- The Washington Times - Wednesday, July 19, 2017

A combative President Trump launched an urgent, last-ditch bid Wednesday to revive an Obamacare repeal effort that had been left for dead just 24 hours earlier, imploring Senate Republicans to stay in Washington until the job is done and warning that failure would decimate the party and its agenda.

“I’m ready to act,” Mr. Trump said at the White House. “For seven years you’ve promised the American people that you would repeal Obamacare. People are hurting. Inaction is not an option.”

The urgent public plea marked a confrontational shift in tone for Mr. Trump, who had been lobbying senators mainly behind the scenes, and a renewed commitment to the effort. One day earlier, Mr. Trump said Republicans should force Democrats to own Obamacare by letting it collapse under its unsustainable weight.

Mr. Trump got personal at times, leaning into Sen. Dean Heller, a Nevada Republican who faces a tough re-election battle next year and is wary of backing the repeal-and-replace effort.

“He wants to remain a senator, doesn’t he?” Mr. Trump said to laughter.

It’s unclear whether the eleventh-hour gambit will work. Several moderates are still concerned about reining in the Medicaid program for the poor, while a Plan B to repeal Obamacare now and replace it later would sow uncertainty in the insurance markets and leave more than 30 million Americans without health care coverage by 2026, according to budget estimates.

Senate Majority Leader Mitch McConnell, Kentucky Republican, said he will force his members to stand up and be counted next week when he moves to bring a House-passed health care bill to the floor to kick-start debate on Senate measures.

“We cannot keep the commitment we’ve made to the American people to repeal and replace Obamacare unless we get on the bill,” Mr. McConnell said.

A sufficient number of Republicans had threatened to link arms with Democrats and sink efforts to bring a replacement bill or a fallback plan that would gut Obamacare and give Congress two years to devise a new program.

Sen. Susan M. Collins of Maine was the only Republican to object to both options, at least openly, so Republican leaders could be hoping to leave things flexible enough to avoid more than two defections from their 52-seat majority for the procedural motion, with Vice President Mike Pence serving as a tie-breaker if necessary.

“There is a large majority in our conference that want to demonstrate to the American people that they intend to keep the commitment they made in four straight elections to repeal Obamacare,” Mr. McConnell said. “I think we all agree it’s better to both repeal and replace. But we could have a vote on either.”

Senators are free to offer a plethora of amendments once the chamber takes up either plan, leaders said, so Republicans will have options and can vote to tweak the underlying proposals.

“Any senator who votes against starting debate is really telling America that you’re fine with Obamacare,” Mr. Trump said.

Conservative groups furious at wavering Republicans piled on. Some threatened to present Senate Republicans who resist repeal with busts of Benedict Arnold, the Revolutionary War turncoat.

“They have to choose. Do they want to be traitors? Do they want to be the next Arlen Specters or Charlie Crists?” said Club for Growth President David McIntosh, referring to notable Republicans who switched to the Democratic Party.

Yet some moderate Republicans are itching to move on. They say party leaders should return to regular order and include Democrats, governors and other stakeholders in the health care reform process after attempts to draft an Obamacare replacement in secret and pass it on Republican votes alone fell short.

“I’d like to get some hearings going in the health committee,” Sen. Lisa Murkowski, Alaska Republican, said Wednesday on her way to a floor vote.

Sen. Lamar Alexander, Tennessee Republican and chairman of the Senate Committee on Health, Education, Labor and Pensions, said he will schedule hearings on ways to stabilize the insurance markets in the short term, regardless of how the vote turns out next week.

Sen. John McCain, an Arizona Republican whose recent surgery forced him to recover at home this week, also called on Senate leaders to “receive input from members of both parties.”

The Congressional Budget Office said the replacement plan that stalled this week would have resulted in 22 million fewer people holding insurance a decade from now. The “repeal, then replace” option would result in 32 million fewer Americans with coverage, the CBO said Wednesday.

The CBO said the repeal-only plan — President Obama vetoed an identical one about 18 months ago — would save $473 billion, but premiums would increase by 25 percent compared with current law in 2018, by 50 percent in 2020 and double by 2026.

Also Wednesday, The Associated Press-NORC Center for Public Affairs Research survey showed only 13 percent of Americans support repealing the health care law without a replacement in hand. It said 8 in 10 believe Republicans should offer to negotiate with Democrats if their own effort fails.

Democrats said Republicans should cut their losses and work on bipartisan fixes to the current program, which failed to attract enough young and healthy people in the early rounds.

Senate Minority Leader Charles E. Schumer, New York Democrat, said allowing the markets to crumble, as Mr. Trump suggested before renewing his replacement push, would be unconscionable.

“President Trump’s promise to let our health care system collapse is so, so wrong on three counts,” he said. “It’s a failure morally, it’s a failure politically and it’s a remarkable failure of presidential leadership.”

The White House said it would make the latest round of cost-sharing payments that reimburse insurers that lose money on low-income customers’ costs, but it hasn’t made a long-term commitment to the payments.

Mr. Schumer urged Congress to do three things immediately to prop up the markets: guarantee funding for cost-sharing payments, establish a reinsurance program that backstops insurers that take on high-cost customers and let people in counties without any insurers on their Obamacare exchanges shop on the D.C. small-business portal that members of Congress use.

“These proposals are specific, nonideological and could pass quickly and make life better for millions of Americans,” he said.

But conservatives said if Senate Republicans continue to flounder on repeal, the near-term fight is to block Democratic measures that look like more Obamacare.

“Make no mistake, when lawmakers call for ‘bipartisan market stabilization’ they mean more taxpayer money and more regulations,” said Heritage Action for America, a conservative pressure group. “That approach is unacceptable.”

A slate of Republican holdouts were scheduled to huddle in the Capitol late Wednesday, hoping to make progress on the replacement effort.

White House legislative affairs director Marc Short said the president discussed with Senate Republicans the devolving of Medicaid programs to states to give them more flexibility, and an amendment put forward by Sen. Ted Cruz of Texas and Sen. Mike Lee of Utah designed to drive down premiums.

Mr. Short said any proposed legislation will retain a stipulation that tax credits cannot be used for abortion funding and will include a one-year ban on federal funding for Planned Parenthood.

Despite long odds, some Senate Republicans said the White House summit gave the repeal-and-replace effort new life.

“Sometimes when you are facing defeat and nobody wants to accept it, that prompts people to rethink positions, open up their minds,” said Sen. Ron Johnson, Wisconsin Republican. “People talk, another accommodation here or there — we want to get a result, we all want to fix this problem. We’re just not giving up. I think that’s a good thing, isn’t it?”

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