Senate Republicans’ push to repeal and replace Obamacare stumbled Wednesday as one conservative forcefully rejected the latest compromise attempt, and insurers said it would further distort health markets that are already struggling to attract young, healthy customers.
Majority Leader Mitch McConnell plans to release a revised bill Thursday, with votes expected next week, as the GOP approaches what one senator called the “fish or cut bait” period.
But he’s still struggling to earn votes, and some Republicans are already looking at an alternative that would involve working with Democrats.
Sen. Lindsey Graham, South Carolina Republican, said he’s about to unveil his own proposal that he hopes could attract bipartisan support — though he’s been coy about details.
“We’re talking to Democrats, we’re talking to governors a lot, to see if we can turn to some critics into supporters,” Mr. Graham said.
For now, GOP leaders will have to thread the needle.
Sen. Rand Paul, Kentucky Republican, said the GOP’s current bill would preserve too much of the 2010 Affordable Care Act, breaking the GOP’s campaign vow to scrap the law.
“I don’t see anything in here really remotely resembling repeal,” Mr. Paul said. “At this point, I cannot support the bill.”
His defection means GOP leaders can only afford one more “no” vote from their 52-seat majority and still pass a plan, with Vice President Mike Pence serving as tie-breaker.
President Trump said he will be “very angry” if the Senate doesn’t pass a bill.
“Mitch has to pull it off. He’s working very hard. He’s got to pull it off,” Mr. Trump said in an interview with Christian Broadcasting Network founder Pat Robertson at the White House.
But insurance lobbyists condemned the idea Wednesday, saying they need those young and healthy customers to buy the more expensive plans on Obamacare’s exchanges in order to subsidize the costs for older, sicker customers.
Without them, America’s Health Insurance Plans, the lobby for the nation’s insurers, said the exchanges “would basically function like a high-risk pool — with unaffordable premiums for those with pre-existing conditions.”
Mr. Cruz argues it is better to backstop those costs with direct taxpayer subsidies and stabilization funds than to force healthy consumers to pay more. The insurance industry, he said, “appears to be on maximizing their own subsidies at the expense of consumer choice.”
Moderate Republicans, meanwhile, are counting on getting more cash for treatment of opioid addiction, and expect the bill to maintain some of Obamacare’s tax increases on high earners, blunting Democrats’ charge that the GOP bill is “Robin Hood in reverse.”
Republican leaders scheduled a pivotal meeting to discuss where things stand Thursday.
Some House Democrats stepped up with their own plan Wednesday, proposing tweaks to Obamacare that would prop up insurance companies with taxpayer money, while also embracing ideas attractive to some Republicans, such as auto-enrolling people into a plan with basic services.
The blueprint offered a rare admission by Democrats that the 2010 law is faltering in places and needs surgery, although drafters also accused President Trump of undermining its enforcement.
The Democrats’ proposal — which has not been endorsed by party leaders — says Congress should let older people buy into Medicare before they turn 65, and consider offering more taxpayer-funded assistance based on age, geography or income for people who haven’t benefited from Obamacare’s subsidies to date.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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