Healthcare bill faces steep climb in Senate

Healthcare bill faces steep climb in Senate
© Greg Nash

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellDavid Axelrod after Ginsburg cancer treatment: Supreme Court vacancy could 'tear this country apart' Pelosi asks Democrats for 'leverage' on impeachment Democrats press FBI, DHS on response to white supremacist violence MORE (R-Ky.) has only three weeks to unify conservatives and moderates in his conference behind an ObamaCare repeal and replacement bill.

The American Health Care Act, which Vice President Pence on Tuesday declared “the framework for reform,” will move first in the House, but it faces perhaps an even steeper climb in the Senate.

Republicans control 52 seats in the upper chamber and can only afford to lose two votes, since Pence can vote to break a 50-50 tie. So far, at least eight Republican senators have voiced concerns with aspects of the legislation.

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McConnell, a master tactician, will have his work cut out for him.

Three conservatives, Sens. Mike LeeMichael (Mike) Shumway LeeA cash advance to consider McConnell, allies lean into Twitter, media 'war' Conservatives buck Trump over worries of 'socialist' drug pricing MORE (R-Utah), Ted CruzRafael (Ted) Edward CruzIs this any way for NASA to build a lunar lander? GOP strategist predicts Biden will win nomination, cites fundraising strength 3 real problems Republicans need to address to win in 2020 MORE (R-Texas) and Rand PaulRandal (Rand) Howard PaulGraham promises ObamaCare repeal if Trump, Republicans win in 2020 Conservatives buck Trump over worries of 'socialist' drug pricing Rand Paul to 'limit' August activities due to health MORE (R-Ky.), are unhappy with parts of the House bill, which allied conservative groups have panned as not going far enough.

Lee blasted the House bill as “a missed opportunity” and “a step in the wrong direction.”

He warned that policymakers don’t know how much tax credits proposed in the House legislation to help Americans buy insurance would wind up costing the federal government.

Paul dismissed the legislation as “dead on arrival” and “a bailout for the insurance companies.”

Cruz has been less vocal about his views on the bill. He skipped a press conference Tuesday afternoon that Paul and Lee held with House conservatives critical of the bill.

The Texas senator told reporters that he has a number of concerns but declined to say whether he would vote no.

“The proper way to address those concerns is working with colleagues in the House, the Senate and the administration, and that’s what I’m doing right now,” Cruz said.  

Meanwhile, two influential Republican senators, Susan CollinsSusan Margaret CollinsSusan Collins challenger hit with ethics complaints over reimbursements Overnight Health Care: Insurance lobby chief calls Biden, Sanders health plans 'similarly bad' | Trump officials appeal drug price disclosure ruling | Study finds 1 in 7 people ration diabetes medicine due to cost Collins downplays 2020 threat: 'Confident' reelection would go well if she runs MORE (Maine) and Lisa MurkowskiLisa Ann MurkowskiOvernight Energy: Green groups sue Trump over Endangered Species Act changes | Bureau of Land Management retirees fight plan to relocate agency | Wildfires in Amazon rainforest burn at record rate Bureau of Land Management retirees fight plan to relocate agency out west The Hill's Morning Report - Progressives, centrists clash in lively Democratic debate MORE (Alaska), have objected to including language in the bill defunding Planned Parenthood — a top priority of House conservatives.

Collins and Murkowski told reporters Tuesday that they were reviewing the newly released legislation.

Three other Republican senators — Rob PortmanRobert (Rob) Jones PortmanSchumer blasts 'red flag' gun legislation as 'ineffective cop out' McConnell faces pressure to bring Senate back for gun legislation Shaken Portman urges support for 'red flag' laws after Ohio shooting MORE (Ohio), Shelley Moore CapitoShelley Wellons Moore CapitoAmerica is in desperate need of infrastructure investment: Senate highway bill a step in the right direction On The Money: Economy adds 164K jobs in July | Trump signs two-year budget deal, but border showdown looms | US, EU strike deal on beef exports Trump border fight throws curveball into shutdown prospects MORE (W.Va.) and Cory GardnerCory Scott GardnerHickenlooper day-old Senate bid faces pushback from progressives The Hill's Campaign Report: Democratic field begins to shrink ahead of critical stretch The Hill's 12:30 Report: Democratic field narrows with Inslee exit MORE (Colo.) — along with Murkowski sent a letter to McConnell Monday warning him that a draft House healthcare plan that leaked last month failed to ensure stability for hundreds of thousands of people in their states who were newly enrolled in Medicaid under ObamaCare.

