Senate GOP Plans Health-Care Vote Next Week

McConnell tries to keep pressure on fellow Republicans

Senate Majority Leader Mitch McConnell, center, with other Republicans on Capitol Hill earlier this month.

Senate Majority Leader Mitch McConnell, center, with other Republicans on Capitol Hill earlier this month. PHOTO: TOM WILLIAMS/ZUMA PRESS
.

Updated June 19, 2017 7:48 p.m. ET

WASHINGTON—Senate GOP leaders have set a timeline to vote next week on legislation to repeal large chunks of the Affordable Care Act, even though they don’t yet appear to have secured enough support to pass it.

Majority Leader Mitch McConnell (R., Ky.) is intent on keeping pressure on Senate Republicans to move quickly on the bill rolling back and replacing much of the 2010 health law, lawmakers and GOP aides said. The push for a quick vote before the weeklong July 4 recess could backfire, however, as some conservative and centrist Republicans have expressed concern about the emerging shape of the legislation.

“I expect us to vote on it next week,” Sen. Richard Burr (R., N.C.) said Monday evening of the health bill. “I believe the majority leader when he says he’s going to take it up.”

Mr. McConnell could pull back if he calculates that a little extra time could get him the votes needed to cross the finish line. He can lose no more than two GOP votes for a bill to pass. All Democrats are expected to oppose it.

Still, Mr. McConnell has reasons to try for a quick health-care vote. The pressure could force lawmakers to reach a consensus on sticking points that have divided them. And GOP leaders in both chambers want to move on to other legislative items.

Failure to take a vote before either the July 4 recess or the longer break later in the summer also could open Republican lawmakers up to pressure from constituents either concerned about losing their health coverage or expecting Republicans to follow through on pledges to repeal the law known as Obamacare. Some town-hall meetings during the spring, when the House was considering its legislation, saw lawmakers greeted by boisterous crowds.

The nonpartisan Congressional Budget Office estimated the House bill passed in May would leave 23 million fewer Americans with health coverage in 2026 versus current law.

GOP aides and others familiar with the negotiations said they anticipate the Senate bill’s text will be released later this week. The CBO is expected to release its estimate of the Senate bill’s impact on the federal budget and insurance coverage early next week, and a vote could potentially be held next Thursday, before lawmakers scatter.

Democrats and consumer groups have criticized Senate Republicans for crafting the bill in closed-door sessions without any hearings or other input. As a form of protest, Senate Democrats are planning procedural maneuvers to try to delay legislation or nominees.

Democrats are planning to “embarrass the heck out of Republicans, who are as much in the dark as we are about their own leadership’s plans on the bill,” said Sen. Richard Blumenthal (D., Conn.). “Our tools are limited, but we’re going to use every one of them.”

For their part, many Senate Republicans have said they have yet to see their bill and want to make sure they are given enough time to review it.

“There isn’t a bill yet—nobody has seen any language,” Sen. Chuck Grassley (R., Iowa) said Monday. Sen. Dan Sullivan (R., Alaska) said he wanted “significant time” to review the bill—“certainly days” rather than hours, he said.

Mr. McConnell has said all 52 Senate Republicans have been involved in the negotiations on issues the party has been talking about since the ACA passed in 2010.

Meanwhile, provisions in the GOP bill that had proved vexing , including the fate of Medicaid expansion and tax credits to consumers, appear close to being resolved, people familiar with the negotiations said.

Under an option being strongly considered, the bill would exact steeper financial cuts to Medicaid than under the House-passed legislation, the people said, a move likely to draw criticism from a number of Republican governors who want to preserve Medicaid open-entitlement funding and the ACA’s expansion of the program.

The entire funding system for the state-federal program for low-income and disabled people would be changed to a per capita cap, which would limit federal spending to states. That is the approach that also passed in the House bill, which would cut federal spending on Medicaid by $834 billion over 10 years.

Under one proposal, the Senate bill would lower Medicaid’s spending growth to a rate set in the House bill until 2025, when it would then be more sharply curtailed, according to people familiar with the discussions. The bill would slow the growth of federal spending on Medicaid by tying its growth rate to a lower price index, a change sought by Sen. Pat Toomey (R., Pa.).

That is likely to draw opposition from Republicans in states that expanded Medicaid under the ACA, including Sens. Rob Portman of Ohio, Dean Heller of Nevada and Shelley Moore Capito of West Virginia.

“Rob does not support a growth rate that is lower than the House bill,” Kevin Smith, a spokesman for Mr. Portman, said Monday.

The bill is expected to start phasing down enhanced federal funding to the 31 states that expanded Medicaid, people familiar with the deliberations said. States could get a lower amount of federal funding for new enrollees in 2020, and the amount would fully phase down by 2023.

The bill would also provide assistance to people who don’t get health insurance on the job. But unlike the House version that set up tax credits based largely on income, the Senate version could provide subsidies that are larger for people who are low-income or in areas with high health-costs, a person familiar with the proposal said.

Those tax credits are likely to be structured in ways similar to the ACA subsidies as a way to preserve restrictions on abortion funding, according to Senate GOP aides. Provisions restricting the use of the House bill’s tax credits to pay for abortion hit procedural hurdles in the Senate.

The ACA subsidies, which are advance tax credits paid to insurance companies to lower the cost of health-insurance premiums, currently can’t be used to cover the cost of abortions.

A senior White House official said they expected to have a stronger sense of how the votes were lining up by the end of the week and that they were confident the tally was heading in the right direction.

The White House is set to continue emphasizing insurance-market woes this week as a reason to get health legislation done fast, an argument that President Donald Trump has made for weeks and that is taking on additional force as state insurance deadlines pass and insurers’ rates and withdrawals from the marketplace become public. Democrats argue that Republicans are hurting the marketplaces by threatening to halt payments that are used to reduce out-of-pocket costs for lower-income patients and by raising questions about enforcement of the ACA’s coverage mandate.

Wednesday is a federal filing deadline for insurance companies to decide whether they will participate in the ACA’s exchanges and the rates they want to charge.

Write to Stephanie Armour at stephanie.armour@wsj.com and Kristina Peterson at kristina.peterson@wsj.com

Appeared in the June 20, 2017, print edition as ‘Senate Planning Health Vote.’

.

Advertisements

Tags: , , , , , , , , , , , , , , , , , ,

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: