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 BluntHit singer Andy Grammer says 'unity' more important than any political party Top GOP senator: 'More harassment than oversight' in House Hillicon Valley: Trump takes flak for not joining anti-extremism pact | Phone carriers largely end sharing of location data | Huawei pushes back on ban | Florida lawmakers demand to learn counties hacked by Russians | Feds bust 0M cybercrime group 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 McConnellThe Hill's 12:30 Report: Trump orders more troops to Mideast amid Iran tensions What if 2020 election is disputed? Immigration bills move forward amid political upheaval 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 PaulO'Rourke: Trump 'provoking' war with Iran by sending troops to Middle East Overnight Defense: 1,500 troops heading to Mideast to counter Iran | Trump cites Iran tensions to push through Saudi arms sale | Senate confirms Army, Navy chiefs before weeklong recess Trump to send 1,500 troops to Middle East to counter Iran 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 LeeOn The Money: Senate passes disaster aid bill after deal with Trump | Trump to offer B aid package for farmers | House votes to boost retirement savings | Study says new tariffs to double costs for consumers Senate passes disaster aid bill after deal with Trump Hillicon Valley: Google delays cutting off Huawei | GOP senators split over breaking up big tech | Report finds DNC lagging behind RNC on cybersecurity MORE (R-Utah) said last Sunday he has “grave concerns” about the direction of the Senate bill.

Among centrists, Sen. Lisa MurkowskiLisa Ann MurkowskiMurkowski celebrates birthday with electric scooter ride Overnight Energy: Park Service plans to pay full-time staff through entrance fees | Oil companies join blitz for carbon tax | Interior chief takes heat for saying he hasn't 'lost sleep' over climate change Democrats grill Trump Interior chief for saying he hasn't 'lost sleep' over climate change 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 Hill's Morning Report - Trump says no legislation until Dems end probes Collins offering bill to boost battery research as GOP pushes energy 'innovation' Biden says Congress must move to protect abortion rights 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 PortmanHouse votes to boost retirement savings The Hill's Morning Report - White House, Congress: Urgency of now around budget WANTED: A Republican with courage MORE (R-Ohio) and Shelley Moore CapitoShelley Wellons Moore CapitoCongress, White House near deal on spending, debt limit GOP presses Trump to make a deal on spending Congressional Women's Softball team releases roster 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 CorkerJeff Daniels blasts 'cowardice' of Senate Republicans against Trump Corker: 'I just don't' see path to challenge Trump in 2020 Ex-GOP Sen. Corker: Trump primary would be 'good thing for our country' 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 JohnsonFrustration boils over with Senate's 'legislative graveyard' Barr throws curveball into Senate GOP 'spying' probe Bipartisan group of senators introduce legislation designed to strengthen cybersecurity of voting systems 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.”