Senate Republicans are dangling billions of dollars in opioid-fighting funds to try to entice wary moderates to sign onto their Obamacare repeal bill, looking to ink a final compromise.
Sen. Shelley Moore Capito, West Virginia Republican, said she is looking for a $45 billion commitment over a 10-year period to make sure addicts in her hard-hit state will be able to get treatment under the Republican health care model, which would phase out Obamacare’s vast expansion of Medicaid coverage for the poor.
“It’s absolutely critical to my state. We’ve got huge problems,” said Ms. Capito, whose been outspoken about the prescription painkiller and heroin problem that is devastating the U.S., particularly in swaths of Appalachia and New England.
As Republican leaders look to build support for the health care overhaul they are writing behind closed doors, they are trying to reassure senators who fear vulnerable constituents would lose access to care.
The amount Ms. Capito and Sen. Rob Portman of Ohio are seeking to fight opioid addiction is equivalent to the $4.5 billion per year that would be cut from treatment if Congress scrapped the Medicaid expansion, according to researchers at Harvard and New York University.
Throwing extra money to assuage concerns is standard legislating. House Republican leaders were able to get their health care bill over the finish line last month by injecting an extra $8 billion for certain states to subsidize the costs of sicker customers who could pay more.
It’s not clear how many Senate votes could be earned with additional money for opioid addiction treatment or if it would even be a part of the final legislation.
President Trump met with 15 senators at the White House on Tuesday to push them to finish the job, though he stopped short of asking for a specific deadline.
“As soon as we can do it,” Mr. Trump said.
On Capitol Hill, Democrats are complaining about the bill-writing process, saying Republicans are hiding their legislating from the public.
Senate Majority Leader Mitch McConnell, Kentucky Republican, defended the push to skip hearings and move the bill — eventually — straight to a vote. He said the issue has been debated for seven years.
“We’ll let you see the bill when we finally release it,” Mr. McConnell told reporters. “Nobody’s hiding the ball here. You’re free to ask anybody anything.”
Yet Democrats say Republicans are trying to obfuscate changes to Obamacare that could leave certain populations worse off, including older Americans who don’t yet qualify for Medicare.
The fight seeped into what was billed as bipartisan exercise — a hearing before the Senate Committee on Health, Education, Labor and Pensions on how to slash prescription drug prices.
“Let’s be blunt. It is insane to pretend to have a bipartisan hearing on lowering drug prices when right now, today, 13 Republicans are writing a secret bill to kick 23 million people off health insurance and their prescription drug benefits. And we can’t even get a look at it,” said Sen. Elizabeth Warren, Massachusetts Democrat.
Mr. Trump pointed the finger back at Democrats, saying they were holding up his overhaul, even though Republicans are working under fast-track budget rules that allow them to cut the minority party out of the process.
“You have the Democrats on the other side who have truly become obstructionists — even their new motto: ‘Resist.’ And I guess it’s a pretty accurate motto,” he told Senate Republicans.
Still, it’s Republicans who are trying to balance competing interests.
The Club for Growth, a conservative pressure group, said Tuesday that the Senate bill must reduce premiums even further than the House version and should scrap Obamacare’s expansion of Medicaid and all of its taxes.
Yet Republicans such as Ms. Capito, Mr. Portman and Dean Heller of Nevada are looking for a more gradual phaseout of generous federal funding that their states used to expand Medicaid for the poor, saying they would like to avoid an abrupt “cliff” in 2020, when the House bill would freeze the expansion.