Senate Republicans felt the squeeze Monday as they returned to work after a weeklong break, with President Trump demanding an Obamacare repeal bill before their August vacation, and vocal activists urging holdouts to resist backroom deals.
Senate Majority Whip John Cornyn said GOP leaders planned to release a revised version of their bill later this week, clearing the way for a budget analysis that they hope will win over wavering Republicans.
“And then we’ll vote on it next week,” Mr. Cornyn told reporters.
Leaders have pushed for a floor vote before, only to pull back after they failed to marshal enough votes for passage. They can only afford two defections, yet roughly a dozen Senate Republicans have opposed or sharply criticized the current plan.
“I do need a complete overhaul to get to a ’yes,’” Sen. Susan M. Collins, Maine Republican, told CNN.
Senate Majority Leader Mitch McConnell urged his troops to rally around the evolving plan, saying they have no choice but to rescue Americans from an ailing insurance market. He pointed to a new survey that says Obamacare’s coverage gains are beginning to ebb, with 2 million fewer people holding insurance compared to late 2016, and a Trump administration report that says 86 fewer insurers filed to participate in the federal Obamacare exchange next year, a 38 percent drop.
“Obamacare has been hurtling toward collapse for years. Today it sits on the edge of total meltdown,” Mr. McConnell, Kentucky Republican, said.
Mr. Trump pressed Republicans from his cyberpulpit, saying they needed to reach a deal before leaving for their August recess.
“I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!” Mr. Trump said on Twitter.
The Senate is revising its plan — itself a rewrite of a House-passed bill — after a “discussion draft” failed to gather enough support for a swift vote before the July 4 holiday.
Budget analysts are expected to score an amendment by Sen. Ted Cruz, Texas Republican, that lets insurers offer plans that don’t comply with Obamacare’s regulations on benefits and pricing for the healthy versus sick, so long as they offer at least one plan that does. The plan would reel in conservatives votes, though moderates are skittish about the idea, saying it will raise prices in the regulated market.
Leaders are scrounging for more cash to win over those centrists, including funding to combat the opioids problem.
Activists said they’ll call foul on any sweetheart offers.
Save My Care, a group that’s fighting the GOP repeal effort, released ads Monday targeting four senators who opposed Mr. McConnell’s draft plan — Ms. Collins, Shelley Moore Capito of West Virginia, Dean Heller of Nevada and Lisa Murkowski of Alaska — who could be tempted by state-specific offers.
If Republicans can’t pass a plan on their own, they may instead have to work with Democrats on a bill that would shore up Obamacare’s flailing exchanges, Mr. McConnell said last week. Some conservatives viewed it as a threat, but Democrats cheered the chance to write a bill.
“When using bipartisanship as a threat is your only argument, it’s time to move on,” Senate Minority Leader Charles E. Schumer said.
Mr. Schumer’s solutions include more government spending and control: permanently authorizing payments to insurers to pick up low-income customers’ costs; creating a permanent reinsurance program to backstop insurers who take on particularly expensive customers; ensuring that people in counties who don’t have an insurer on their Obamacare exchange can use the D.C. small business portal; and smoothing out Obamacare’s subsidy structure so people who make slightly over 400 percent of the federal poverty line — nearly $100,000 for a family of four — can still claim taxpayer-funded help.
Mr. McConnell rejected their overtures as “Band-Aids” for a market that’s failing. He pointed to new data from the Gallup-Sharecare Well-Being Index that said the uninsured rate has risen to 11.7 percent, up from a record low of 10.9 percent in the latter half of 2016.
The survey said troubles in the Obamacare exchanges are partly to blame for the increase. Rising premiums likely scared people out of the market, while the exodus of insurers from some of the exchanges could be driving down competition and deterring customers.
Gallup also said there is more uncertainly about the future of health policy since Mr. Trump took office since he has given mixed signals about how firmly he will enforce the “individual mandate” requiring Americans to hold insurance.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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