GOP leader tempers ObamaCare expectations

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellHouse to resume mask mandate after new CDC guidance Five takeaways from a bracing day of Jan. 6 testimony McCarthy, McConnell say they didn't watch Jan. 6 hearing MORE (R-Ky.) is tempering expectations that the Senate will pass an overhaul of the nation’s healthcare system, promising his colleagues a vote but not success.

McConnell in his public comments and private conversations about the ObamaCare repeal-and-replace bill is painting a more sober picture than Speaker Paul RyanPaul Davis RyanRealClearPolitics reporter says Freedom Caucus shows how much GOP changed under Trump Juan Williams: Biden's child tax credit is a game-changer Trump clash ahead: Ron DeSantis positions himself as GOP's future in a direct-mail piece MORE (R-Wis.), who in March guaranteed passage through the House.

McConnell is stopping well short of any grand pronouncement.

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He says he will bring a bill to the floor for a vote but is not making any promises whether he will get at least 50 members of the 52-member Senate Republican Conference to back it.

“Mitch has been very clear in our conference, and that is there will be a bill and we will be voting on it,” said Sen. Dean HellerDean Arthur HellerDemocrat Jacky Rosen becomes 22nd senator to back bipartisan infrastructure deal 9 Senate seats most likely to flip in 2022 On The Trail: Democrats plan to hammer Trump on Social Security, Medicare MORE (R-Nev.).

But that’s as far as the GOP leader has been willing to go.

“He hasn’t gone beyond explaining that,” said Heller, who recently met with the special working group that is negotiating the healthcare bill.

McConnell warned in an interview with Reuters that passing healthcare reform will be tougher than tax reform, another of President Trump’s top priorities.

Expectations for repealing major parts of ObamaCare soared after the House passed its bill earlier this month, but McConnell cautions the votes in the Senate aren’t there yet.

What’s more, he’s not sure of the path to success.

“I don’t know how we get to 50 [votes] at the moment. But that’s the goal. And exactly what the composition of that [bill] is I’m not going to speculate about because it serves no purpose,” McConnell told Reuters on Wednesday.

Ryan sounded a much more bullish tone in March.

“We’ll have 218 when this thing comes to the floor,” Ryan declared, referring to the number needed to pass a bill through the House. “I can guarantee that.”

That prediction almost blew up in his face when House leaders were forced to pull the bill from floor consideration later that month because it did not have enough support.

The House bill squeaked through, however, with 217 votes on May 4 after conservatives negotiated a compromise with Rep. Tom MacArthur (R-N.J.), a leader at the time of the centrist Tuesday Group.

McConnell’s interview with Reuters caught some Republican colleagues by surprise.

“I don’t know why he’s doing media on it, but he might be lowering expectations,” said a GOP senator who requested anonymity to speculate on the leader’s motivations.

Other lawmakers have long been skeptical of the chances of passing healthcare reform through the Senate.

One GOP senator told The Hill shortly before the House vote that healthcare legislation based on the House bill had only a 1 in 5 chance of passing the upper chamber.

Senate Republicans are using special budgetary rules to prevent a Democratic filibuster, meaning they need just 50 votes to pass healthcare legislation, with Vice President Pence breaking a tie. But that means McConnell can only lose two votes.

McConnell has to find a way to balance the concerns of moderates, who are worried about capping the federal contribution for expanded Medicaid enrollment and higher costs for older, low-income Americans, with those of conservatives, who are leery about creating a new health entitlement.

Sen. John BoozmanJohn Nichols BoozmanTrump getting tougher for Senate GOP to ignore Former NFL player challenging Boozman in Arkansas GOP primary Senate GOP opens door to earmarks MORE (R-Ark.) said McConnell “is just being realistic.”

“We’ve had many, many meetings. It’s difficult,” he added.

The legislation that passed the House earlier this month cannot pass the Senate, Republicans in the upper chamber say.

Yet Senate Republican Whip John CornynJohn CornynBiden officials pledge to confront cybersecurity challenges head-on Eight Republicans join Democrats to confirm head of DOJ environmental division Federal officials abroad are unprotected — in a world of increasing volatility MORE (Texas) told reporters this past week that the Senate bill will overlap the House bill by as much as 70 or 80 percent.

That means the daunting task for McConnell is to find a way to replace 20 to 30 percent of the House bill in a way that will bring him 50 GOP votes.

