Republican Leaders Hope to Stage Healthcare Vote Next Week

Senate Republican leaders are hoping to stage a vote on their healthcare bill next week, though internal disagreements over issues like coverage requirements and Medicaid cuts leave the timing and even the measure’s fate in question.

“We need to start voting” on the GOP bill scuttling much of President Barack Obama’s healthcare law, Senate GOP leader John Cornyn of Texas told reporters Monday. Some Republicans said a revised version of the bill could be introduced Thursday, and Cornyn said the “goal” was for a vote next week.

Moreover, Cornyn cited seven years of unresolved Republican debate over how to replace the 2010 statute during which “we gain a vote, we lose a vote.” That underscored a sense among top Republicans that they had little to gain by letting their disputes drag on much further.

Consensus on a replacement seemed more remote than ever as senators returned to the Capitol from a July Fourth recess. Senate Majority Leader Mitch McConnell, who crafted the bill largely in secret, postponed a vote last month in the face of certain defeat. Republicans were hearing divergent messages from the White House Monday. President Donald Trump pressured GOP senators to pass the measure quickly, while Vice President Mike Pence suggested they might have to revert to a straightforward “Obamacare” repeal if they can’t agree on an alternative.

McConnell has little room for error as he tries to pass a bill with 50 GOP votes, and Pence as the tie-breaker, in a Senate Republicans control by 52-48. All Democrats are opposed.

At least a dozen Republicans oppose or challenge parts of McConnell’s bill. Hence, the leader has been working on revisions aimed at bringing more GOP senators on board. Final decisions remain to be made on how tightly to curb the growth of Medicaid, the health insurance program for the poor, whether to let insurers sell low-cost policies with very limited coverage, and how much money to devote to making healthcare tax credits more generous, said No. 3 Senate Republican John Thune of South Dakota.

Congress is beginning a three-week sprint toward its traditional five-week August recess, and GOP leaders want to finish work on the measure by then. Some lawmakers have suggested the break should be shortened or canceled if they can’t get healthcare done first, though that’s unlikely to happen.

“I cannot imagine that Congress would dare to leave Washington without a beautiful new healthcare bill fully approved and ready to go!” Trump tweeted early Monday.
Hours later, Trump emphasized another approach Trump has at times suggested.

“We believe if they can’t pass this carefully crafted repeal and replace bill, do those two things simultaneously, we ought to just repeal only,” and then turn to replacement legislation later on, Pence told conservative radio host Rush Limbaugh.

Many Republicans oppose repealing Obama’s law without also enacting an alternative to give that tactic much chance of succeeding.

To succeed, the new legislation will have to address the concerns of conservatives like Mike Lee of Utah and Ted Cruz of Texas, who want a more full-blown repeal, and moderates like Susan Collins of Maine and Lisa Murkowski of Alaska, who want essentially the opposite, a more generous bill.