Senate Republicans picked up the health care debate Monday by promising a new start, saying they’ll write their own legislation that looks substantially different than the embattled plan that cleared the House last week.
Ideas already are pouring in from across the GOP.
Sen. Shelley Moore Capito of West Virginia wants to make sure states that expanded their Medicaid programs retain “a voice” in the process, while Sen. John Hoeven of North Dakota said Republicans need to offer “robust” enough tax credits for low-income people to afford coverage.
Sen. Bill Cassidy, a Louisiana doctor, said any GOP bill must pass the “Kimmel test” — a nod to late-night TV host Jimmy Kimmel’s concern that some people with pre-existing conditions won’t be able to afford coverage under the House bill, an issue made personal after his son was born with a heart problem.
And Sen. Susan Collins of Maine said she still hopes there’s a way to bring Democrats into the fold to forge a bipartisan solution to Obamacare’s wobbly markets.
“It’s bringing all those ideas together and sort of packaging them in something,” said Sen. Richard Burr, North Carolina Republican.
President Trump is counting on Senate Majority Leader Mitch McConnell to negotiate ideological gaps in his conference and deliver a final bill, after the House GOP muscled through its own Obamacare repeal last week, using a series of last-minute changes to win just enough support to clear that chamber.
Senate Republicans said they will largely start from scratch as they push to undo the 2010 Affordable Care Act.
“This process will not be quick or simple or easy, but it must be done — it’s the least members in both parties owe to the countless Americans who continue to suffer under Obamacare, and the countless more who will be hurt if we don’t act,” said Mr. McConnell, Kentucky Republican.
The GOP is relying a working group of 13 senators, all men, to lead the rewrite. The group includes moderate-leaning senators in Sens. Rob Portman of Ohio and Cory Gardner of Colorado, whose states vastly expanded their Medicaid populations under Obamacare, and conservative stalwarts in Sens. Ted Cruz of Texas and Mike Lee of Utah, who’d like to scrap the 2010 health care law outright.
Mr. Cruz, who frequently sparred with GOP leaders during the Obama administration, said he is ready to collaborate.
“I don’t think it’s productive to be drawing lines and ultimatums during the conversations,” Mr. Cruz said. “My focus is: How do we lower premiums?”
He said conservatives in the House pushed that bill in “a positive direction” by allowing states to waive certain strictures on insurers, though other senators have questioned whether the template would result in too many coverage losses or be unaffordable for poorer and older Americans.
“We’re writing a Senate bill. We’ll read and review the House bill — there’s good work there. Where we see good ideas, we’ll borrow them,” said Sen. Lamar Alexander, Tennessee Republican.
Senate Republicans said they’ll wait for a full report from the Congressional Budget Office before voting on their plan. The House moved ahead last week with only an estimate on a previous version.
Senators also will have to wait for the chamber’s referee — the parliamentarian — to say what provisions meet arcane rules needed to pass the bill as part of the budget process. Using the budget allows the GOP to avoid a Democratic filibuster.
“Our rules are different, we know we’ve got to have a CBO score,” said Sen. Jeff Flake, Arizona Republican. “Why not start fresh?”
Senate Republicans can only lose two votes from their 52-seat majority and still pass a bill, with Vice President Mike Pence serving as a tie-breaker. That gives Mr. McConnell little margin for error.
“He will have to take his time to listen to moderates and conservatives, and find the threads that keep them together,” said Darrell West, director of governance studies at the Brookings Institution. “Outsiders may chafe at how long it takes to produce a bill, but McConnell cannot rush through a bill and have any hope that it will pass.”
Democrats who passed the Affordable Care Act without a single GOP vote told Senate Republicans to turn back. They said the House bill polls poorly and appears to flout Mr. Trump’s own pledge to cover everybody.
“I hope my Republican friends toss this House bill out the window and resist the temptation to follow the same partisan, rushed process,” said Senate Minority Leader Charles E. Schumer, New York Democrat. “I hope my friends on the other side of the aisle drop repeal, which is hurting our health care system, right now, just the threat of it, and start working with Democrats to make our health care better.”
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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