Republicans’ long-held plans to repeal Obamacare are again in serious doubt, with no clear timetable for a Senate vote following the surprise news that John McCain will be out as he recovers from surgery.
Senate Majority Leader Mitch McConnell (R-Ky.) shelved a vote planned for this week following the disclosure of McCain’s procedure, which leaves the GOP clearly short of support to advance the bill. McConnell’s office could give no new schedule for the vote, and most on Capitol Hill are waiting for a pathology report to assess how long it will be before McCain returns after undergoing surgery to remove a blood clot from above his eye.
Privately Republicans said the delay could be as little as a week as McCain recovers in Arizona, though others worried it could stretch for several weeks and jeopardize the entire repeal effort.
Whether the bill would advance even if McCain was in Washington is another question altogether, as the Arizona senator is one of more than half a dozen undecided Republicans, any one of whom could tank the bill.
The two GOP senators who publicly oppose the current draft of the legislation, conservative Rand Paul of Kentucky and centrist Susan Collins of Maine, appeared on several Sunday morning news shows to rain on the bill’s prospects. Both sounded doubtful that the bill would have advanced this week on a procedural vote even with McCain present.
“It would be extremely close,” Collins said on ABC’s “This Week.” “I would estimate that there are about eight to 10 Republican senators who have deep concerns, but how this would all translate out I’m not certain. And I never underestimate Leader McConnell’s skills.”
Asked on “Fox News Sunday” if McConnell has the support of at least 50 Republicans needed to begin debate on the bill, Paul answered bluntly: “I don’t think right now he does.” He said on CBS’S "Face the Nation” that the longer the bill’s consideration drags on, the less conservatives will like it.
If one more skeptical senator comes out against the bill, McCain absence would be moot.
And the fatal blow could come as soon as Monday, when the Congressional Budget Office is expected to release its analysis of Republicans’ latest plan. Several wavering GOP senators have said they are waiting to hear from the non-partisan agency before announcing their position.
The CBO projected that 22 million fewer Americans would have health insurance over a decade and that premiums would initially rise sharply for some people under Senate Republicans’ previous plan. McConnell was forced to delay a vote on the bill last month after it was clear he lacked the votes to pass it.
McConnell’s chief deputy, Majority Whip John Cornyn of Texas, suggested the vote’s timing would be based on McCain’s return.
“As soon as we have a full contingent of senators, we’ll have that vote. It’s important we do so,” Cornyn said on NBC’s “Meet the Press.” “Health care is hard. And we know that. But we have no choice.”
He said if the bill fails this summer, the GOP will “keep trying” on a solution but acknowledged the party may have to come up with a “different plan.”
McConnell revised the bill after intense negotiations last week in an attempt to win more votes. He included a divisive amendment from Sen. Ted Cruz (R-Texas) that would allow the sale of cheap health plans that lacked Obamacare consumer protections as long as Obamacare-compliant plans were still sold by insurers.
Some Republicans doubted that the CBO would have time to analyze the complex amendment before a vote this week; the delay may give the non-partisan budget-crunchers sufficient time to figure out how the proposal would affect premiums and insurance coverage.
McConnell’s latest draft also left in place some of Obamacare’s tax increases, plowed $70 billion more into lowering premiums, allowed pre-tax dollars to pay for insurance premiums and delivered $45 billion to fight opioid addiction.
The White House has also been increasingly engaged in the whip process — and hasn’t given up on Collins and Paul either. Paul has spoken to Trump about health care recently, while Collins has heard from Trump’s chief of staff, Reince Priebus.
The Trump administration’s top Medicaid official, Seema Verma, spent the weekend trying to persuade governors and senators that those changes will blunt the reductions in Medicaid spending and the phase-out of Obamacare’s Medicaid expansion under the “Better Care Reconciliation Act.”
“BCRA includes the funding states need to provide healthcare freedom and choices for people whose only option under ACA was Medicaid,” Verma said in a statement Sunday.
Yet those additions have not yet garnered the support of 50 votes to even start debate on the bill and have not convinced wavering GOP governors like Brian Sandoval of Nevada, who is advising Sen. Dean Heller (R-Nev.) on the bill. Heller is the most vulnerable GOP senator up for reelection next year and his opposition to the previous version helped delay last month’s vote.
“I am struggling to validate the numbers that are being presented to me by the administration versus what I’m hearing from independent [experts],” said Sandoval at a governors’ conference in Rhode Island.
Cruz signed on to the latest version after his amendment was included, but a number of Republicans remain undecided on voting to advance the legislation, including: Shelley Moore Capito of West Virginia, Rob Portman of Ohio, Mike Lee of Utah, Lisa Murkowski of Alaska, John Hoeven of North Dakota, Jeff Flake of Arizona, McCain and Heller.
Moderate Republicans still worry about the Medicaid cuts, while conservatives complain that not enough of Obamacare would be dismantled. And any major changes to the bill to mollify critics could squeeze out votes on the right or in the center.
In his weekend address, President Donald Trump insisted that things were moving his way: “We are very, very close to ending this healthcare nightmare. We are so close.”
Paul and other conservatives — and occasionally the president himself — have suggested that the GOP should move back to a repeal of the health care law and then figure out the replacement later if McConnell’s latest draft falls flat.
But such a plan almost certainly cannot pass the Senate, despite being supported by almost all GOP lawmakers just two years ago.
On “Fox News Sunday,” Michael Needham, president of the conservative Heritage Action for America, estimated there are 20 votes at most for full repeal of Obamacare.
"The Republican Party wasn’t serious about repealing,” Needham said.
While McConnell and his leadership team hunt for votes this week on health care, action on the floor will focus on other, potentially less controversial issues.
The Senate may consider an extension of Food and Drug Administration user fees as well as lower level nominees while McCain is out, according to Republicans. The Senate may also try to raise the debt ceiling; Trump administration officials have urged Congress to extend the government’s borrowing limit by the end of this month. A massive defense policy bill is also possible, though the absence of McCain, the Senate Armed Services Committee chairman, makes that less likely.
McConnell canceled two weeks of the August recess last week as GOP senators grew antsy at the swelling workload. That leaves the Kentucky Republican the option of bringing up the health care bill in August if McCain is able to return and they can find the votes to pass it.
Jennifer Haberkorn and Rachana Pradhan contributed to this report.