GOP Health Plan Hits Another Wall and McConnell Once Again Postpones a Vote

GOP Health Plan Hits Another Wall and McConnell Once Again Postpones a Vote

Aaron Bernstein

The fate of the controversial Senate GOP bill to repeal and replace the Affordable Care Act just got even murkier, as Senate Majority Leader Mitch McConnell (R-KY) postponed the vote yet again.

This time, it was because 80-year-old Sen. John McCain (R-AZ) had undergone emergency surgery to remove a blood clot from above his left eye and would be hospitalized for at least one week. McConnell must muster the support of at least 50 of the 52 Senate Republicans to pass the measure under budget reconciliation rules that prohibit a Democratic filibuster, and even then, Vice President Pence would have to cast a tie-breaking vote.

Related: Last Chance for the Senate GOP Health Plan: Let the Arm Twisting Begin!

Passage of the Better Care Reconciliation Act has been hanging by a thread for weeks, and time is running out to pass the bill before the end of the fiscal year.

With Republican Sens. Susan Collins of Maine and Rand Paul of Kentucky both vowing to oppose a plan that the Congressional Budget Office says could strip as many as 22 million Americans of their health insurance, the defection or loss of one more GOP senator would doom the legislation and hand President Trump a humiliating setback. There have been tweaks to the bill since then, but the CBO has not yet scored that revised bill and won’t meet tomorrow’s original deadline.

McCain, the Republicans’ 2008 presidential nominee, has voiced concern about the health care bill but has not said how he would vote. However, he said recently on the CBS program “Face the Nation” that “My opinion is that it’s likely to be dead.”

Related: Senate Republicans May Try to Skirt CBO Score on Health Bill

This is the second-time McConnell has had to delay action on the Senate bill; he put off a scheduled vote shortly before the July 4th recess when it became apparent he lacked the votes to pass his bill or even simply begin the debate. It’s anyone’s guess whether the latest postponement will improve or diminish the chances for passage.

Senate Majority Whip John Cornyn (R-TX) said on Sunday that the Senate would begin debating and voting on the plan once “we have a full contingent of senators.”

“Health care is hard,” Cornyn told NBC’s “Meet the Press” host Chuck Todd in explaining why the absence of just one Republican senator could upset the apple cart for the GOP. “We know that, but we have no choice to try to come to the rescue of the millions of people who are being failed because of the problems of Obamacare.”

The news of the delay dominated the Sunday talk shows, which also highlighted the Trump Administration’s mounting political and legal woes stemming from the widening investigations of possible collusion between the Trump campaign and the Russians in trying to influence the outcome of the 2016 presidential election.

McConnell, the chief author of the Senate health care plan to overhaul and dismantle key provisions of Obamacare, has been wheeling and dealing over the past several days to try to buy off a half dozen or so recalcitrant moderate and conservative GOP senators who are threatening to oppose the measure when it finally comes to the floor.

Collins said on the ABC News This Week program that there are “eight to 10” Republican senators who still have “deep concerns” about the health care bill and could vote against it, although she doesn’t underestimate McConnell’s ability to pull out a narrow victory.

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In a scathing assessment of the Senate measure, Collins said, “This bill would make sweeping and deep cuts in the Medicaid program which has been a safety-net program on the books for more than 50 years, ensuring that some of our most vulnerable citizens, our disabled children, our low-income seniors receive the health care that they need.”

“It would also jeopardize the very existence of our rural hospitals and our nursing homes, which not only provide essential care to people in rural America but also are major employers in the small communities in which they are located,” she added.

McConnell unveiled a fresh list of revisions on Thursday aimed at placating many of those recalcitrant senators, including Sens. Rob Portman of Ohio, Dean Heller of Nevada, Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia who have been pressing for more funding for Medicaid coverage and treatment of opioid addiction and a slower phase-out of expanded Medicaid in 31 states and the District of Columbia.

The changes made by McConnell would also preserve two Obamacare tax hikes on the wealthy to provide about $70 billion of additional funds to help reduce premiums and hold down out of pocket costs in many states.

Related: McConnell Infuriates Some Conservatives by Preserving Two Big Obamacare Taxes

In a major concession to conservatives, McConnell also included a provision promoted by Sen. Ted Cruz (R-TX) and Mike Lee (R-UT) that would allow insurers under certain circumstances to offer skimpy, low-cost health plans that don’t provide all the “essential benefits” mandated by Obamacare, such as maternity care, prescription drugs and mental health treatment.

However, those insurers would have to offer at least one plan providing all the benefits – an approach that critics warn would lead to a “segmentation” of the market between young, healthy people and older, sicker Americans.

America's Health Insurance Plans (AHIP), the nation's largest industry lobbying group, teamed up with the Blue Cross Blue Shield Association on Friday night to urge McConnell to drop the Cruz plan., saying in a letter that “It is simply unworkable in any form.”

President Trump said last week that he “will be very angry” if McConnell and the Senate Republicans fail.

Related: Surprise! There Are Now Two Senate GOP Health Care Bills in Play 

However, the plan has drawn overwhelming opposition from the nation’s health care providers, insurers, and researchers. Moreover, a new poll by the Washington Post and ABC News shows that, by a two-to-one margin, Americans prefer keeping Obamacare to the plan being pushed by Senate Republicans.

Health and Human Services Secretary Tom Price said today that he finds continued public support for Obamacare “really perplexing” in the face of skyrocketing premiums and out of pocket costs, insurers pulling out of many of the government-subsidized individual insurance markets.

“This is a system that is crying out for reform and revision, and that’s what we’re trying to do, for people to be able to have the kind of doctor and the kind of coverage that they want,” he said.