bevy of other senators from both flanks of the party seemed headed in the same direction if they did not see changes made to the Senate health care bill, leaving the measure in deep peril, since Republicans can only lose two votes from their own party.
The Washington Post has more details:
Facing a rebellion within their own ranks, Senate Republican leaders on Tuesday postponed a vote to overhaul the 2010 Affordable Care Act until after the July 4 recess.
The delay, which came after five Senate Republicans said they could not support a move to bring up the bill this week in the wake of a new budget analysis of its impacts, means that lawmakers will be exposed to a barrage of lobbying in their home states in the coming days. The current proposal by Senate Majority Leader Mitch McConnell (R-Ky.), which would make deep cuts to the Medicaid program while rolling back many of the existing law’s insurance mandates and tax increases, has come under attack from both the left and right.
On Monday the prospects for a quick vote on the measure deteriorated after the Congressional Budget Office concluded that it would cause an estimated 22 million more Americans to be uninsured by the end of the coming decade while reducing federal spending by $321 billion.
Even as the new analysis deepened the unease of some moderate GOP senators, conservatives stepped up their attacks against the proposal as insufficiently ambitious. Club for Growth President David McIntosh, who has clashed with Republican Party leaders in the past, issued a statement Tuesday saying the proposal “restores Obamacare
“Only in Washington does repeal translate to restore,” McIntosh said. “And while it’s hard to imagine, in some ways the Senate’s legislation would make our nation’s failing health-care system worse.”
(…)
As late as Tuesday morning, [Speaker of the House Paul] Ryan had downplayed the chances that the bill could stall.
“I would not bet against Mitch McConnell,” Ryan said. “He is very, very good at getting things through the Senate even with this razor-thin majority.”
But the release of the 49-page CBO report late Monday afternoon provided a formidable hurdle for the bill. No new senators immediately said they would back the legislation, and Sens. Johnson, Paul, Susan Collins (R-Maine) and Mike Lee (Utah) signaled that they would vote against starting debate on the bill in its current form. A fifth senator, Dean Heller (R-Nev.), had expressed his opposition last week and has not shown subsequent signs of changing his mind.
Collins, a moderate Republican, tweeted that the measure would “hurt [the] most vulnerable Americans” and failed to solve the problems of access to care in rural Maine, where, she wrote, “hospitals are already struggling.”
Others signaled that while they would vote yes on the procedural motion, they remained undecided on the bill itself.
Senate leaders quickly began working with undecided senators to determine whether any skeptics could be won over with additional spending on priorities such as expanding incentives for health-savings accounts favored by conservatives or a fund to help battle opioid addiction favored by Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.). Leaders can spend about $188 billion on increased spending without running afoul of Senate budget rules.
From the time that it was introduced less than a week ago, it was clear that the Senate health care bill faced an uncertain future. Almost immediately, conservatives who didn’t think the bill went far enough because it left some of the basic structure of the Affordable Care Act in place and moderates who thought the bill went too far when it came to issues such as the impact it would have on the PPACA’s expansion of Medicaid, on premiums, and on issues such as funding for Planned Parenthood that includes not just direct Federal subsidies for Medicare and Medicaid reimbursement for routine medical procedures that the organization provides to the public. Despite these initial signs of weakness, Senate Majority Leader Mitch McConnell and the rest of the Senate leadership persisted in their insistence on a vote on the measure prior to the July 4th break, which meant a perilous week the outcome of which was far from certain. This plan persisted notwithstanding the fact that more and more Republican Senators either came out against the bill or said that they would oppose even opening debate. The real fate of the bill, though, seemed to be set late yesterday when the Congressional Budget Office released a report that found that some 22,000,000 people would lose coverage under the bill and that another 4,000,000 would lose employer-provided coverage. With that, it clearly became more difficult for the Senate leadership to continue with their efforts to get the bill through the Senate by the end of this week.
While this doesn’t necessarily mean the Senate bill is dead, it certainly is a setback for Senate Republicans and an opportunity for opponents of the bill, who will now likely use the additional time likely to come between now and whenever there might actually be a bill to lobby and organize against the bill. This is likely to include organizing supporters in the states where wavering Senators are located to put pressure on members to oppose the bill. Additionally, as even supporters of the bill have conceded, any delay of the bill makes passage less likely due to the fact that opponents tend to harden their position and to find more and more wrong with the bill. Because of this, the initial read of the situation on the ground has to be that this delay makes it less likely that the bill will ultimately pass, although it’s likely that Republican leaders in the Senate will persist in their efforts to get something passed if only to say that they tried. The fact that what they’ve come up with seems designed from the beginning not to be a realistic alternative to the status quo barely seems to matter to them.
