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ObamaCare repeal and the Senate: Where it stands

ObamaCare repeal and the Senate: Where it stands
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It's a key two weeks for Senate Republicans, who are edging closer to a vote as soon as the end of this month on legislation to repeal and replace ObamaCare.

Lawmakers have yet to see text of a bill and are deeply divided over key questions, such as how quickly to phase out ObamaCare’s Medicaid expansion.

They’re also under enormous pressure to move as the Trump White House seeks a legislative win and the clock ticks on other priorities, from tax reform to funding the government and lifting the debt ceiling.

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GOP senators acknowledge they need to move.

“This doesn't in my opinion get better over time,” said Sen. Roy BluntRoy Dean BluntUS Chamber of Commerce to stop supporting some lawmakers following the Capitol riots Senate to be briefed on inauguration security after Capitol attack This week: Democrats barrel toward Trump impeachment after Capitol attack MORE (R-Mo.). “It won't be appreciably better a month from today than it is today. At some point to get this done, you're going to get it done in the last 10 days before the vote.”

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellTrump has talked to associates about forming new political party: report McConnell, Schumer fail to cut power-sharing deal amid filibuster snag McConnell keeps GOP guessing on Trump impeachment MORE (R-Ky.) has suggested he wants to hold a vote before the July 4 recess to prevent healthcare from eating up more of the Senate’s time.

“He’s bound and determined to have the vote pre-July Fourth recess,” a Republican lobbyist said of McConnell.

Here’s what is clear and not clear as Republicans step toward a critical vote.

Tightrope

Republicans in the Senate have always had very little room for error, something that has only become more clear in the last two weeks.

With a 52-seat majority, the GOP can lose just two votes. And there are both conservatives and centrists who sound wobbly.

Sen. Rand PaulRandal (Rand) Howard PaulMcConnell about to school Trump on political power for the last time Legislatures boost security after insurrection, FBI warnings Former Missouri senator says backing Hawley was 'worst mistake of my life' MORE (R-Ky.) is the most likely “no” GOP vote. He criticized core elements of the measure as “new entitlements,” a strong signal his vote may be lost.

Conservative Sen. Mike LeeMichael (Mike) Shumway LeeRepublicans wrestle over removing Trump Lawmakers, leaders offer condolences following the death of Capitol Police officer GOP senators urging Trump officials to not resign after Capitol chaos MORE (R-Utah) said last Sunday he has “grave concerns” about the direction of the Senate bill.

Among centrists, Sen. Lisa MurkowskiLisa Ann MurkowskiMcConnell keeps GOP guessing on Trump impeachment FDA chief says he was 'disgusted' by Capitol riots, considered resigning The Memo: Biden prepares for sea of challenges MORE (R-Alaska) has said she doesn’t want to end ObamaCare’s additional funding for Medicaid’s expansion unless her state legislature supports such a vote.

“My position on Medicaid expansion and my support for it hasn’t changed,” Murkowski said.

Sen. Susan CollinsSusan Margaret CollinsThe Memo: Biden prepares for sea of challenges Biden's minimum wage push faces uphill battle with GOP GOP senators wrestle with purging Trump from party MORE (R-Maine) said the Senate bill so far appears to be “far superior” to the House version, but she still has concerns about Medicaid cuts.

Sens. Rob PortmanRobert (Rob) Jones PortmanBiden DHS, Intel picks stress need to prioritize cybersecurity after SolarWinds hack Senators vet Mayorkas to take lead at DHS Graham pushes Schumer for vote to dismiss impeachment article MORE (R-Ohio) and Shelley Moore CapitoShelley Wellons Moore CapitoMcConnell about to school Trump on political power for the last time GOP senator: Trump rhetoric on election fraud 'certainly not helpful' in Georgia Senate GOP opposition grows to objecting to Electoral College results MORE (R-W.Va.) are open to ending the Medicaid expansion funding over the course of seven years, a longer time frame than conservatives want. But it’s not clear Collins can go along with any phase-out of the Medicaid benefits.

“I know that some of the governors have said that a seven-year phase-out is something they could live with,” Collins said this week. “It's certainly far better than the House approach, but I really want to see the whole package.”

Closed doors

The GOP’s work is being carried out behind closed doors, opening Republicans up to attack.

Democrats say the GOP is not giving sufficient time for public review, and fear that McConnell could offer the final bill as an amendment just hours before the vote.

Even some Republican senators have joined the criticism.

“I would have liked for this to be a public process. It’s not going to happen,” said Sen. Bob CorkerRobert (Bob) Phillips CorkerGOP lawmaker patience runs thin with Trump tactics Former GOP senator: Republicans cannot let Trump's 'reckless' post-election claims stand Cornyn: Relationships with Trump like 'women who get married and think they're going to change their spouse' MORE (R-Tenn.).

There have been no hearings on the healthcare bill, and discussions are mostly taking place at Republican conference meetings and meetings of a healthcare task force.

This leaves Republicans open to criticism — a fact some seem to be worried about.

“What I’ve been primarily asking for is once leadership finally does believe they have enough input … I want to make sure the American people, I want to make sure the members of Congress have enough time to evaluate it,” said Sen. Ron JohnsonRonald (Ron) Harold JohnsonGOP senators call for commission to investigate Capitol attack Wisconsin Democrats make ad buy calling on Johnson to resign Efforts to secure elections likely to gain ground in Democrat-controlled Congress MORE (R-Wis.). “I want to have enough time to really take a look at what we’re voting on.”

Polls

The House-passed ObamaCare repeal-and-replace bill is deeply unpopular in polling, posing a further obstacle to the Senate’s effort.

A Quinnipiac University poll this month found that just 17 percent of the public approves of the bill, known as the American Health Care Act, while 61 percent disapproves.

While the Senate is moving a different measure, the negative polling suggests there is some danger for the GOP in making deep cuts to the healthcare law.

Medicaid cuts, which are at the center of the plan in both chambers, are also unpopular. The poll finds 30 percent support decreasing federal funding for the program, while 65 percent oppose doing so.

Healthcare is President Trump’s worst issue area in an Associated Press poll this week, which found that 66 percent disapprove of his handling of the issue.  

All of these numbers make that tightrope on a vote tougher to walk.

Timeline could slip

Given all the difficulties, some senators think the timeline could slip into July.

In addition to the Medicaid debate, there are disagreements over how many ObamaCare regulations to let states waive, and whether to delay repealing some ObamaCare taxes to provide more revenue for the bill.

Conservatives are worried that the measure is tilting too much toward moderate Republicans.

They object to the longer Medicaid phase-out discussions. They are also concerned about the possibility that the bill would only allow states to repeal ObamaCare rules on what an insurance plan must cover, known as essential health benefits, and not protections against people being charged more based on their health, known as community rating. That is a departure from the House bill.

“I don't envy the majority leader in trying to cobble together 50 votes for a bill,” Collins said. “I think it is extremely difficult, and it's even more difficult if you care about maintaining coverage for millions of Americans who need health insurance coverage.”