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December 16, 2017
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GOP’s modest healthcare reform plan up in air as senators rebel

US President Donald Trump departs after delivering remarks to the American Legion Boys Nation and Auxiliary Girls Nation in the Rose Garden at the White House on Wednesday.

Brawl over Obamacare repeal returns to Senate floor

WASHINGTON — US Senate Republican leaders continued working yesterday to round up votes for a modest overhaul of the Affordable Care Act, as lawmakers pressed ahead with a series of votes that underscored the GOP’s deep divide on how to fix the nation’s healthcare system.

But at press time last night, those efforts looked to be in even more danger after three GOP senators — Lindsey Graham, John McCain and Ron Johnson — warned they would not vote for a slimmed-down repeal bill without guarantees that the House of Representatives will go into negotiations with the Senate on the measure. The senators said they fear the House will simply take up the Senate-passed bill and approve it, instead of negotiating with the Senate to produce a more comprehensive measure.

They think the slimmed-down healthcare bill, which Senate Republicans are still developing, will be an insufficient replacement for the ACA, which is commonly branded “Obamacare” by the GOP. The three senators are enough to block a bill from passing the Senate, assuming no Democrats will vote for an Obamacare repeal bill.

On Wednesday the Senate rejected a proposal that would have repealed major parts of the ACA outright, with seven Republicans joining all of the chamber’s Democrats in opposition.

But GOP leaders said yesterday morning they were cautiously optimistic that later this week they could pass a “skinny repeal” that would abolish the individual and employer insurance mandates and perhaps just one tax in an attempt to sustain their seven-year quest to unwind President Barack Obama’s signature health-care law. Even if they succeed — and start negotiations with the House — they will face significant obstacles in accomplishing anything more substantial.

Speaking on the Senate floor yesterday, Senate Majority Leader Mitch McConnell emphasised that the series of votes this week would not reverse the law even if they culminate in passage of a bill. Votes were still being held as the Herald went to press.

“One phase of that process will end when the Senate concludes voting this week, but it will not signal the end of our work. Not yet,” McConnell said.

While McConnell predicted there would be an all-night marathon of votes, Democrats have decided to save their political ammunition until Republicans reveal the substance of the “skinny repeal” that they have been crafting. Senate Minority Leader Charles Schumer said in a Senate floor speech that Democrats would offer no more amendments until that point.

Top Republicans such as Senator John Thune, number three in the chamber’s GOP hierarchy, said that although leaders have not yet found “the sweet spot” between conservatives and centrists, they have picked up support for a more modest plan because it does not include deep cuts to Medicaid. Some Republican senators were simply open to any legislation that could keep alive the roller-coaster push for an overhaul.

“We’re edging closer and closer” to getting 50 votes for a bare-bones plan, Thune said.

Trump digs in

US President Donald Trump exhorted Republicans on Twitter on Wednesday morning to fall in line and back some sort of proposal to scale back the law.

“Come on Republican Senators, you can do it on Healthcare,” he tweeted. “After 7 years, this is your chance to shine! Don’t let the American people down!”

While McConnell has led the negotiations over a health-care plan for weeks, Trump has sought to drum up support by publicly pressing wavering Republicans.

Even if Republicans agree on a minimalist plan to alter the ACA, uniting with their House colleagues to enact a bill would be far more challenging. On Wednesday — even before the “skinny repeal” came up for a vote — some House conservatives were calling it untenable.

Representative Mark Meadows, chairman of the House Freedom Caucus and a key player in negotiating the House-passed bill, told reporters recently that a skinny repeal would be “dead on arrival” in the House and that a conference committee would have to be convened to work out a compromise.

Still, House Speaker Paul Ryan said yesterday that House leaders are “considering” extending their session so they can be prepared to act on whatever the Senate approves this week.

McConnell overcame serious opposition from his rank-and-file members to begin debate on healthcare — a prospect that seemed dim just last week. Trump has taken to Twitter and made public statements challenging Senate Republicans to support an overhaul or take ownership of the ACA’s failure.

With the idea of a scaled-back bill emerging as the most likely outcome of this week’s votes, the proposal now faces increased scrutiny.

Senate Democrats announced late Wednesday afternoon that a preliminary CBO estimate found that 16 million people would lose coverage and that premiums would rise 20 percent if Republicans enacted a handful of the policies floated for the pared-down repeal bill. The analysis was based on the assumption that the GOP wants to repeal the individual and employer mandates, end a 2.3 percent tax on medical device manufacturers, ban funding for Planned Parenthood and repeal funds for preventive healthcare.

— Herald with Reuters, Washington Post

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