Health Care

Republicans struggle to keep ObamaCare repeal alive

Senate Republicans are struggling to find a path forward on their latest bid to repeal and replace ObamaCare, in the face of ongoing resistance within their own party.

GOP leadership is heading toward a potential vote this week on a bill from GOP Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.) without 50 votes locked down. 

Two more senators on Sunday indicated resistance to the bill in its current form, and if they turn into hard “no” votes – added to the opposition already announced – then Republicans will not be able to pass the bill.

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Backers of the bill—including Cassidy and Graham, as well as Trump administration officials—insisted during Sunday show appearances that the legislation, that replaces ObamaCare’s Medicaid expansion and insurance subsidies with block grants, could still pass the Senate this week.

“It’s not dead,” Marc Short, the White House director of legislative affairs, told “Fox News Sunday.” “Here we are, just days away from a final vote and we’ve trying to win over the support of the last couple senators to get there.”

Short added that he anticipated a vote on the healthcare legislation to come up on Wednesday. Senate Majority Leader Mitch McConnell (R-Ky.) hasn’t formally scheduled a vote but said last week that he “intends” to bring up ObamaCare repeal.

Graham and Cassidy separately insisted during a joint interview on ABC News that they thought they could get the bill across the finish line despite an increasingly uphill battle.

“I think we’re going to get the votes next week. We’re using the exact same process the Democrats did to pass ObamaCare,” Graham said.

GOP leadership faces no room for error if they want to pass the legislation by Cassidy and Graham, which is also co-sponsored by GOP Sens. Ron Johnson (Wis.) and Dean Heller (Nev.).

The Republicans have 52 seats and need 50 senators to back the proposal while depending on Vice President Mike Pence break a tie. GOP Sens. John McCain (R-Ariz.), a close friend of Graham’s, and Rand Paul (Ky.), have both said they are “no” votes.

And hurdles for the legislation continued to crop up on Sunday, with key holdouts questioning whether they will be able to support the bill.

“It’s very difficult for me to envision a scenario where I would end up voting for this bill,” GOP Sen. Susan Collins (R-Maine) told CNN’s “State of the Union.”

She added that she had a handful of “serious reservations” about the bill, including its impact on pre-existing conditions, Medicaid and the cost and coverage levels for health insurance.

Separately, Sen. Ted Cruz (R-Texas) said he is not prepared to support the Graham-Cassidy bill at the moment, and predicted that Sen. Mike Lee (R-Utah) isn’t voting for it either.

“Right now they don’t have my vote and I don’t think they have Mike Lee’s either,” Cruz told the Texas Tribune.

Cruz, noting that he wants to get to “yes” on the bill, said he and Lee are pushing for changes to the legislation.

“We said if you take these edits we’re a yes. They took our edits and then a day later they removed our edits,” Cruz added.

The comments underscore the herculean task currently facing leadership: with Paul and McCain as “no” votes, leadership has to win over every other member of the Republican caucus that ranges from moderates to firebrand conservatives.

Senators and the White House are involved in a spate of final hour negotiations as they try to win over several key holdouts.

Graham, echoing a tweet from Saturday by President Trump, said he thought they could potentially win back Paul—an uphill effort that could give them more leeway.

“I think Senator Paul associated health plan married up with our bill changes health care,” the South Carolina senator said.

Short added that “we hope we can earn his support, because when else would he get the opportunity to vote on a bill that actually provides real entitlement reform.”

Republicans are under a tight timeline to try to clear ObamaCare repeal by a simple majority. The special fiscal year 2017 budget rules that allow them to avoid a Democratic filibuster expire at the end of the month.

Though Cruz called Sept. 30 a “bogus deadline,” the Senate parliamentarian has determined that the current rules expire at the end of the fiscal year.

Republicans could package rules for healthcare into their fiscal year 2018 budget, though that could complicate their effort to pass tax reform.

But Paul appeared dug in on his opposition to Graham-Cassidy without substantial changes.

“They could remove the block grants from it and then we could vote on actually what we all agree on,” he told NBC’s “Meet the Press,” adding that the block grants create a “food fight” among the states.

The block grants, however, are a key part of the legislation.