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 BluntThe Hill's Morning Report - Will Schumer back down on his deadline? GOP fumes over Schumer hardball strategy Cybersecurity bills gain new urgency after rash of attacks 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 McConnellHas Trump beaten the system? Yellen to Congress: Raise the debt ceiling or risk 'irreparable harm' The Hill's 12:30 Report - Presented by Goldman Sachs - Tokyo Olympics kick off with 2020-style opening ceremony 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 PaulGOP Rep. Cawthorn says he wants to 'prosecute' Fauci Writer: Fauci, Paul clash shouldn't distract from probe into COVID-19 origins S.E. Cupp: 'The politicization of science and health safety has inarguably cost lives' 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 LeeOvernight 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 US launches second Somalia strike in week Biden's misinformation crackdown spotlights partisan divide on content reform MORE (R-Utah) said last Sunday he has “grave concerns” about the direction of the Senate bill.

Among centrists, Sen. Lisa MurkowskiLisa Ann MurkowskiWhy Biden's Interior Department isn't shutting down oil and gas Biden signs bill to bolster crime victims fund Bipartisan group says it's still on track after setback on Senate floor 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 CollinsTransit funding, broadband holding up infrastructure deal The Hill's Morning Report - Infrastructure vote fails; partisan feud erupts over Jan. 6 panel Senate falling behind on infrastructure 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 PortmanKey Biden ally OK with dropping transit from infrastructure package Frustration builds as infrastructure talks drag Hillicon Valley: Democrats introduce bill to hold platforms accountable for misinformation during health crises | Website outages hit Olympics, Amazon and major banks MORE (R-Ohio) and 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 (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 CorkerCheney set to be face of anti-Trump GOP How leaving Afghanistan cancels our post-9/11 use of force The unflappable Liz Cheney: Why Trump Republicans have struggled to crush her  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 JohnsonThe Hill's Morning Report - Pelosi considers adding GOP voices to Jan. 6 panel McConnell pushes vaccines, but GOP muddles his message Ron Johnson: 'I may not be the best candidate' for 2022 midterms 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.”