A report released Wednesday by the Congressional Budget Office underscored a variety of problems moderates have with the bill.

It would leave 23 million more people uninsured by 2026 compared to ObamaCare and increase premiums for older, low-income Americans by as much as 850 percent.

“There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well,” said Sen. Susan CollinsSusan Margaret CollinsOvernight Health Care: CDC advises vaccinated to wear masks in high-risk areas | Biden admin considering vaccine mandate for federal workers Eight Republicans join Democrats to confirm head of DOJ environmental division The Hill's Morning Report - Presented by Facebook - Crunch time for bipartisan plan; first Jan. 6 hearing today MORE (R-Maine), who cited the CBO report’s finding that 23 million people would lose insurance under the House bill over the next decade.

In March, four moderate-leaning Republican senators warned McConnell in a letter that the House bill, which cuts nearly $900 billion in Medicaid funding, did “not include stability for Medicaid populations.”

Sens. Rob PortmanRobert (Rob) Jones PortmanBiden, Sinema meet as infrastructure talks hit rough patch Feehery: It's time for Senate Republicans to play hardball on infrastructure The Hill's Morning Report - Presented by Facebook - Crunch time for bipartisan plan; first Jan. 6 hearing today MORE (Ohio), Shelley Moore CapitoShelley Wellons Moore CapitoOfficials warn of cybersecurity vulnerabilities in water systems Graham, Hawley call on Judiciary Committee to hold hearing on US-Mexico border GOP senators urge Biden to keep Trump-era border restrictions MORE (W.Va.), Cory GardnerCory GardnerEx-Sen. Cory Gardner joins lobbying firm Biden administration reverses Trump changes it says 'undermined' conservation program Gardner to lead new GOP super PAC ahead of midterms MORE (Colo.) and Lisa MurkowskiLisa Ann MurkowskiEight Republicans join Democrats to confirm head of DOJ environmental division Manchin grills Haaland over Biden oil and gas moratorium The Hill's Morning Report - Presented by Facebook - Crunch time for bipartisan plan; first Jan. 6 hearing today MORE (Alaska) signed the letter.

Portman said earlier this month that he would like to see “a longer runway” for reforming Medicaid instead of abruptly capping enrollment for the program in 2020.

Another sticking point with moderates is language defunding Planned Parenthood for a year, something to which Collins and Murkowski have both voiced objection.

If McConnell tries to woo moderates by boosting subsidies for older Americans or by softening Medicaid reforms, he risks losing the support of a trio of conservatives: Sens. Rand PaulRandal (Rand) Howard PaulSenators reach billion deal on emergency Capitol security bill GOP Rep. Cawthorn says he wants to 'prosecute' Fauci Writer: Fauci, Paul clash shouldn't distract from probe into COVID-19 origins MORE (R-Ky.), Ted CruzRafael (Ted) Edward CruzTrump's Texas endorsement boosts a scandal-plagued incumbent while imperiling a political dynasty Trio of Senate Republicans urges Supreme Court to overrule Roe v. Wade Overnight Defense: US launches another airstrike in Somalia | Amendment to expand Pentagon recusal period added to NDAA | No. 2 State Dept. official to lead nuclear talks with Russia MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeSenate confirms Biden's Air Force secretary Trio of Senate Republicans urges Supreme Court to overrule Roe v. Wade Biden signals tough stance on tech with antitrust picks MORE (R-Utah).

Paul is philosophically opposed to establishing new taxpayer-funded subsidies to help people buy private insurance.

“There’s not been a louder voice up here for repealing ObamaCare. I really want to repeal it. I just don’t want to replace [it] with ObamaCare lite or another federal program,” he told Fox News recently.

Cruz has warned it would be “catastrophic” if Republicans fail to repeal ObamaCare.

He is holding back from criticizing the House bill while participating in negotiations on a Senate rewrite, but one of his big problems with the House legislation is that he felt it did not do enough to lower premiums.

He and other conservatives feel the best way to lower premiums would be to remove the mandate on insurance companies to provide coverage to older, sicker Americans — but that proposal is not popular with moderates.

“It’s a challenge anytime you’re trying to get a consensus on a complex issue when you have to get 50 of 52 votes,” said Sen. Lamar AlexanderLamar AlexanderAuthorities link ex-Tennessee governor to killing of Jimmy Hoffa associate The Republicans' deep dive into nativism Senate GOP faces retirement brain drain MORE (R-Tenn.), chairman of the Senate Health Committee.