Senate returns more pessimistic than ever on healthcare

Senators went into a recess skeptical over whether they could agree to legislation repealing and replacing ObamaCare.

They will return on Monday more doubtful than ever.

Sen. Richard BurrRichard Mauze BurrHoekstra emerges as favorite for top intelligence post Trump casts uncertainty over top intelligence role Trump withdraws Ratcliffe as Intelligence pick MORE (R-N.C.), one of Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellDemocrats press FBI, DHS on response to white supremacist violence The Hill's 12:30 Report: Democratic field narrows with Inslee exit McConnell rejects Democrats' 'radical movement' to abolish filibuster MORE’s (R-Ky.) most loyal allies, said Thursday that it’s “unlikely” the GOP will get a healthcare deal.

“I don’t see a comprehensive healthcare plan this year,” he told a local news station. 

Senate Republicans hoped to have a draft bill this week, but it now looks like there will at best be an outline. 

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A Senate Republican aide said it’s too early to begin drafting legislation that can come to the floor in the next few weeks.

“Parameters are more likely,” said the aide, who explained that McConnell wants to keep the details held closely so the legislation doesn’t get picked apart before lawmakers have a chance to consider it carefully.

“The last thing we want to do is litigate this in the press,” the aide said. “We want to discuss parameters and concepts without releasing a draft.”

“Maybe they can start talking to members about a specific product next week, but I would not be surprised if we don’t,” said another Senate GOP aide.

More unhelpful news came in the form of a Kaiser Family Foundation poll underscoring how unpopular the bill approved by the House is.

It found that three-quarters of Americans surveyed think the House bill does not fulfill President Trump's promises on healthcare. 

A full 82 percent said federal funding for ObamaCare’s expansion of Medicaid should be continued, an issue that deeply divides the Senate GOP. The House bill ends the ObamaCare funds in 2020.

Yet another factor for Republicans is Trump’s approval rating, which has fallen to its lowest point with Republicans since he took office in the latest Reuters/Ipsos tracking poll.

Republicans already had sought to lower expectations.

McConnell conceded last week that, “I don’t know how we get to 50 [votes] at the moment.”

He sounded more optimistic about passing major tax reform legislation, rating its chances as “pretty good.”

Republicans control 52 seats and can afford only two defections from their ranks. Vice President Pence could cast the deciding vote in case of a 50-50 tie.

The Senate GOP hasn’t given up hope on healthcare and faces tremendous pressure from the White House and House Republicans to hold a vote.

Republicans for years have promised to repeal ObamaCare, so failure would be a major blow. They also face pressure to finish their work on healthcare because of the tax reform push.

The GOP is using special budgetary rules to prevent Democrats from filibustering legislation on tax reform and healthcare.

Republicans can’t move to tax reform until the healthcare debate is finished because once they pass a new budget resolution that would allow them to move tax legislation with 51 votes, they will lose the vehicle set up to enable a healthcare bill that would circumvent a Democratic filibuster.

Those on a special 13-member working group have heard very little about the drafting efforts that were supposed to take place over the recess.

Senate Budget Committee Chairman Mike EnziMichael (Mike) Bradley EnziThe 23 Republicans who opposed Trump-backed budget deal On The Money: Fed poised to give Trump boost with rate cut | Parties unable to reach deal in Trump tax return lawsuit | New York opens investigation into Capital One data breach Outgoing Senate Budget chair unveils plans to replace Budget Committee MORE (R-Wyo.) was to provide the framework in consultation with GOP leaders and Senate Finance Committee Chairman Orrin HatchOrrin Grant HatchTrump to award racing legend Roger Penske with Presidential Medal of Freedom Trump awards Presidential Medal of Freedom to economist, former Reagan adviser Arthur Laffer Second ex-Senate staffer charged in aiding doxxing of GOP senators MORE (R-Utah).

A major sticking point in the Senate is Medicaid. The House bill would cut nearly $900 billion from the program and cap the federal contribution for expanded enrollment in that program by 2020.

Several Republican governors from Medicaid expansion states, led by Govs. John Kasich (Ohio) and Rick Snyder (Mich.), earlier this year came out against the House bill, warning that it failed to provide adequate resources.

Sen. 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 (R-Ohio) said he wants a more gradual “glide path” for capping the expansion, an idea not popular with conservatives.

Twenty Republican senators, including Portman, represent states that opted to expand Medicaid, and many of them worry that cutting federal funding will cause significant budget problems at home.

But another group of GOP governors, primarily from states that opted out of the Medicaid expansion, want to end federal support for the expansion.

Senators are divided as well over proposals to limit federal assistance for health insurance subsidies, which would hit older, low-income Americans disproportionately.

McConnell hasn’t set a deadline for passing the ObamaCare repeal-and-replace bill, but he has indicated concern about the debate dragging on for months, which could imperil tax reform.

“We can’t take forever,” he told Bloomberg TV last month.

By raising doubts about the possibility of getting a deal that musters 51 votes, the GOP leader is putting pressure on his colleagues to either come together or move on before the August recess.

McConnell has told colleagues that the 13-member working group will put together a bill and that he will bring it to the floor for a vote, but he has stopped short of promising that it will pass — in contrast to Speaker Paul RyanPaul Davis RyanUSCIS chief Cuccinelli blames Paul Ryan for immigration inaction Soaring deficits could put Trump in a corner if there's a recession Paul Ryan moving family to Washington MORE (R-Wis.), who earlier this year guaranteed that the House bill would pass.

If the Senate bill fails on the floor, McConnell is likely to declare the GOP conference has worked its will and move on.

Even as the House voted to narrowly pass the House's American Health Care Act last month, there was already strong pessimism among Senate Republicans about the chances of putting together a comprehensive package in the upper chamber.

A senior GOP senator at the time said the chances of getting 51 votes for legislation based on the House healthcare bill were less than 1 in 5.

When House Republicans debated healthcare reform earlier this year, some of their Senate colleagues said privately that they thought it might be better if the legislation died in the lower chamber.