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Thursday, July 27, 2017

Bare-bones repeal plan gains steam in Senate

Bare-bones repeal plan gains steam in Senate
By Peter Sullivan and Nathaniel Weixel - 07-26-17 18:34 PM EDT

Momentum for a "skinny" ObamaCare repeal bill is growing in the Senate as one by one other measures to reform the nation's healthcare law fall by the wayside.

Legislation to repeal ObamaCare with a two-year delay only secured 45 votes on Wednesday, a day after a repeal-and- replace bill won just 43 votes in a procedural motion.

Those tallies suggest Senate Republicans may have to narrow their goals to win 51 votes for legislation in the face of unified Democratic opposition.

Sen. John Cornyn (Texas), the No. 2 Senate Republican, told reporters Wednesday that a scaled-down bill might be the best way to move forward on the issue, possibly by holding a conference committee with the House, which approved a broader repeal-and-replace bill.

It "seems to have a lot of benefits, getting us to conference," Cornyn said.

It's even possible that Senate passage of a skinny bill could lead to quick action in the House, which is scheduled to begin its recess at the end of the week.

One House GOP lawmaker close to leadership said it's possible the House could stay in until Saturday to pass the skinny repeal bill, which would mean skipping a conference committee. But the lawmaker said the course had not been decided.

It's not clear that House Republicans would embrace an approach that would fall far short of a full ObamaCare repeal. The skinny bill would be expected to repeal ObamaCare's individual and employer mandates, as well as a tax on medical devices.

"We support the concepts in there, but it's not a repeal, not even close to repeal," House Freedom Caucus Chairman Mark Meadows (R-N.C.) said in an interview with Bloomberg TV. "We see it as a vehicle to hopefully continue the negotiations."

Likewise, Cornyn said the House-passed bill, which was rejected by many senators as not doing enough to protect Medicaid, could serve as a "template" for conference negotiations.

While most of the ObamaCare bills being bandied about have Republican opponents, no GOP senators have ruled out voting for the skinny bill - a development that could be music to Senate Majority Leader Mitch McConnell's (R-Ky.) ears.

Sen. Dean Heller (R-Nev.), perhaps the most vulnerable Republican up for reelection next year, and conservative Sen. Rand Paul (R-Ky.) both said they could support it.

"I look on it ... favorably," said Heller, whose opposition to an earlier repeal-and- replace bill killed that measure and drew friendly fire from a group aligned with President Trump that ran ads criticizing him in Nevada.

Unlike the House and Senate replacement bills, the skinny bill wouldn't cut Medicaid.

"I've always said I'm for healthcare reform, I'm not for entitlement reform, and that makes it a healthcare reform bill and not an entitlement reform bill," Heller said.

It's not certain that McConnell would have the votes to pass the skinny bill, however.

He can afford just two defections, and Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) both voted against a motion to even open the debate the Senate is now having.

"I don't know what would be in a skinny repeal bill. That hasn't been shared with us," Collins said Wednesday.

Sens. Rob Portman (R-Ohio), Shelley Moore Capito (R-W.Va.), Ron Johnson (R-Wis.) and John McCain (R-Ariz.) all said they needed to find out more about what would be in the skinny bill before making a decision.

A spokesman for Sen. Mike Lee (R-Utah) said it "depends how skinny it is" when asked whether Lee would support the bill.

Paul said he would prefer that if the skinny bill passes the Senate, it just be approved by the House.

He said he wanted to avoid a conference committee where lawmakers could "stuff all the goodies and all the bailouts back in there."

"We'll simply get back to where we were before and losing conservatives again," he said.

Heller also expressed concern that the massive cuts to Medicaid and the elimination of funding for ObamaCare's Medicaid expansion could be put back into the bill during conference.

Some senators said they thought the broader repeal-and- replace effort still had a chance of passing after a conference committee, if amendments were added to it in conference.

Two key measures come from Sen. Ted Cruz (R-Texas), who wants to let insurers sell plans outside of ObamaCare's regulations, and Portman, who wants to add $100 billion to help people losing Medicaid afford private coverage.

Sen. Mike Rounds (R-S.D.) said he thought a replacement bill could pass with those amendments and that going to conference committee would buy time for the proposals to be scored by the Congressional Budget Office.

If the skinny bill were actually to become law, experts and insurers say repealing the mandate to buy insurance without having a replacement would destabilize health insurance markets and spike premiums.

The Congressional Budget Office previously found that repealing the individual mandate on its own would result in 15 million more uninsured people and raise premiums by about 20 percent.

The Blue Cross Blue Shield Association on Wednesday warned of "steep premiums increases and diminished choices" if the mandate were repealed.

"A system that allows people to purchase coverage only when they need it drives up costs for everyone," the group said.

Many senators also aren't ready to fall back on the bill after years of GOP promises to repeal ObamaCare "root and branch."

"The skinny plan is not a replacement. I would vote for a skinny plan to get in conference to come up with a replacement," Sen. Lindsey Graham (R-S.C.) said. "If I thought that was all the conference was going to do, no, I wouldn't vote for it."

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