- The Washington Times - Wednesday, September 20, 2017

Senate Republicans will hold a vote on an Obamacare repeal bill next week, leaders announced Wednesday, attempting one final Hail Mary play to kill off the 2010 law before the chamber runs out of time.

While they don’t appear to have secured enough votes yet, the announcement by Majority Leader Mitch McConnell, Kentucky Republican, will put pressure on the handful of holdouts to either get on board or else explain to the party’s conservative base why they are standing in the way of fulfilling a campaign promise.

President Trump said the bill “has a very good chance” at passing.

SEE ALSO: New Obamacare repeal cuts $215B to states overall, study shows

“Certainly we’re at 47 or 48 … senators, and a lot of others are looking at it very positively,” he said.

Questions about the repeal effort followed the president to New York, where he was meeting with world leaders on the sidelines of the U.N. General Assembly.

Mr. McConnell, who has been burned twice so far this year on failed floor showdowns over repeal bills, was reluctant to forge ahead without a guarantee that he could muster the votes this time. But the White House has pushed for a vote, and Mr. Trump took to Twitter to goad holdouts to back the plan, sponsored by Sen. Lindsey Graham, South Carolina Republican, and Sen. Bill Cassidy, Louisiana Republican.

“I hope Republican Senators will vote for Graham-Cassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!” Mr. Trump tweeted.

The bill would pool money being used to subsidize Obamacare customers and expand Medicaid in parts of the country and siphon it back to the states as block grants.

All told, the plan would slash federal funding to the states by $215 billion through 2026, a Washington-based consultancy said Wednesday in a study that found less than a third of states would have an increase in funding compared with current law.

Avalere Health said 34 states and the District of Columbia would face federal cuts — seven of them would lose more than $10 billion — while 16 states would receive more money.

“The Graham-Cassidy bill would significantly reduce funding to states over the long term, particularly for states that have already expanded Medicaid,” said Caroline Pearson, senior vice president at Avalere. “States would have broad flexibility to shape their markets but would have less funding to subsidize coverage for low- and middle-income individuals.”

Those numbers could undermine the bill, with a number of Republican governors complaining that they have become too attached to the federal cash.

Five Republican governors signed onto a bipartisan letter Tuesday opposing the bill, and The Associated Press reported Wednesday that New Jersey Gov. Chris Christie, a Republican and Trump ally, also opposes it because it would take money away from his state.

West Virginia — solid Trump country — is expected to lose $1 billion by 2026 thanks to less federal money to support its Medicaid program. Florida and North Carolina, two other Trump states, would lose funding partly because so many of their residents had signed up and received subsidies to buy plans on Obamacare’s exchanges.

Still, Republican-led states in the Southeast and Midwest generally do better than Democrat-led states, according to the Avalere study. California, for example, would lose nearly $80 billion in projected money from federal taxpayers over the next decade.

House Minority Leader Nancy Pelosi, California Democrat, called the plan a “stinkeroo” and said she would try to rally blue-state Republicans to join Democrats in opposition if a bill emerges from the Senate.

“I don’t see how they could vote for it,” Mrs. Pelosi said.

The bill’s supporters, however, say it would shift power from Washington to the states, giving them flexibility to tailor coverage mandates to their own needs.

But the bill is a break with other Republican repeal efforts, which replaced Obamacare’s exchange subsidies with less-generous tax credits and slowly scaled down federal funding for states that expanded Medicaid.

“The bill’s repeal of certain provisions of the Affordable Care Act (ACA) are more disruptive for most states than prior Republican efforts,” said Fitch Ratings, a credit agency.

The main insurers lobby, America’s Health Insurance Plans, said it opposes Graham-Cassidy because it doesn’t do enough to bolster the private markets and Medicaid or protect sick customers. It also fails to repeal the tax on health insurers or prevent states from pursuing government-run single-payer systems, the lobby said.

Sen. Rand Paul, Kentucky Republican, said he opposes the plan because it doesn’t go far enough in gutting Obamacare. He is the only member of the 52-seat Republican majority to announce his opposition to the bill.

Among other Republican holdouts, Sens. Susan M. Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona haven’t said how they will vote. The trio linked arms with Democrats in July to kill a limited repeal bill designed to prolong the debate.

Ms. Collins told CNN that she was disappointed to see a bipartisan effort to bolster insurance markets stall in the Senate Health, Education, Labor and Pensions Committee.

Ms. Murkowski has said she is trying to calculate the potential impacts of Graham-Cassidy on her state.

Mr. McCain told Politico on Wednesday that he still wanted “regular order” — Capitol-speak for an orderly and open debate that bubbles up through committees and compels bipartisanship.

“Nothing has changed,” he told the outlet. “If McConnell wants to put it on the floor, that’s up to McConnell.”

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