With Chuck Todd reporting that as many as eight Republican Senators are leaning toward voting against Trumpcare, the Republicans’ Senate leadership faces a difficult road if it intends to accomplish its ambitious goal of sending the bill to President Donald Trump’s desk by the end of the week.
And unsurprisingly, they’re taking a hard line in whipping up votes, as the Hill reports…
“Do you want to be known as the Republican who killed the repeal of ObamaCare? That’s the question every GOP senator will weigh over the next week, and it’s an integral part of the Republican leadership’s strategy to get the prized legislation a step closer to President Trump.”
Senate Majority Leader Mitch McConnell is expected to force a vote this week, despite complaints from conservatives that his draft bill doesn’t really repeal Obamacare, and reservations from centrist Republicans who believe it goes too far. Three influential senators took to the weekend talk shows to discuss their reservations about the bill, with Sen. Susan Collins of Maine saying she feared the impact of Medicaid cuts on chronically ill constituents, while Sen. Rand Paul said the bill doesn’t go far enough in repealing regulations adopted under Obamacare.
During an appearance at a Koch Network donor summit over the weekend, Sen. John Cornyn said he expects procedural votes to begin Wednesday, though he admitted that the vote was “going to be close.”
The plan is to push the bill through before the Senate’s summer holiday begins at the end of the week.
As the Hill notes, McConnell has little margin for error, as he can afford just two defections from his conference with all Democrats expected to oppose the bill. Vice President Mike Pence could then be called in to break the tie.
Meanwhile, the Congressional Budget Office is expected to issue its analysis of the bill this week, which Politico notes could add to the leadership's difficulties.
“The CBO is poised to tell Senate Republicans this week that their health plan will leave millions more uninsured than Obamacare — with the losses estimated from 15 million to 22 million over a decade, according to a half dozen budget analysts polled by POLITICO.”
The report could be particularly problematic for three unconfirmed moderates, according to Politico.
“Still-uncommitted moderates like Sens. Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska) and Shelley Moore Capito (R-W.Va.), will face increasing pressure to oppose the bill. All hail from states that have expanded Medicaid, where hundreds of thousands of newly covered Americans may lose coverage.”
The CBO score of the House bill, which was released 10 days before an initially planned floor vote and projected a coverage decline of 24 million people, was a factor in House Speaker Paul Ryan's decision to cancel the vote in late March.
Here are some initial takeaways from the draft bill, which was unveiled last week:
Ends ACA mandates for individuals AND employers
Funds the ACA's cost-sharing subsidies through 2019 but then only provides tax credits for people with incomes up to 350% of the federal poverty level
Tax cuts largely similar to those in the House bill. That includes repealing a 3.8% tax on investment income retroactively to January 2017 and delaying the repeal of a 0.9% payroll tax until 2023
Contributes $62 billion to a "State Innovation Fund"
Seeks funding for insurers through 2021
Allows 'children' to stay on parental plans until the age of 26
Bill suspends 'Cadillac Tax' on employer health plans through 2025
Medicaid: The plan would roll back the Affordable Care Act’s Medicaid expansion more gradually than the House version would, but would ultimately make deeper cuts to the program. While states' funding from Washington would be capped for the first time in the history of the Medicaid program, states would be given a choice of the formula used -- 'block grants' or 'per capita caps' -- to curb it under the bill.
Planned Parenthood: The bill would strip federal funding from Planned Parenthood Federation of America for one year. It also prohibits tax credits from being used to purchase plans that offer abortion coverage.
You can read the full text of the bill here.