Sen. Dean HellerDean Arthur HellerThis week: Barr back in hot seat over Mueller report Trump suggests Heller lost reelection bid because he was 'hostile' during 2016 presidential campaign Trump picks ex-oil lobbyist David Bernhardt for Interior secretary MORE (R-Nev.), widely considered the most vulnerable Senate Republican incumbent in 2018, has also raised concerns about rolling back the Medicaid expansion. On Tuesday he said he hadn’t yet reviewed the House bill.

Taken together, it’s clear that there will be a large number Republican votes for McConnell to shore up by the week of March 27, when he plans to bring the American Health Care Act to the Senate floor, provided the legislation passes the House on schedule.

McConnell wants to get the bill done before the Senate begins debate on Supreme Court nominee Neil Gorsuch, who is scheduled to reach the floor the first week of April. Congress is scheduled to leave town April 7 for a two-week recess.

Democrats made clear Tuesday that GOP leaders shouldn’t expect any votes from their side of the aisle.

Senate Democratic Leader Charles SchumerCharles (Chuck) Ellis SchumerJewish Democratic congresswoman and veteran blasts Trump's 'disloyalty' comments Schumer says Trump encouraging anti-Semites Saagar Enjeti: Biden's latest blunder; Krystal Ball: Did Schumer blow our chance to beat McConnell? MORE (N.Y.) vowed that his caucus would fight “tooth and nail” against “TrumpCare.”

“TrumpCare means higher costs for less healthcare, plain and simple,” he said. “TrumpCare cuts taxes on the very wealthy while forcing average Americans to pay more. Premiums are going to go up.”

McConnell called in the heavy artillery Tuesday by inviting Pence to a Senate GOP lunch to persuade wavering colleagues to get behind the House bill.

Pence told lawmakers pointedly that Trump supports the legislation, and while he’s open to making changes, he will not scrap it and start over, as some conservatives would prefer.

“We’re certainly open to improvements and to recommendations in the legislative process,” Pence told reporters after the meeting, though he emphasized that “this is the bill.”

Over the next several weeks McConnell and his leadership team will argue to colleagues that voters are expecting action from Congress, and this month presents them with a historic opportunity to deliver on their campaign promises to repeal ObamaCare.

“The American people have given us an opportunity to govern. We’re no longer floating ideas,” McConnell said. “We have an obligation now to the American people to deliver a replacement for ObamaCare that is better than the status quo.”

He noted ObamaCare was a “huge issue” in the 2010, 2012, 2014 and 2016 elections.

Pence tried to reassure Republicans nervous about capping the Medicaid expansion that the House bill would “return resources and flexibility to the states that will allow them to reform Medicaid so it can more effectively meet the needs of our most vulnerable citizens.”

Gardner, who signed the letter to McConnell expressing concerns about Medicaid, said Tuesday he’s still trying to understand the details of how the House bill would impact low-income constituents.

“We’re looking at it,” he said.

Specifically, he wants to figure out whether new Medicaid enrollees starting in the year 2020 will still be eligible for the same federal subsidies that have covered the cost of expanding the program in 31 states under ObamaCare.

“You can add new people to the program. At least, that’s the way we initially understand it,” he said. 

Centrist Democrats showed no signs of being inclined to back the House GOP bill.

Sen. Jon TesterJonathan (Jon) TesterNative American advocates question 2020 Democrats' commitment House Democrats targeting six more Trump districts for 2020 Budget deal sparks scramble to prevent shutdown MORE (D-Mont.), who is up for reelection next year in a state Trump won by 20 points, said he has serious reservations.

“Some things they’re doing with Medicaid [are] not going to be helpful. I’m not sure they’re helping with lowering premiums for people who are really getting gouged with big premiums,” he said. “On first blush, it’s certainly got some issues. Major issues.”

Sen. Joe ManchinJoseph (Joe) ManchinTrump awards Medal of Freedom to NBA legend Bob Cousy Overnight Energy: Green groups sue Trump over Endangered Species Act changes | Bureau of Land Management retirees fight plan to relocate agency | Wildfires in Amazon rainforest burn at record rate Bureau of Land Management retirees fight plan to relocate agency out west MORE (D-W.Va.), who is running next year in a state Trump won by nearly 42 points, said he was reviewing the bill.

Manchin said, however, that he would not vote for legislation he views as a straight repeal of ObamaCare.

Schumer told reporters that the House bill is an ObamaCare repeal, even though it will keep in place some of the law’s reforms, such as allowing adults to stay on their parents’ health plans until age 26.

Republicans say it would also bar insurance companies from discriminating against people with pre-existing medical conditions, but Democratic leaders are disputing that claim.

Jessie Hellmann contributed.