Getty Images

Senate Majority Leader Mitch McConnell (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 Ryan (R-Wis.), who in March guaranteed passage through the House.

McConnell is stopping well short of any grand pronouncement.

{mosads}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 Heller (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 Boozman (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 Cornyn (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 Collins (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 Portman (Ohio), Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (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 Paul (R-Ky.), Ted Cruz (R-Texas) and Mike Lee (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 Alexander (R-Tenn.), chairman of the Senate Health Committee.

Tags Cory Gardner Dean Heller John Boozman John Cornyn Lamar Alexander Lisa Murkowski Mike Lee Mitch McConnell ObamaCare Paul Ryan Rand Paul Rob Portman Shelley Moore Capito Susan Collins Ted Cruz

Most Popular

Load more

Video

See all Video