Senate GOP leaders said Tuesday they’re “close” to settling on their own plan to repeal and replace Obamacare, as pressure mounts on them to deliver on their health promises before the August recess.
It’s been more than a month since House Republicans muscled their own repeal bill to passage. Senate Republicans have rejected that bill, but have struggled to come up with their own alternative that can win a majority vote in the upper chamber.
Majority Leader Mitch McConnell said his negotiators are putting pen to paper to see where his troops stand as the effort moves into a do-or-die phase.
“We’re getting close to having a proposal to whip and to take to the floor,” Mr. McConnell said. “We’ve had seven years to talk about health care.”
The GOP cleared a major procedural hurdle Tuesday, as the Senate’s main referee — the parliamentarian — said the House template comports with fast-track budget rules Republicans are using to avoid a Democratic filibuster of their plans.
Yet political obstacles remain. Rank-and-file Republicans claimed progress after yet another closed-door meeting Tuesday, yet hedged on whether they’ll muster the votes for passage.
“We’re all cautiously optimistic — that’s the best I can do for you,” Sen. James E. Risch, Idaho Republican, told reporters. “We want to get this done. It’s a heavy lift.”
The GOP faces the twin pressures of quenching President Trump’s thirst for a repeal bill so he can focus on cutting taxes and patching up a wobbly Obamacare market with mounting problems.
Another major insurer, Anthem, said Tuesday it is pulling out of Ohio’s exchange, leaving 20 of Ohio’s 88 counties without an option next year.
That withdrawal follows similar exits across the Midwest in recent weeks, as insurers blame both the 2010 Affordable Care Act and Mr. Trump’s handling of the law.
Anthem sells individual policies in 13 other states, so its withdrawal could be an ominous bellwether for the markets heading into 2018.
“If Congress doesn’t act to save Americans from this Democrat-inflicted catastrophe, next year is only going to be worse,” President Trump said before a meeting with Mr. McConnell and House Speaker Paul D. Ryan.
Yet Sen. John Thune said Republicans might have to consider short-term fixes to Obamacare if they can’t settle on a long-term replacement soon, since the markets are “waiting to see what’s going to happen.”
Senators who darted between meetings said they are considering ways to entice more people to hold insurance by making their tax credits more generous than the House’s plan, perhaps adjusting the benefits by geography.
They’re also trying to rein in the 2010 law’s vast expansion of Medicaid without inflicting too much pain.
There are 20 Republican senators who represent states that accepted an influx of federal cash to expand Medicaid to their poorest residents, so they’re seeking a soft landing.
Some Democrats tried to poke holes in the House bill. For instance, they said its repeal of “cost-sharing” subsidies for American Indian populations fell outside the committees handling the reconciliation process.
Aides said other aspects of the bill will still have to be scrubbed in a process known as the “Byrd bath” to ensure they relate to the budget and satisfy the fast-track rules. Yet those aspects can be fixed without harming the integrity of the whole bill.
If the parliamentarian had discovered a fatal error on Tuesday, it would have forced the House to hold a difficult revote.
Democrats said the entire GOP effort is doomed to fail on its merits.
“They are not going to be able to rescue a deeply flawed bill by doling out some tax credits here and tax credits there,” Sen. Ron Wyden, Oregon Democrat, said.
Senate Republicans are negotiating their plan in secret, with lawmakers in a 13-member working group shuffling from one closed-door meeting to another without holding public hearings.
Sen. Ted Cruz, Texas Republican, defended the process, saying it fostered comity among Republicans.
“One of the most encouraging aspects of these discussions is they have not been litigated in the press,” he said. “Rather, members are coming together, I believe in good faith, [and] working to come to common ground.”
Yet some divisions emerged on Tuesday, as conservatives continue to be wary of refundable tax credits for people who buy insurance on their own, arguing they replace one entitlement with another, even as centrists try to make the assistance more generous.
Mr. Graham reportedly told media outlets at the Capitol that Sen. Rand Paul of Kentucky was “irretrievably gone” because he can’t support the tax credits, so the 52-seat majority is starting at 51 votes.
His comments earned a rebuke from Mr. Paul’s office, which said Mr. Graham should apply for an opening in their press office if he wants to make statements on Mr. Paul’s behalf.
“Sen. Paul remains optimistic the bill can be improved in the days ahead and is keeping an open mind,” Paul spokesman Sergio Gor said.