- The Washington Times - Sunday, July 9, 2017

Republican lawmakers will return to Washington on Monday deeply divided over health care, with leading conservatives eyeing a breakthrough or swift repeal vote even as moderates talk of starting over, but with Democrats at the table.

“My view is it’s probably going to be dead,” Sen. John McCain, Arizona Republican, told CBS’ “Face the Nation.”

Others aren’t giving up, saying Republicans who seized all levers of political power in November cannot afford to fall short and risk a political bloodbath in 2018.

Sen. Ted Cruz, Texas Republican, is pushing a plan that would let insurers offer plans that do not meet Obamacare’s insurance regulations, so long as they offer ones that do. Skeptics said it looks like a ploy to get around protections for people with pre-existing conditions, though Mr. Cruz insists it’s the best way to drive down premiums.

“I think we’re making real progress. In my view, failure is not an option,” Mr. Cruz told “Face the Nation.”

At the same time, Mr. Cruz acknowledged that Senate Majority Leader Mitch McConnell faces a “rocky path” in avoiding more than two defections from their 52-seat majority, with Vice President Mike Pence serving as a tie-breaking vote.

Moderates such as Sen. Susan Collins, Maine Republican, say they would prefer bipartisan talks on health care, while conservatives, including Mr. Cruz, say Senate Republicans should move to repeal Obamacare now and work on a replacement later on if they cannot come to an agreement in the coming weeks.

President Trump recently tweeted support for the latter strategy, despite having pushed for a simultaneous replacement earlier this year, and at least one moderate called it a “non-starter” on Sunday, since people with pre-existing conditions won’t know if they’ll be able to secure affordable coverage moving forward.

“I think it betrays President Trump’s campaign pledges,” Sen. Bill Cassidy, Louisiana Republican, told “Fox News Sunday.”

Mr. Cassidy said Congress should take up the bill he wrote with Ms. Collins, which allows states to keep Obamacare or auto-enroll residents into a more conservative plan.

Facing few good options, Mr. McConnell last week signaled that Congress will have to patch up Obamacare’s ailing markets if Republicans cannot smooth over their differences and pass a replacement plan.

“If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,” Mr. McConnell told the Rotary Club luncheon in Kentucky.

Hoping to rub salt in the wound, Sen. Bernard Sanders held rallies in Covington, Kentucky and Morgantown, West Virginia, on Sunday in opposition to the Republican legislation.

“At a time when Kentucky is struggling with an opioid addiction epidemic, there is no question that if McConnell’s legislation were to be passed, thousands of Kentuckians would no longer be able to receive the treatment they desperately need,” said Mr. Sanders, Vermont independent and hero of the progressive left.

The White House, meanwhile, said it is counting on the Senate GOP to find a way forward.

“I know that this president expects them to get this done. Whether it’d be before August recess or during August recess, the president expects the Senate to fulfill the promises it made to the American people,” White House Chief of Staff Reince Priebus told “Fox News Sunday.”

In the days ahead, the Congressional Budget Office is expected to score Mr. Cruz’s “freedom” amendment. Conservative supporters say the plan would help young and healthy customers who’ve been forced to pay more under the Affordable Care Act’s model.

“You have millions of people who are winners, straight off,” Mr. Cruz said.

However, opponents say consumers will pay less for skimpier benefits, while those who still want or need the type of robust coverage mandated by Obamacare will have to pay more.

Senate Minority Leader Charles E. Schumer, New York Democrat, said sicker Americans would be segmented to a pool with ever-rising costs, since healthier people will gravitate toward the cheaper, barebones plans.

“Americans with pre-existing conditions will almost certainly be left without access to affordable and quality health care, making this even worse than the House bill on this issue,” Mr. Schumer said. “The only way to truly improve our nation’s health care system is for the Trump administration to stop sabotaging the marketplaces and for Republicans to finally heed Democrats’ requests to come together and work in a bipartisan way.”

Mr. Cruz punched back Friday by saying Democrats made a series of promises about their own health program that have fallen flat. Some Americans lost plans that didn’t meet the law’s coverage requirements, while premiums are rising instead of falling on the exchanges.

Yet it’s not just Democrats who are complaining.

Sen. Charles E. Grassley, Iowa Republican, said over the recess that there is “a real feeling” that Mr. Cruz’s plan could amount to “subterfuge” to get around regulations that protect people with pre-existing medical conditions.

Mr. Cruz said it is true that sicker Americans could face higher costs, but it is better to blunt those costs with taxpayer-funded subsidies and stabilization funds than to force everyday Americans in the risk pool to pay more for their own insurance.

“There’s no doubt this has been a rocky path to getting there,” he said, “but I continue to believe we can get this done.”

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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