How Trump's repeal push came up short

How Trump's repeal push came up short
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The Trump administration pushed hard — and ultimately unsuccessfully — to convince reluctant senators and governors to support the Senate GOP’s ObamaCare replacement effort.

Its two top health officials and Vice President Pence became fixtures in closed-door GOP conference meetings on Capitol Hill, along with other key advisers such as budget director Mick Mulvaney and White House chief of staff Reince Priebus.

The administration had hoped the policy expertise of Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma would be enough to convince holdout senators that the GOP legislation would help their states.

But it didn’t work.

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Senate Republicans' ObamaCare replacement effort officially fell apart Monday night, leaving the GOP reeling as it tries to reconcile competing ideas on what to do next.

Did the administration do enough to convince senators of the merits of the repeal-and-replace plan?

Sen. John BarrassoJohn Anthony BarrassoTrump boxed in on trade Export-Import Bank back to full strength after Senate confirmations Mike Enzi announces he'll retire from Senate after 2020 MORE (R-Wyo.) pushed back when asked if he thought the administration could have had a better message. 

“No, no,” Barrasso told The Hill. “They are committed to fundamental healthcare reform in this country. They campaigned on it, they’ve been working very closely with us.”

After a vote on the initial version of the ObamaCare replacement was delayed, moderate GOP senators expressed hope that some of the harshest Medicaid cuts would be taken out of the bill before it was brought to the floor.

When the cuts were left in place, Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellThe Hill's Morning Report - Pelosi remains firm despite new impeachment push Iraq War looms over Trump battle with Iran 2020 Dems break political taboos by endorsing litmus tests MORE (R-Ky.) enlisted the help of Price, Pence and Verma to try to downplay concerns.

Verma and Price spent the past week telling skeptical senators that the $182 billion state stabilization fund and $45 billion in funding to combat opioid abuse contained in the legislation would be enough to ensure that everyone who needs coverage could get it.

But the senators weren’t convinced.

Verma huddled in McConnell’s office with undecided GOP Sens. Dean HellerDean Arthur HellerThis week: Barr back in hot seat over Mueller report Trump suggests Heller lost reelection bid because he was 'hostile' during 2016 presidential campaign Trump picks ex-oil lobbyist David Bernhardt for Interior secretary MORE (Nev.), 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 (W.Va.), Lisa MurkowskiLisa Ann MurkowskiCongress must press Interior secretary to act on climate change Senate panel approves Interior nominee over objections from Democrats Women's civil rights are not a state issue MORE (Alaska) and Rob PortmanRobert (Rob) Jones PortmanThe Hill's Morning Report - White House, Congress: Urgency of now around budget WANTED: A Republican with courage Companies warn Trump trade war is about to hit consumers MORE (Ohio) late last week. All four expressed concerns about the bill’s Medicaid cuts and phaseout of Medicaid expansion funding.

Those concerns were echoed by Sen. Susan CollinsSusan Margaret CollinsCollins offering bill to boost battery research as GOP pushes energy 'innovation' Biden says Congress must move to protect abortion rights Women's civil rights are not a state issue MORE (R-Maine) in a Sunday CNN interview.

"This bill would impose fundamental sweeping changes in the Medicaid program and those include very deep cuts,” she warned. “You can't take more than $700 billion out of the Medicaid program and not think that it's going to have some kind of effect.”

Verma reportedly told hesitant senators that states would have much more flexibility in how they use federal Medicaid funding once the legislation passed.

But after the meeting in McConnell’s office, not one senator there said they were ready to support the bill.

“My position hasn’t changed,” Portman, who wanted to see a Congressional Budget Office analysis of the changes, said at the time.

Verma also accompanied Price and Pence to the National Governors Association meeting last weekend to pitch both Democratic and Republican governors on the Senate’s bill. For many governors, it was their first meaningful interaction with the administration related to the legislation.

The message, according to Connecticut Gov. Dannel Malloy (D), was about state flexibility.

It fell flat, he added.

“If their job was to convince a bunch of governors to jump from their current position to be supportive, they were abject failures,” he told The Hill. “If you travel from Washington to Providence to convince everyone that you are right and everyone else is wrong, and you didn’t, there’s only one conclusion to draw.”

In a closed-door meeting with governors from both parties, Verma reportedly started her presentation by urging the governors not to accept the conclusions of an independent study that warned states would experience drastic reductions in Medicaid money if the bill became law.

She ended her presentation by attacking estimates from the Congressional Budget Office that 15 million people would lose Medicaid coverage by 2026 and that $772 billion would be cut from the program.

According to Malloy, governors from both parties pressed Verma and Price about spending cuts to Medicaid, expressing skepticism that states could make up for the loss of funding by being innovative with how they run the program.

“The argument that I can somehow innovate my way around a spectacular Medicaid cut has somehow escaped me,” Malloy said.

Edwin Park, vice president of health policy at the Center on Budget and Policy Priorities, acknowledged that Verma and Price were trying to help the administration pass the bill, but he said making “outlandish claims” didn’t help.

“You can’t deny $772 billion will have an adverse effect on Medicaid,” but that’s what they tried to do, Park said. “I don’t think making those claims” helped their credibility.

The opposition from governors was just one major obstacle to passage.

Republicans like Ohio Gov. John Kasich and Nevada Gov. Brian Sandoval also put pressure on their home-state senators to oppose the bill. 

It became clear Tuesday that GOP leaders do not have the votes to move a standalone bill to repeal ObamaCare without a replacement, with at least three senators expressing opposition.

They were followed by a bipartisan group of governors who similarly came out against the Senate's effort to move forward with a plan to first repeal ObamaCare, then pass a replacement later.

Sen. Lindsey GrahamLindsey Olin GrahamCongress, White House near deal on spending, debt limit Hillicon Valley: Google delays cutting off Huawei | GOP senators split over breaking up big tech | Report finds DNC lagging behind RNC on cybersecurity Roger Stone considers suing to discover if he was spied on by FBI MORE (R-S.C.) said whatever the next step is on healthcare, governors need to be included.

“If you’ve got the governors behind the plan, that changes the politics. If you can marry out support from governors and the White House, then the politics of the Senate change,” Graham said Tuesday.

What happens next is unclear, with Republicans deeply divided over what to do and other pressing matters — including funding the government and raising the debt ceiling — looming on the agenda.