The Senate is careening toward a final decision on whether it can repeal, replace or revise Obamacare, with no certain outcome and Republican leaders desperate to get rid of their political headache after several failed votes earlier this week.
The Senate will begin a series of votes on Thursday afternoon designed to test what senators will support for an Obamacare replacement bill, dubbed a “vote-a-rama.” This will help determine if Senate Republicans can reach any consensus among themselves. The session could last until Friday morning, depending on GOP and Democratic maneuvers.
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Initial votes will include a GOP effort to see whether Democrats will support a single-payer health care system, as many in their base support. The amendment was offered by Sen. Steve Daines (R-Mont.) and is designed to put moderate Democrats in a tough spot.
Senate Majority Leader Mitch McConnell (R-Ky.) is expected at some point to unveil the GOP’s highly anticipated “skinny repeal” bill — the narrowest effort to dismantle Obamacare that can win at least 50 votes. Many Republicans believe this proposal may be their only hope for reaching an agreement inside the GOP conference and forcing House-Senate talks to hash out a final Obamacare repeal package.
“We all know this is likely to be a long night. It’s part of a long process that has taken a lot of hard work from a lot of dedicated colleagues already,” McConnell said on the floor Thursday. “One phase of that process will end when the Senate concludes voting this week, but it will not signal the end of our work — not yet. Ultimately, the goal is to send legislation from Congress to the president — legislation that can finally move us beyond Obamacare’s years of failures.”
McConnell won’t introduce the bill until after a meeting of all Republican senators today.
“We have to pass something. So it’s likely that we’ll pass that. But a lot depends on what’s in the skinny bill,” said Sen. Orrin Hatch (R-Utah), the most senior GOP senator and chairman of the Finance Committee. “The leader’s going to call up what he thinks can pass and he’s probably going to be right. [But] I’ve been wrong before. This is a touchy thing right now.”
Senate Democrats have refused to offeramendments until they see the Republican’s latest repeal proposal, which was still in flux as of Thursday morning.
McConnell and his top lieutenants are starting from a bare bones plan that would repeal Obamacare’s individual and employer coverage mandate, as well as the medical device tax. Such a move could cause 16 million fewer people to have health insurance and could lead to a sharp spike in premiums, according to Congressional Budget Office estimates. However there are some questions over how much of the mandate can be repealed and if any of the taxes can be repealed.
Senate Republicans, though, are seeking a bridge to negotiations with the House, not necessarily a final policy solution. They want to pass something — anything — and hope they can forge a broader deal with the House and White House, even if it could reopen painful party divisions on proposed cuts to Medicaid spending and efforts to slash Obamacare’s regulations.
“In all likelihood, what we will pass is a bill that we will then take to a conference committee with the House, so we’re working on that final idea,” said Senate Majority Whip John Cornyn (R-Texas). “But basically something that repeals the mandates and is a vehicle that gets us to conference.”
Some GOP senators were pushing for billions of dollars in new funding for fighting opioid addiction to be included in leadership’s package, part of an effort to restore the $45 billion in such funding already promised by McConnell in previous bills. But that has been ruled out as spending too much money to hit budget targets; the Senate must hit at least $133 billion in savings, as required under Senate rules, GOP sources said.
“I doubt that we can,” Hatch said when asked if the GOP can pass additional provisions beyond repealing the mandates and medical device tax.
No final decisions have been made on what the leadership bill will include, those sources said.
Republicans are also considering offering states flexibility to use waivers to get out of Obamacare’s regulations and defunding Planned Parenthood. Republicans are seeking to repeal as many of Obamacare’s taxes as they can, but doing so would blow holes in the budget. Some sources off the Hill doubted Republicans would even be able to repeal the medical device tax.
“What exactly it looks like is a point of conversation and debate,” said Sen. John Thune (S.D.), the number three Senate Republican. “But we’re having those conversations with our members and we’re hopefully going to get to a point where we can figure something out.”
Some conservatives feel that an agreement is within reach.
“We are a lot closer than many outside observers believe, and from the beginning I have believed we can and will get to yes,” said Sen. Ted Cruz (R-Texas).
Yet several moderate GOP senators like Rob Portman of Ohio and Shelley Moore Capito of West Virginia have not signed on to the scaled-back plan, although Sen. Dean Heller of Nevada signaled support Wednesday. Ohio and Nevada’s governors oppose the “skinny” repeal bill, which could cause Heller and Portman to break with their popular state leaders.
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