WASHINGTON ― After the Congressional Budget Office dealt another blow to the Republican health care plan, Senate GOP leaders on Monday night scrambled to figure out a way forward for a bill already on shaky ground.
Republican leaders seemed to have no margin of error left.
Sen. Susan Collins (R-Maine) announced Monday night she will oppose the GOP bill, joining Sen. Dean Heller (R-Nev.). That leaves Senate Majority Leader Mitch McConnell (R-Ky.) without the option of losing another Republican. The problem for McConnell is that he may have already lost senators, as Sen. Rand Paul (R-Ky.) and other conservatives increasingly trash-talk the GOP plan for not lowering premiums.
“It’s a terrible bill,” Paul told reporters Monday night.
“It’s worse to pass a bad bill than to pass no bill,” Paul continued. “And 2018 is going to roll around and people are going to ask themselves, ‘Are my premiums lower?’ and they’re going to find out, ‘You know what, my premiums still went up 25 percent.’”
Paul said he would oppose a motion to proceed without assurances to improve the bill, and suggested there are other conservative senators who also will hold out.
McConnell hasn’t committed to holding a vote on the GOP bill before senators leave for a July 4 recess. The No. 2 Senate Republican, Majority Whip John Cornyn (R-Texas), said Monday he was “closing the door” on a delay, saying insurers need to come up with plans for 2018.
But Cornyn’s pledge was before Collins came out against the bill. While Republican leaders have faced a vote problem all along, putting the bill to a vote now, only to see it fail on the floor, could complicate efforts in the future. It’s a question for leaders: Do they think they’re better served by a delay than by a failure?
Republicans find themselves in this position after the CBO predicted Monday afternoon that the Senate bill would insure 22 million fewer people and cut $772 billion from Medicaid. While the most reliable Republicans were happy to cast doubt on the projections (Sen. Pat Toomey of Pennsylvania), or embrace the report as welcome news of deficit savings (Sen. James Inhofe of Oklahoma), senators who remain question marks on the bill seemed to take the report seriously.
Even Sen. Ted Cruz (R-Texas) was citing the report for its conclusions that premiums would not go down, though he wouldn’t answer reporters on whether he would vote against the bill ― or the motion to proceed ― if the legislation came up for a vote this week. Sen. Ron Johnson (R-Wis.) was also cagey, but warned that leaders “better not” count on his vote this week. Johnson signed a statement last week with Mike Lee (R-Utah), Cruz and Paul suggesting they opposed the bill in its current form.
Without amendments that could further endanger the support of moderates, those conservative senators may never get behind the bill. And with Sen. Lisa Murkowski (R-Alaska) still avoiding questions about where she stands, McConnell may simply be unable to wrangle the votes in the three days before senators are scheduled to leave for vacation.
The one bit of news that offers McConnell a glimmer of hope is that the CBO said the bill would save $321 billion over 10 years. McConnell could use some of that money to shore up support of senators concerned about Medicaid cuts, potentially even winning back Collins. He also has money to address concerns of rural-state senators like Murkowski that the bill would be an especially raw deal for states like Alaska.
But with Collins and Heller out, McConnell needs to win back conservatives, perhaps with a new version of the amendment in the House that would allow insurers to charge more for people with preexisting conditions. That may endanger the support of moderates, but it may be the only way to win senators like Paul, Lee, and Cruz.
That sort of gambit would rely on the rest of the GOP conference swallowing provisions they don’t like, but it’s not impossible to envision Republicans going along with a bill that does things they disagree with.
When reporters asked Sen. John McCain (R-Ariz.) if there were things in the health care plan that he didn’t like, he answered Monday night that there were “lots” of things.
Asked if he would withhold support until those things were changed, McCain showed just how much he cares about this issue. “That’s not how it works,” said McCain, who has been in the Senate for 30 years.