For a day at least, Senate Majority Leader Mitch McConnell has his party’s beleaguered efforts to repeal Obamacare back on track.
After two weeks of increasingly dour assessments from Republicans on the party’s stalled health care efforts, Senate Republicans emerged from more than two hours of meeting with a fresh burst of optimism that they could actually pass a bill to repeal and replace the health law.
Sen. Lindsey Graham went into Tuesday’s party lunch predicting that the Republican effort to gut Obamacare was “more likely to fail than not.”
He emerged singing a different tune: The health care overhaul he heard about contains “promising proposals” and he was for holding a vote this month after the Congressional Budget Office weighs in and the party’s idea are put into legislative form.
“Now I say promising, but I don’t know what it looks like legislatively … the key word is promising,” Graham said. “There better be [a vote this month], because this is not like fine wine, it does not get better with age.”
Ditto Sen. Bill Cassidy (R-La.), who has been outspoken about his concerns on the direction the party has taken, but now says he is feeling increasingly comfortable and "very encouraged" by Republicans’ plans.
"Of course it’s not everything I want, but that’s life," Cassidy told reporters Tuesday.
Though senators said McConnell, his deputies and key chairmen and Senate staff did not present a clear-cut legislative framework to them after two key meetings, the Senate’s proposal for repealing and replacing Obamacare is slowly coming into focus as the Kentucky Republican presses for a vote before the July Fourth recess.
Senate Republicans expect their bill to be more generous than the House-passed measure in almost every way: A longer runway for ending the Medicaid expansion, more money for insurance market stabilization to lower premiums and beefed up tax credits for Americans of lower income, senators said. But no decisions have been made on some key policy questions, including on handling Medicaid. Still, it’s almost impossible for the public to assess what precisely Republicans are working on — the GOP is writing the bill behind closed doors and with no committee hearings.
And while the bill is not drafted or finished, Republicans said they were zeroing in on a final product that could be passed. At the party lunch, McConnell told his colleagues that “failure is not an option” and that the Senate has “to lead,” senators said.
Asked whether McConnell would put up a vote purposefully designed to fail so the party could move on to other issues, Sen. Pat Roberts (R-Kan.) replied: “He sure as hell doesn’t want to do that.”
“We’re in the back seat with Thelma and Louise and we need to get out of the car. So details matter, but we need to get out of the car. That was the pre-eminent message,” Roberts said. “The upshot is: This has to happen.”
While the ultimate whip count for a bill that must get 50 of the Senate GOP’s 52 members’ support lies in the details and CBO’s projections for coverage losses and insurance premium decreases, the mood of the party has noticeably improved in the short term. In part, it’s because Republicans are more comfortable after staffers gave them a PowerPoint presentation laying out the path forward and what would happen if they do nothing.
"I don’t think we’re there yet. We’re not there yet on all of my issues. But we’re getting closer,” said Sen. Shelley Moore Capito (R-W.Va.), who is trying to protect her state’s Medicaid expansion.
But there’s also a sense that the GOP is eager to get the divisive health care debate off its plate.
"There’s a general agreement that we cannot still let a failed program stay in place,” said Sen. Thom Tillis (R-N.C.). “The key here is we have so many other things that we have to do. We’ve got tax issues to work, we’ve got infrastructure. We’ve got to continue to move forward.”
Whether the rush to a vote produces passage is uncertain, and not all of the party’s pessimism has dissipated. Sen. Richard Burr (R-N.C.), who was unable to attend the meeting, said “given the differences, it’s hard for me to envision how [Republicans] come together.” And as the bill moved toward the political center and made Cassidy and Graham feel better, some conservatives seemed alienated, according to senators and aides.
“If I go back to the people who elected me to repeal Obamacare, they’re going to say you’re keeping 90 percent of it and you’re not fixing the problem,” said Sen. Rand Paul (R-Ky.).
But McConnell may be able to triumph without Paul, and he’s pressing for fast action ahead of a legislative pile-up that includes big-ticket agenda items as well as must-pass bills to fund the government and raise the debt ceiling.
McConnell and his leadership team hope to have a preliminary framework submitted to CBO by the end of the week and a floor vote by month’s end, Republican sources said. On Tuesday, the Senate Budget Committee said the House bill cleared the Senate’s stringent reconciliation rules, allowing the House to formally send the bill to the Senate. Otherwise, the House would have had to vote again on a modified bill, further derailing the repeal effort.
There is general GOP consensus around boosting the tax subsidies in the House bill and a general framework of how to reduce premiums. An agreement on Medicaid is unlikely this week, Republicans said, but progress on premiums is more doable.
Senate Republicans also appear poised to preserve the Obamacare pre-existing condition protections. The House bill allowed states to opt out of rules that required insurance companies to charge everyone the same, with few exceptions. That opened the GOP members up to charges that they were harming people with pre-existing conditions.
McConnell told reporters on Tuesday that the GOP is making progress on the repeal plan, but refused to offer specifics. He also downplayed the pressure facing Republicans to coalesce on a single plan during this week’s series of gatherings.
"We’ve had plenty of time to discuss this issue," he said. "I wouldn’t say that this meeting was pivotal."
After speaking to reporters, McConnell and Senate Majority Whip John Cornyn (R-Texas) traveled to the White House to meet with President Donald Trump and House GOP leadership.
And while Senate Republicans aren’t guaranteeing they will pass a health care bill despite a more optimistic day of meetings, the president had no problem predicting victory.
The "Senate I’m sure will follow suit and get a bill across the finish line this summer that will be great health care for Americans,” Trump told reporters ahead of his meeting with congressional leaders.