Senate Obamacare Repeal Now Hinges on Conservative Support

While moderates also have concerns, critics on the right were first out of the gate Thursday.

Sen. Ted Cruz arrives at the Capitol as Senate Republicans released their long-awaited bill to scuttle much of President Obama's Affordable Care Act on Thursday.
AP Photo/J. Scott Applewhite
Alex Rogers
Add to Briefcase
Alex Rogers
June 22, 2017, 8 p.m.

After seven years of promising to “repeal and replace” Obamacare, the Republican leaders in the Senate finally unveiled a bill Thursday they said would do just that. But the bill wasn’t public for four hours before four conservative senators announced their opposition, threatening the Trump administration’s top priority in Congress.

The senators—Ted Cruz of Texas, Rand Paul of Kentucky, Mike Lee of Utah, and Ron Johnson of Wisconsin—oppose the current legislation for a variety of reasons. Should they get what they want, the bill would move further to the right, further antagonizing the Republican senators who are already wary of supporting a bill that would eliminate Medicaid coverage for millions.

Rank-and-file senators have been frustrated with how the Republican leadership crafted the bill, which did not receive a hearing in a major departure from the normal legislative process. “How you rush this thing through and take a vote at the end of next week is really beyond me,” said Johnson, who wants more information and more time to evaluate the draft with his governor and state. The Congressional Budget Office plans to score the bill by early next week, perhaps a couple of days before senators vote on it.

But Sen. John Cornyn, the No. 2 Republican, said Thursday that despite his colleagues’ concerns, the Senate will still vote on the bill next week before members go home for the July 4 recess.

“It doesn’t get any better,” said Cornyn. “It doesn’t get any easier.”

The draft legislation would eliminate the Affordable Care Act’s penalty urging Americans to purchase health care insurance and the penalty requiring large companies to provide it. It would cut billions of dollars in federal funding for Medicaid by eventually eliminating the ACA’s Medicaid expansion and changing the public program for low-income people from an open-ended entitlement to a per capita or block-grant program. It would cut taxes primarily on the affluent used to pay for the ACA and reduce the subsidies helping Americans purchase health care on the federal exchanges. It would allow states to waive some policies, including requiring insurers to provide for essential health benefits such as maternity treatment. And it would keep some popular provisions, such as allowing children to stay on their parents’ insurance until they’re 26.

Some conservatives who had derided the House’s bill as “Obamacare-lite” would like to make further changes. In the meeting with his fellow Republican senators Thursday morning, Lee talked about his “need” to repeal all the Title I regulations, which includes provisions eliminating lifetime annual limits on benefits and extends dependent coverage up to age 26, according to a Lee aide. After the meeting, Paul released a statement saying the bill “does not keep our promises to the American people” as it “does not repeal Obamacare.”

One editor from the libertarian Reason magazine said it might be “Obamacare lite—later,” noting the delays in many of the bill’s provisions. Another from the Washington Examiner tweeted it “does more to rescue Obamacare than it does to repeal it.”

Outside groups like FreedomWorks echoed Paul’s message, while health care experts from the Heritage Foundation said the bill should expand its waiver authority.

If the bill went to the floor today, it wouldn’t pass, since Republicans can only afford to lose two out of 52 GOP senators with zero Democratic support. And even if it could, it also likely wouldn’t be able to pass the House over conservatives’ concerns there. “I think we’re probably going to get a lot of push back from people from the Right in the House,” said Sen. Lindsey Graham.

Rep. Mark Meadows, the leader of the House Freedom Caucus, said the “majority” of his arch-right group would support the bill if Cruz is successful in inserting “consumer choice” provisions. Meadows said the amendments would allow for insurers to compete across state lines and allow people to use subsidies to purchase a plan that doesn’t meet the ACA’s standards.

“We should do more to ensure consumers have the freedom to choose among more affordable plans that are tailored for their individual health care needs,” said Cruz in a statement. “As currently drafted, this bill draft does not do nearly enough to lower premiums.”

Still, conservatives are hopeful that they can still get support for the ultimate bill in order to deliver on their promises. Cruz, who’s up for reelection, noted that he’s worked on this bill for four months. While Cruz has antagonized his leadership almost since he got to the Senate, Cornyn says he’s “convinced” his colleague from Texas “wants to get to yes.”

Of course, it may not be enough. Other Republicans, such as Sens. Rob Portman and Shelley Moore Capito, have their own concerns, including increasing the funding to combat the opioid crisis. Moderate Sen. Susan Collins wants to examine the impact on insurance coverage; the House legislation increased the number of uninsured by 23 million. And Sen. Dean Heller, perhaps the most vulnerable Republican up for reelection, has “serious concerns” about the bill’s effect on his state, which saw 200,000 Nevadans get insurance under the Medicaid expansion.

And other conservatives besides Cruz might already be gone.

“Senator Paul, I think, has unique concerns that aren’t necessarily shared by the others,” said Cornyn.

Jason Plautz contributed to this article.
What We're Following See More »
AND POLICE OFFICERS IN EVERY SCHOOL
Gov. Scott Wants to Raise Gun-Purchase Age to 21
15 hours ago
THE LATEST
IN THE WAKE OF NEW CHARGES
Gates Expected to Plead Guilty, Cooperate with Mueller
16 hours ago
THE LATEST

Former Trump campaign adviser Rick Gates is expected to plead guilty to a raft of new tax and fraud charges filed against him by special counsel Robert Mueller on Thursday. Gates is expected to cooperate with Mueller's investigation.

Source:
32 COUNTS
Mueller Hits Manafort, Gates with New Charges
1 days ago
THE LATEST

Robert Mueller announced new charges against former Trump campaign chairman Paul Manafort advisor Rick Gates. "The new indictment contains 32 counts, including tax charges." The pair had been indicted on 12 charges in October. Since then, Gates's attorneys have asked to be excused from the case.

Source:
SECOND TIME FBI FAILED TO ACT
FBI Failed To Act On Parkland Shooter Tip
1 days ago
THE DETAILS

The FBI has reported that it failed to respond to a warning from "a person close to" Nikolas Cruz, the teen accused of killing 17 people at Parkland High School on Thursday. "It was the second time the FBI apparently failed to follow up on Cruz." On the first occasion, it failed to properly investigate Cruz after it was reported to them that he left the following comment on a Youtube video: "Im going to be a school shooter."

Source:
FBI MISSED TIP ON PARKLAND SHOOTER
Florida Governor Calls on FBI Director to Resign
1 days ago
THE DETAILS

Florida Governor Rick Scott called on FBI Director Christopher Wray to resign following revelations that the FBI had failed to adequately investigate multiple warnings about Parkland High School gunman Nikolas Cruz. “The FBI’s failure to take action against this killer is unacceptable,'" said Scott. '...We constantly promote ‘see something, say something,’ and a courageous person did just that to the FBI. And the FBI failed to act.'" According to an FBI statement, the FBI failed to inform local offices of information regarding "Cruz's desire to kill people, erratic behavior, disturbing social media posts, as well as the potential of him conducting a school shooting."

Source:
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login