Senate Republicans’ uncertain efforts to repeal Obamacare are at a crossroads, with GOP leaders pressing members to make decisions on moving forward and pushing for a vote by the end of June, according to senators and aides.
After spending a month deliberating over a response to the House’s passage of a bill to repeal the law, Senate Majority Leader Mitch McConnell (R-Ky.) is accelerating the party’s stagnant work as a jam-packed fall agenda confronts congressional leaders and President Donald Trump. Republican leaders want resolution to the tumultuous Obamacare repeal debate by the Fourth of July recess, Republican sources said, to ensure that the whole year isn’t consumed by health care and that the GOP leaves room to consider tax reform.
It’s a gut-check situation for Republicans, who are about to be confronted with tough choices that may result in millions fewer people with insurance coverage as a condition for cutting taxes and lowering some people’s premiums.
“I don’t think this gets better over time,” said Sen. Roy Blunt (R-Mo.), a member of leadership. “So my personal view is we’ve got until now and the Fourth of July to decide if the votes are there or not. And I hope they are.”
Senate staff spent last week and the weekend writing the bill but left some key decisions blank. At a party lunch on Tuesday, McConnell and his deputies will present an early blueprint of the party’s health care overhaul efforts as well as several potential solutions for moving forward on internal divisions.
The GOP is getting close to a framework on how to reduce premiums, and there is general agreement on more generous tax subsidies than those the House passed, with the Congressional Budget Office assessing those proposals’ budgetary impact. Some of the thorniest policy decisions remaining include when to roll back Obamacare’s Medicaid expansion and how much to cut Medicaid overall: Sen. Shelley Moore Capito (R-W.Va.) said on Monday she isn’t yet committing to a bill that phases out the expansion.
Sen. Susan Collins (R-Maine) said: “Just listening to the debate over the past few weeks, I think cobbling together a bill that could get 50 votes is going to be a challenge, but you never know.”
Those divisions are not being soothed by the party’s thrice-weekly health care lunches and twice-weekly working group meetings. Now GOP leaders are confronting a painful choice: craft a bill that can get 50 of the party’s 52 votes or demonstrate that Republicans are simply too divided for success despite their years-long crusade against the law.
“There’s a huge reason we have to get 50 on this,” said Sen. John Thune of South Dakota, the No. 3 Senate Republican. “We’re going to have a vote one way or the other. But if we don’t pass something, and we go into ’18? It’s on us to try and get this fixed.”
Early drafts of legislation could be released by the end of this week, according to GOP sources. Republicans are “thinking we’ll be able to make progress on drafting the legislation” once senators make additional decisions, a Senate source said. People working on the legislation said they hope those decisions occur on Tuesday.
But with so much at stake and several senators offering gloomy forecasts of the party’s work in recent days, Senate Republican leaders have been leery of committing to a definite timeline, given that it could take weeks for the CBO to vet their legislation.
“We have to do it before we get out of here in August,” said Majority Whip John Cornyn of Texas.
“We pretty much know what we have to do. We’ve talked about it for seven years. I wouldn’t want to necessarily rush it, but it’s hard to think it’s necessarily going to go beyond July.”
McConnell has made it increasingly clear to his members that his preference is to deal with the issue before July to avoid weighing down the rest of Republicans’ agenda. In addition to working on tax reform, Republicans need to begin planning to avoid default and a government shutdown in the fall.
“He wants to be done with this one way or the other,” said one person familiar with the negotiations.
To vote by June 30, Republicans would have to have their bill to the CBO about two weeks prior.
Unlike the House, the Senate needs to have the score before its members vote on the bill because they are required to come up with $133 billion in savings. Staff has already started early discussions with CBO on pieces of what could be in the bill. That gives the Senate only about 10 more calendar days to finalize its legislation.
If a repeal bill is approved by the Senate by June 30, Republicans would still have one month before the August recess to merge the House and Senate bills, which are expected to have major differences.
If the Senate vote fails, Republican leaders want to have a decisive end to the Obamacare repeal debate and move on to tax reform while potentially making more piecemeal changes to the health care law to combat spiking premiums and unstable insurance markets.
Republicans are also hoping that the House-passed bill will soon officially move to the Senate, something that won’t happen until the GOP is confident that it cleared all the procedural requirements to keep the repeal process moving. While the Senate will write its own bill, the House bill cannot violate Senate rules or the measure would have to go through the House again. The parliamentarian is expected to make a ruling this week, according to a person briefed on the matter.
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