Bills

GOP senators threaten to kill their own Obamacare bill

Senate Republicans are threatening to tank their own Obamacare repeal bill if they don’t receive a guarantee from Speaker Paul Ryan that it will merely be a starting point for negotiations and not become law.

So Ryan (R-Wis.) seemed to provide the assurance they were looking for, but it’s not clear it will be enough.

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In an unusual press conference Thursday afternoon, GOP Sens. Lindsey Graham of South Carolina, John McCain of Arizona and Ron Johnson of Wisconsin called the Senate GOP’s “skinny” repeal bill, which would gut Obamacare’s coverage mandates, as unworkable and a “fraud,” as Graham put it.

They demanded that Ryan vow that the House would not quickly pass the bill and send it to President Donald Trump. The senators’ stand threatened, once again, to thwart the GOP’s tortured effort to scuttle the Democratic health care law.

“The skinny bill as policy is a disaster,” Graham said, explaining it would cause a crisis in the insurance markets. “I need assurances from the House speaker … if I don’t [get them], I’m a no.”

On Thursday night, Ryan responded with a lengthy statement stating the House was “willing” to go to conference. It was a tepid endorsement of the Senate leadership’s drive to pass something — anything — in order to keep moving forward, but hardly more than that.

“It is now obvious that the only path ahead is for the Senate to pass the narrow legislation that it is currently considering. This package includes important reforms like eliminating the job-killing employer mandate and the requirement that forces people to purchase coverage they don’t want,” Ryan said. “Still it is not enough to solve the many failures of Obamacare. Senators have made clear that this is an effort to keep the process alive, not to make law. If moving forward requires a conference committee, that is something the House is willing to do.”

Ryan also demanded the Senate vote first on any conference committee agreement.

“We expect the Senate to act first on whatever the conference committee produces,” Ryan added.

It was unclear whether that will allow Senate Majority Leader Mitch McConnell (R-Ky.) to get the bill over the hump.

Sen. Shelley Moore Capito (R-W.Va.) said that Ryan’s commitment was not as firm as senators had been requesting.

“I thought It was a bit hard to decipher what exactly he meant by that,” she said in an interview. A key swing vote, she’s still undecided.

“Not sufficient,” McCain agreed.

The bizarre turn of events, coming as the Senate braced for an all-night series of votes on amendments known as a “vote-a-rama,” came as McConnell made one last frantic plea to his Senate Republican members to advance the party’s scaled-back Obamacare repeal, assuring them at a private lunch that the vote is merely aimed at getting to conference with the House rather than preparing it to land on President Donald Trump’s desk.

But Graham said McConnell could not offer a promise that Ryan would do so, echoing concern among wavering Senate Republicans that the House was adopting a “martial law” procedure that would allow them to quickly take up and pass the health care bill.

The House Rules Committee adopted a “martial law” procedure that extends through Tuesday. Republicans on the panel defeated a Democratic attempt to limit fast-track motions to go to conference.

Privately some Republicans predicted Ryan would have to act to sooth the senators’ concerns. Asked what such a guarantee would look like from Ryan, Graham compared it to pornography.

“You know it when you see it,” Graham said. He said House Freedom Caucus Chairman Mark Meadows (R-N.C.) had assured him it cannot pass the House as written anyway. The bill’s cornerstone is repeal of the individual and employer mandates, and does not touch Medicaid.

The Senate majority leader picked up some key votes at lunch, with Sen. Rob Portman (R-Ohio) endorsing the shriveling repeal effort as a bridge to bicameral negotiations. Not everyone was sold, but GOP leaders were emphasizing that the bill, which would slash Obamacare’s coverage mandates and result in millions more uninsured, is not the ultimate goal.

“I believe the leader has been in communication with Speaker [Paul] Ryan on that topic,” said Senate Majority Whip John Cornyn (R-Texas). “The request to go to conference has to come from the House so that would probably be the best people to talk to. But I have every expectation we will.”

Still, rank-and-file GOP senators struggled to explain whether there is any guarantee that the bill they are set to vote on would not actually become law.

The House is set to begin its August recess Friday, but House Majority Leader Kevin McCarthy sent a note to lawmakers Thursday instructing them to keep their schedules flexible for the next few days in case the Senate passes Obamacare repeal legislation and the House decides to act on it.

“Just the term martial law worries me,” Johnson said. Of the thought that the House could just pass the Senate’s latest repeal plan, “That would concern me.”

Earlier Sen. Steve Daines (R-Mont.) likened the Senate bill to a “motion to proceed” to conference rather than concrete policy, though Sen. Roger Wicker (R-Miss.) said “theoretically there’s no way” to get a concrete assurance that the House won’t just pass the bill and send it to the president.

“We want assurances of that. And I think they will get them. I know Mitch is planning to give that and I think people will support whatever it is that can keep our efforts alive,” said Sen. Bob Corker (R-Tenn.).

Other Senate Republicans were upset that the House could just adopt the “skinny” repeal package and declare victory.

