Senate Republicans say they’re weeks away from healthcare vote

Republican senators are downplaying the chances of a quick vote next week on their ObamaCare replacement bill amid divisions in the party over what the legislation should look like. 

“We’re still several weeks away from a vote, I think,” Sen. Pat Toomey (R-Pa.) said at an event Wednesday. 

Likewise, Sen. Ted Cruz (R-Texas) said in a radio interview on Wednesday that a vote could happen “in the next several weeks.”

Senate Republicans had originally planned to vote on the bill last week, before the July Fourth recess, but leaders delayed action when it became clear the measure would fail to clear a procedural hurdle.

Senate Majority Leader Mitch McConnell (R-Ky.) said after announcing the delay last week the vote on the bill would occur in a “couple weeks.”

Leaders have set an ultimate deadline of the end of July, before Congress leaves for its August recess. 

McConnell is now looking to make changes to the bill to win support, but faces a tough task in threading the needle between the demands of conservatives and centrists.

Leaders are expected to include $45 billion in the legislation for fighting opioid abuse in a bid to win over moderate Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.). But those two senators they also want Medicaid cuts in the bill to be eased, which is a thornier matter. 

Other moderates are even firmer in their opposition to the bill. Sens. Susan Collins (R-Maine) and Dean Heller (R-Nev.) have indicated the legislation would need to be overhauled substantially before they could support it. They have pointed to issues like Medicaid cuts and the 22 million more people who are expected to be uninsured over a decade if the bill becomes law.

Even some senators not normally known for bucking leadership are opposed to the current version. Sen. John Hoeven (R-N.D.) said Wednesday that he “doesn’t support the bill as it stands,” according to The Bismarck Tribune.

Meanwhile, conservatives opposed to the measure are tugging in the other direction. Sens. Cruz and Mike Lee (R-Utah) say adding a change to allow insurers to sell plans that don’t meet ObamaCare regulations would win their votes. That would allow cheaper plans that don’t cover as many healthcare services to be sold.

But many other Republican senators oppose that change because they worry it would undermine protections for people with pre-existing conditions by leaving only sick people in the ObamaCare-compliant plans, spiking their premiums. 

“The challenge is we’ve got a bunch of moderate Republicans who want to keep those mandates,” Cruz said in a radio interview Wednesday, referring to the ObamaCare regulations. Those regulations include “essential health benefits,” which mandate services a plan must cover, and community rating, which prevents people with pre-existing conditions from being charged more.  

“If we include the consumer freedom amendment, I think conservatives will support this bill, it would make it a much better bill, but that remains an open question,” Cruz said. “I think we’re going to have some vigorous debates over the coming days and the coming weeks on that question.” 

Conservative Senate aides have floated a possible deal where moderates would get some of the changes they want to ease the Medicaid cuts in the bill, while conservatives would get some of what they want on loosening ObamaCare’s regulations. 

But the more moderate senators worried about pre-existing conditions might not agree to such a tradeoff. 

“There’s no attempt whatsoever to do away with pre-existing condition [protections]” Sen. Bob Corker (R-Tenn.) told a pair of constituents opposed to the bill in a video posted by a Chattanooga Times Free Press reporter on Thursday.

Corker is pushing not to repeal an ObamaCare tax on the wealthy in order to fund increased subsidies for low-income people in the bill. But conservatives have been pushing back on the idea of not repealing all of the ObamaCare taxes.   

Leaders sent two versions of a revised bill to the Congressional Budget Office (CBO) for analysis over the recess, one with the Cruz amendment and one without.

A conservative aide said leadership has not been specific about what would be needed in the CBO analysis for the change to be included, though.   

Just three Republican senators voting “no” would sink the bill, as Republicans have a narrow 52-48 majority.

“We’ve got to get 50 out of those 52 and that is not easy because you’ve got views all over the spectrum, all over the map,” Cruz said.