GOP infighting erupts over healthcare bill

Senate Republicans are struggling mightily to find a path forward for their ObamaCare repeal bill, with infighting between moderates and conservatives threatening to create an impasse heading into the July Fourth recess.

GOP leaders say they want to have an agreement on changes to the legislation by Friday, but senators said they made virtually no progress at a lunch meeting on Wednesday. In fact, the two sides appeared to grow further apart.

Conservatives represented by Sen. Ted CruzRafael (Ted) Edward CruzO'Rourke faces pressure from left on 'Medicare for all' O'Rourke not planning, but not ruling out big fundraisers O'Rourke: Being a white male not a disadvantage in 2020 Dem field MORE (R-Texas) squared off against moderates led by Sen. Susan CollinsSusan Margaret CollinsRepublicans up for reelection fear daylight with Trump The 25 Republicans who defied Trump on emergency declaration The Hill's Morning Report — Trump readies first veto after latest clash with Senate GOP MORE (R-Maine) over lunch, according to lawmakers who attended.

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They battled over Cruz’s “Consumer Freedom” proposal, which would allow companies to sell health insurance plans that don’t meet the requirements of the Affordable Care Act.

Collins and other moderates expressed strong opposition to the plan, fearing that it would lead to sicker Americans becoming segregated in the insurance markets.

Sen. Ron JohnsonRonald (Ron) Harold JohnsonThe Hill's 12:30 Report: O'Rourke jumps into 2020 fray Trump vows veto ahead of Senate vote on emergency declaration Senate to rebuke Trump on wall MORE (R-Wis.), meanwhile, continued to chastise leadership for not running a more open process in drafting the legislation and ignoring many ideas from rank-and-file colleagues — criticisms he has voiced over the past few weeks.

One senator described the talks as “running in circles.”

Cruz, leaving the lunch, told reporters that most of the discussion was about proposed market reforms to “reduce premiums to make health insurance more affordable for families who are struggling.”

Collins, who is worried about projections that millions of people will lose coverage under the Senate bill, said she remains concerned with “a number of aspects such as coverage, the Medicaid cuts.”

“Tinkering around the edges, adding a bit more money isn’t going to be the answer,” she said.

Walking out of the meeting, Senate Republican Whip John CornynJohn CornynJulian Castro hints at brother Joaquin's Senate run Joaquin Castro closing in on 2020 Senate bid: report Five questions for Beto O'Rourke MORE (Texas) said leadership is aiming to come up with a bill by Friday that both moderates and conservatives can embrace, allowing a vote for the week after the July Fourth recess.

Cornyn said leaders want “to get a bill we can then get scored” by the Congressional Budget Office.

But several Senate Republicans scoffed at the timeline, saying it’s far too optimistic to think a deal can be reached in the next few days.

When asked about the prospects of getting a new bill by Friday, Sen. John McCainJohn Sidney McCainCNN anchor hits Trump: He didn't go to Vietnam 'until he was in his 70s' with 'Secret Service protection' Trump reignites criticism of McCain months after senator's death Graham defends McCain amid Trump attacks: 'Nothing about his service will ever be changed' MORE (R-Ariz.) joked to reporters, “And pigs could fly!”

Collins, fellow moderate Sen. Dean HellerDean Arthur HellerTrump suggests Heller lost reelection bid because he was 'hostile' during 2016 presidential campaign Trump picks ex-oil lobbyist David Bernhardt for Interior secretary Oregon Dem top recipient of 2018 marijuana industry money, study finds MORE (R-Nev.) and conservative Sen. Rand PaulRandal (Rand) Howard PaulThe 25 Republicans who defied Trump on emergency declaration Overnight Defense: Senate rejects border emergency in rebuke to Trump | Acting Pentagon chief grilled on wall funding | Warren confronts chief over war fund budget 12 Republican senators defy Trump on emergency declaration  MORE (R-Ky.) all signaled this week they were unlikely to move from no to yes on the legislation by Friday.

Heller said during a tele-town hall meeting Tuesday that he does not think GOP colleagues are “anywhere close” to a deal and warned it would be “very difficult to get me to a yes,” according to Nevada political commentator Jon Ralston, who reported on the event.

Paul declared after the Wednesday lunch that the GOP conference is at “an impasse.”

He objects to core aspects of the bill as “new entitlements,” including refundable tax credits to help people afford coverage and billions of dollars in a “stabilization fund” intended to bring down premiums. 

