Senate Republicans are casting doubt on their leaders’ plans to vote this week on repealing Obamacare, with lawmakers from all wings of the party so far withholding support from the massive reshaping of the health care law that they campaigned on for seven years.
Majority Leader Mitch McConnell of Kentucky faces problems from seemingly every corner of his conference, and — from wary moderates to conservatives and even leadership allies — few Republicans were willing Sunday to predict the Senate repeal bill could pass this week, before lawmakers leave Washington for a weeklong July 4 recess.
Sen. Susan Collins (R-Maine) outlined “very serious concerns” about GOP leaders’ bill on ABC’s “This Week,” saying that “it’s certainly going to be very difficult” for McConnell to win the 50 votes he needs to pass it on such a tight time frame.
Collins said her biggest problems with the Republican Obamacare repeal bill are its steep Medicaid cuts and effects on older Americans’ premiums. The draft would let insurers charge older people more for plans than Obamacare does.
On the other ideological end of the GOP Conference, conservatives were also flashing yellow lights.
“There’s no way we should be voting on this” before the recess, Sen. Ron Johnson (R-Wis.) told NBC’s “Meet the Press,” urging his party’s leaders to “not rush this process.”
Senate Majority Whip John Cornyn, speaking to reporters at the Koch Brothers’ donor conference in Colorado Springs, said he was unsure if Republicans would be able to round up the votes. He said the party needed to move quickly, and things were on schedule for a vote this week.
“We don’t have the luxury of waiting around. It’s not going to get easier,” Cornyn said, identifying Aug. 1 as a “drop-dead line.”
Asked if President Donald Trump was doing enough to help the bill over the finish line, the Texas Republican responded: “We’re trying to hold him back a little bit.”
It is not yet clear what changes McConnell would accept to win over critics. An attempt in the House of Representatives in March to quickly push through Obamacare repeal legislation was unsuccessful, but Republicans narrowly passed a tweaked version a little more than a month later. GOP leaders, including President Donald Trump, have said the Senate draft is open to negotiation.
Still, the surprising level of criticism from Republicans so far — no Democrats are expected to support repealing Obamacare — has made Senate leaders’ goal to vote this week seem optimistic.
Johnson, for example, emerged as an unexpected skeptic after the push to repeal Obamacare helped propel him into office in 2010. He joined three other conservatives Thursday — just hours after McConnell released the details — to announce they would not vote for the legislation in its current form.
The GOP leadership’s problems grew deeper on Friday, when Sen. Dean Heller of Nevada, widely viewed as the most vulnerable Republican senator on the ballot next year, also came out in opposition to the bill.
In addition to the five senators who have announced that they don’t support the Republican health care measure as currently written, several others remain publicly up in the air.
“Right now, I am undecided,” said Sen. Bill Cassidy (R-La.), who had crafted an Obamacare alternative with Collins that had gained little traction with the rest of the conference. “There are things in this bill that adversely affect my state that are peculiar to my state.”
Cassidy urged Senate GOP leaders to slow the bill down: “I don’t know quite why the rush.”
“I, frankly, would like more days to consider this,” Cassidy said. “That’ll probably be a discussion coming back. I think a few more days to consider will be helpful.”
Republicans are also facing resistance from key governors worried about the bill’s cuts to Medicaid. Anda forthcoming estimate from the Congressional Budget Office about the bill’s impact on premiums and the number of the uninsured could turn off lawmakers who are on the fence.
The CBO report is expected early this week. On “Fox News Sunday,” Health and Human Services Secretary Tom Price attempted to pre-empt the analysis by arguing that the agency has been “woefully inadequate” in predicting the coverage impact of health care measures.
Rural health groups, medical organizations and other hospital associations have already come out in opposition. During a debate on “Fox News Sunday,” Sen. Dick Durbin (D-Ill.) pointedly noted to Sen. John Barrasso (R-Wyo.) that the head of the Wyoming Hospital Association and the CEO of a major Wyoming hospital had both announced opposition to the GOP health care measure. (Barrasso responded that the hospital CEO hadn’t read the bill.)
Republican Ohio Gov. John Kasich on Sunday declined to urge Sen. Rob Portman (R-Ohio) to oppose the bill but underscored his own opposition.
"I’m not saying just kill the bill," Kasich told CNN. "Let’s get something that is going to work … stabilizing all these issues around insurance and coverage, and then get to the heart of the matter, which is the rising costs of health care — frankly, which this bill doesn’t begin to even do."
Planned Parenthood remains a sticking point for some; the bill cuts off its federal funding for a year. Collins, who along with Sen. Lisa Murkowski (R-Alaska) opposes defunding the women’s health group, said Sunday that she is “optimistic we’ll prevail” on that issue, though removing that language could alienate social conservatives who have long advocated cutting funds for Planned Parenthood.
Another conservative opposing GOP leaders’ current bill, Sen. Rand Paul (R-Ky.) said on Sunday that his party’s leadership has “promised too much.” He focused his frustration on how much the GOP repeal bill leaves intact Obamacare’s subsidies for health coverage.
“I will get to yes if they change their approach,” Paul said in an interview with ABC. “And will they change their approach if they don’t get 50? I think they ought to. Why don’t we whittle it down to what the whole caucus agrees on?”
Administration officials and Senate leaders tried to downplay the internal discord, saying they would work with Paul, Heller, Johnson and Sens. Ted Cruz of Texas and Mike Lee of Utah to modify the bill to win them over.
“Every one of them is committed to a fundamental change away from Obamacare and central government control and into local control and patients making decisions,” Barrasso, a member of leadership, said of the five GOP holdouts.
Barrasso added: “I believe we’ll get it passed, and that’s the only way we can fundamentally change away from Obamacare.”
Nebraska Sen. Ben Sasse, speaking to donors, said he was about 40 percent done reading the legislation. But he wasn’t prepared to say he would vote for it. Koch network leaders have been critical of the proposal, but haven’t announced outright opposition.
“This is largely a Medicaid reform package,” Sasse said, lamenting Republicans didn’t have the 60 votes necessary for a “full repeal or full replace piece of legislation.”
Pressed by the moderator for a position, Sasse dodged. “This session is actually on the record, right? There’s press here?,” he said. “I have nothing to announce today.”
Sen. Pat Toomey (R-Pa.), speaking on CBS’ “Face the Nation,” also stressed to his conservative colleagues that the GOP measure was a “first step” and “not the last step.” Meanwhile, Price argued that the legislation would stabilize insurance markets so insurers would return to communities they’ve recently abandoned, while offering flexibility to both consumers and to states.
“It’s significant reform,” Price said on Fox. “It’s a move in a much better direction, because it is a patient-centered move.”
If McConnell cannot muster 50 votes to take up his Obamacare repeal bill this week, it remains unclear whether he would return to the effort after July 4 or move on to other top GOP priorities, including tax cuts and raising the federal debt limit.
“I think they have, at best, a 50-50 chance of passing this bill,” Senate Minority Leader Chuck Schumer of New York said on “This Week.”
Should Republicans fail to push repeal through the Senate, Schumer said, he would reach out to the White House to renew his offer of a bipartisan discussion on ways to fix Obamacare without repealing the law.
Some Republicans said they thought McConnell could still pull it off.
“This is still a work in progress, although the leader of the United States Senate is very good at establishing coalitions to see that legislation passes,” Sen. Jerry Moran (R-Kan.) said on Fox’s “Sunday Futures.” “I just don’t know whether the votes will be there by the end of the week.”
Kevin Robillard contributed to this report.