“How can the House say, ‘We’ll just pass it.’ Pass what?,” asked Sen. Lisa Murkowski (R-Alaska), who has opposed both the House and Senate GOP bills. “I think it signals they don’t like very much what they passed.”

McConnell was short of the votes as of Thursday afternoon, although it was clear he and Cornyn were picking up support as the day wore on – as long Ryan gave a guarantee.

Republicans must get 50 of their 52 members on board; Vice President Mike Pence would break a 50-50 tie to pass the bill.

Sen. Dean Heller (R-Nev.), who indicated earlier support for the effort because it skirts the issue of Medicaid, was noncommittal on Thursday afternoon after Nevada Gov. Brian Sandoval savaged the bill. So were Sens. Capito and Murkowski.

Sen. Mike Lee (R-Utah) — who served cheeseburgers, french fries, onion rings and fry sauce from Hires Big H in Sandy, Utah during the GOP lunch — wants a “fatter repeal” than has been presented, a spokesman said.

Sen. Jeff Flake (R-Ariz.) and Portman said they would vote “yes.” Portman’s governor, Republican John Kasich, also urged against voting for the bill on Wednesday, though Portman said he would vote for the bill only if it leads to negotiations with House Republicans.

But Rep. Greg Walden (R-Ore.), a top health care legislator, said “All options are on the table.”

The bill itself was evolving rapidly, as Senate Republicans’ once ambitious Obamacare repeal effort kept narrowing, with growing doubts over whether the GOP can fully eliminate the health law’s coverage mandates or any of its taxes.

The GOP’s “skinny” repeal bill, in other words, was getting even skinnier.

“I don’t know whether at the end of this process it’s going to be fat, skinny, bulimic, anorexic, I don’t know. This is not being orchestrated, I can assure you,” said Sen. John Kennedy (R-La.).

Sources on and off Capitol Hill on Thursday described a blueprint that would repeal the law’s individual mandate and partially delay its employer mandate. It also would defund Planned Parenthood and give states more flexibility to opt out of Obamacare regulations; the law’s Prevention and Public Fund is also expected to be sharply cut. But there are growing concerns among Republicans that budget requirements will prevent the Senate from repealing any of Obamacare’s taxes.

Senate Republicans are also considering language to allow people to buy insurance with pre-tax money, favored by conservatives. Leaders have not been decided if it will be included.

McConnell emailed GOP senators on Thursday outlining the current provisions in the bill; the message noted that the employer mandate would be repealed for a minimum of six years, according to a source who viewed the email. Another GOP source said the employer mandate would be halted for eight years.

And it’s unclear whether there will be a complete CBO score of the Republican plan in time for the vote. Republicans say if there isn’t, they would rely on prior CBO scores of provisions of the bill and Budget Committee Chairman Mike Enzi would make a ruling.

Even as the chamber careens toward a final decision on whether to repeal, replace or revise Obamacare, with no certain outcome, Republican leaders are desperate to get rid of their political headache after several failed votes earlier this week.

“We have to pass something,” said Sen. Orrin Hatch of Utah, the most senior GOP senator and chairman of the Finance Committee.

The Senate will begin a series of votes later Thursday afternoon designed to test what senators will support for an Obamacare replacement bill, dubbed a “vote-a-rama.” This will help determine whether Republicans can reach a consensus among themselves. The session could last until Friday morning, depending on GOP and Democratic maneuvers, and culminates in a final passage vote.

A GOP effort to see whether Democrats support a single-payer health care system garnered zero “yes” votes. Most Democrats voted “present,” though some moderates, all up for reelection in 2018, voted against it.

McConnell is expected at some point to unveil the GOP’s highly anticipated “skinny repeal” bill — the narrowest effort to dismantle Obamacare that can win at least 50 votes. Senate Minority Leader Chuck Schumer (D-N.Y.) said he’s been assured by senators in both parties that if the bill fails, the Senate will start over in committee.

McConnell and his top lieutenants started from a bare-bones plan that would repeal Obamacare’s individual and employer coverage mandate, as well as the medical device tax. There are now major questions about whether those three things can pass Senate rules.

Republicans are seeking to repeal as many of Obamacare’s taxes as they can, but doing so would blow holes in the budget. Some sources doubted Republicans would even be able to repeal the medical device tax.

Some GOP senators were pushing for billions of dollars in new funding for fighting opioid addiction to be included in leadership’s package, part of an effort to restore the $45 billion in such funding already promised by McConnell in previous bills. But that has been ruled out as spending too much money to hit budget targets; the Senate must hit at least $133 billion in savings, as required under Senate rules, GOP sources said.

The parliamentarian has found that language allowing states to undo some of Obamacare’s consumer protections might not be allowed under reconciliation rules, according to Sen. Bernie Sanders (I-Vt.), the ranking member on the Budget Committee.

“We’re trying to come up with a package that does the things that we want and I think principally those are going to be the mandates,” said South Dakota Sen. John Thune, the third-ranking Senate Republican. Asked if that would include tax cuts he said: “At the moment, it doesn’t look like it.”

Rachael Bade contributed.

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