Paul told reporters after the GOP lunch Wednesday that he suggested taking the stabilization fund out of the bill and passing it in a separate measure with Democratic votes. But he said his ideas did not go over well with his colleagues, likening his proposal to a “lead balloon.”

Collins on Wednesday said it’s time to work with Democrats instead of trying to win over 50 of 52 Republicans, including conservative holdouts such as Cruz, Paul and Sen. Mike LeeMichael (Mike) Shumway LeeThe 25 Republicans who defied Trump on emergency declaration Dems prepare next steps after Trump's veto Overnight Defense: Senate rejects border emergency in rebuke to Trump | Acting Pentagon chief grilled on wall funding | Warren confronts chief over war fund budget MORE (R-Utah).

“It’s hard for me to see how we get there. I think a better approach would be to try to involve some moderate Democrats in the process and see if we can come up with a bipartisan bill,” she said. “It’s never good to pass major legislation without the input of both parties.”

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellRepublicans up for reelection fear daylight with Trump Overnight Energy: Students around globe demand climate action | EPA bans consumer sales of deadly chemical in paint strippers | Green New Deal set for Senate vote The Hill's Morning Report — Trump readies first veto after latest clash with Senate GOP MORE (R-Ky.) postponed a vote he hoped to hold this week on the healthcare bill after five members of his conference warned they would vote against a motion to begin debate.

After he delayed the vote, three other Republicans — Sens. Rob PortmanRobert (Rob) Jones PortmanThe 25 Republicans who defied Trump on emergency declaration Overnight Defense: Senate rejects border emergency in rebuke to Trump | Acting Pentagon chief grilled on wall funding | Warren confronts chief over war fund budget 12 Republican senators defy Trump on emergency declaration  MORE (Ohio), Shelley Moore CapitoShelley Wellons Moore CapitoPence, GOP senators discuss offer to kill Trump emergency disapproval resolution Bipartisan think tank to honor lawmakers who offer 'a positive tenor' Trump tries to win votes in Senate fight MORE (W.Va.) and Jerry MoranGerald (Jerry) MoranThe 25 Republicans who defied Trump on emergency declaration Overnight Defense: Senate rejects border emergency in rebuke to Trump | Acting Pentagon chief grilled on wall funding | Warren confronts chief over war fund budget 12 Republican senators defy Trump on emergency declaration  MORE (Kan.) — announced they opposed the measure.

A variety of Republican senators cycled in and out of McConnell’s Capitol office Wednesday as he scrambled to keep the legislation from collapsing.

He met with Alaska Sens. Lisa Murkow-ski and Dan Sullivan, who are worried about whether the bill’s tax credits are generous enough to help constituents buy insurance in a state where healthcare costs are several times more expensive than other parts of the country.

Moderates who worry the bill’s tax credits are not generous enough are wondering whether some of ObamaCare’s tax increases, such as a 3.8 percentage-point increase on capital gains, should be kept in place.

“I do not see a justification for doing away with the 3.8 percent tax on investment income, because that is not something that increases the cost of healthcare,” Collins told reporters.

Keeping that tax increase, however, would outrage conservatives. 

McConnell also met with Capito, who wants to raise the cap on Medicaid spending that would cut the program by $160 billion in 2026 compared to current law.

After 2025, the Senate bill sets a less generous formula than included in the House-passed bill to index Medicaid to inflation.

Conservatives led by Sen. Pat Toomey (R-Pa.), who had a role in drafting the bill, said the stricter Medicaid inflation formula is “very important.”

Also on the conservative side, an aide to Lee said his boss had not yet met in person with McConnell, but that their two staffs were working on a change related to the ability of states to opt out of ObamaCare regulations.

The ability for states to repeal more of those regulations is key for Lee, as it is for Cruz and other conservatives.

Aside from the moderates, some Republican senators are growing impatient with conservatives holding out after campaigning for years to repeal ObamaCare.

Senate Finance Committee Chairman Orrin HatchOrrin Grant HatchNY's political prosecution of Manafort should scare us all Congress must break its addiction to unjust tax extenders The FDA crackdown on dietary supplements is inadequate MORE (R-Utah) grumbled that conservatives, whom he called “recalcitrants,” are inadvertently helping the Democrats keep the controversial law intact.

He said Democrats may eventually bring about “socialized Medicine” and warned “it may take a few of these conservative Republicans to help the Democrats be able to do that to us.”

Jordain Carney contributed.