WASHINGTON — The first complete draft of a last-ditch Republican effort to replace the Affordable Care Act, led largely by Louisiana Sen. Bill Cassidy, is set to be revealed Wednesday morning.
But even before Cassidy and Sen. Lindsey Graham, R-South Carolina, have unveiled the details of their proposal, several of their Republican Senate colleagues were throwing cold water on the bill’s chances while party leaders remained noncommittal.
A kindling debate over a radically different health insurance overhaul — Vermont Sen. Bernie Sanders also picked Wednesday to unveil his “Medicare for All” plan — also appeared to draw attention away from the efforts by Cassidy and Graham to replace former President Barack Obama’s signature achievement.
U.S. Sen. John Thune of South Dakota, the No. 3 Republican in the Senate, described the bill’s chances as something of a “double-double bank shot,” apparently alluding to an extremely difficult billiards shot.
Thune said there’s significant interest in the idea among Republican Senators but indicated it was largely up to Cassidy, Graham and the pair’s co-sponsors — Republican Sens. Dean Heller of Nevada and Ron Johnson of Wisconsin — to build up enough support for the bill before getting it to a vote.
“If it looks like this is starting to get some traction, we’ll do whatever we can to help speed it along,” Thune said, before adding, “We’ll see where the discussions go but the clock’s ticking and it’s a pretty short window.”
Even if Cassidy, Graham, Heller and Johnson can cobble together enough votes among Senate colleagues to hit the 50-vote threshold — something that eluded Senate Majority Leader Mitch McConnell this summer — they face numerous procedural roadblocks ahead of a September 30 deadline to get the bill passed on a party-line vote.
Although senators could still consider health insurance after the end of the month, Republicans would need to collect 60 votes to do so because their authority to pass the bill with a simple majority under a process known as reconciliation will have expired. To get 60 votes to repeal and replace Obamacare seems nearly impossible, given a razor-thin Republican majority and unified Democratic opposition.
Cassidy, a physician and Baton Rouge Republican who’s made overhauling the nation’s health insurance system his prime focus for months, seemed largely undeterred by the criticism of his plan or the daunting timeline.
Cassidy had hoped to unveil a draft of the bill on Monday. But the senator said Tuesday he was still reworking portions of its text while consulting with numerous stakeholders — including state governors and insurance commissioners — to build support.
At the heart of the Cassidy-Graham-Heller-Johnson plan is a provision that would bundle the billions of federal dollars that currently cover the cost of Obamacare’s Medicaid expansion and individual insurance subsidies into block grants for states. Although exact details won’t be clear until the bill’s text is made public, states would have considerable freedom to use the money as each sees fit and to reshape the structure and scope of government-supported healthcare for low income residents.
Some critics of the plan, including many Democrats, have raised concerns that loosened regulations could create loopholes for insurers to cut back on coverage. The block grants also wouldn’t grow as fast as current federal spending under Medicaid, meaning the Cassidy-Graham-Heller-Johnson proposal likely amounts to a substantial future cut in federal money for most states when compared to current law.
WASHINGTON — For months, Louisiana Senator Bill Cassidy has poured his time into possible re…
On Monday, U.S. Sen. Rand Paul, R-Kentucky, came out against the proposal, telling reporters it would “probably” be worse than letting Obamacare stand because it doesn’t go far enough to repeal some of Obamacare’s provisions. Paul also told Congressional Quarterly the bill had a “zero” percent chance of passing.
U.S. Sen. Orrin Hatch, the Senate’s longest-serving Republican and the chair of the finance committee, one of the likely venues to hold hearings on the bill, answered with a simple “no” when asked if the Cassidy-Graham bill would get a vote in the Senate, according to The Hill newspaper.
“All you can say is you’re going to keep on doing what’s right,” Cassidy responded on Tuesday. “We’re going to meet the vice president now. Sen. John McCain (R-Arizona) has spoken very favorably of it — he was obviously a key vote last time — so we keep on pushing.”
McCain, whose dramatic “no” vote on the most recent attempt to undo Obamacare proved decisive in killing the effort, told The Advocate he’s “supportive” of Cassidy’s efforts but couldn’t say whether he’d vote for it until he’d had a chance to review the bill’s text and consult with Arizona’s governor about its impact on his home state.
Thune, the South Dakota Republican, noted that one thing Cassidy and Graham have done is reach out to Republican governors, a number of whom came out against prior repeal-and-replace efforts because of the potential impact on Medicaid expansion.
Cassidy touted the added flexibility — as well as a block-grant formula that would boost federal dollars headed toward some swing states — as particularly attractive aspects of the package for state-level leaders. Cassidy has also expressed hope that some Democrats might be wooed by those facets of his plan, rejecting the notion that he and Graham have been pushing a “partisan” bill.
But Cassidy also acknowledged he’s unlikely to win any support from the other side of the aisle.
“Right now every indication I get is they’ll vote party line,” Cassidy said.
McCain had leveled fierce criticism at previous attempts to repeal Obamacare that skipped committee hearings and other key opportunities for debate that are typically part of normal Senate procedure. He stopped short of demanding a full committee hearing on Cassidy-Graham on Tuesday.
“I can’t get into the hypotheticals,” McCain said, “but I think the chances are dim if we go through the same drill we just went through.”
Cassidy said he’s had discussions with committee chairmen about possibly holding hearings on the bill but hadn’t lined up firm commitments or scheduled anything yet.
McConnell, whose efforts to undo Obamacare went down in dramatic fashion in July, appeared to hedge when asked Tuesday afternoon about the Cassidy-Graham proposal. McConnell also pointed to a bipartisan effort to shore up Obamacare’s health insurance exchanges — led by Sen. Lamar Alexander, R-Tennessee, and Sen. Patty Murray, D-Washington — and indicated he wasn’t sure yet which might have the better shot.
“I think the way forward, as of today, is not clear,” said McConnell, a Kentucky Republican, at a Senate leadership press conference in the Capitol, flanked by other top-ranking Republicans.
McConnell and his top deputies focused most of their attention Tuesday on two higher priorities: ongoing negotiations over the military budget and Republican tax reform proposals, an issue which has shot to the top of many Republican’s list of priorities.
McConnell came around to addressing the Obamacare repeal-and-replace effort only after U.S. Sen. John Barrasso, R-Wyoming, lit into Sanders’ “Medicare for All” proposal, blasting it as a “complete government takeover of healthcare.”
Sanders’ plan — and several competing Democratic proposals to allow people to buy into Medicare or provide a government-run “public option” for health insurance — have gained increasing traction on the left in recent months.
“We want to move the issue forward and we’re looking at all of these,” Sen. Chuck Schumer of New York, the top Democrat in the Senate, said Tuesday.
The push toward single-payer healthcare by liberals — and fierce counterattacks by conservatives — are opening a new and very different arena of debate over the country’s healthcare system even as Cassidy and a handful of Republican colleagues continue trying to fulfill their party’s years-long pledges to scrap Obamacare.
And even as Democrats struggled internally over the proposals, which some moderates have rejected and others have viewed tepidly, many of Cassidy’s Republican colleagues have appeared increasingly interested in moving onto other issues after earlier failures to undo Obamacare.
Fellow Louisiana Republican Sen. John Kennedy, who voted in favor of the previous repeal-and-replace proposals, called passage of the Cassidy-Graham bill “theoretically possible” but said he didn’t sense much of an appetite among other senators to consider the bill.
“I just don’t sense that the body is ready to revisit healthcare right now, we’ve kind of moved to tax reform,” Kennedy said. “It doesn’t mean we won’t do healthcare, it doesn’t mean we don’t eventually do Graham-Cassidy.
“I’m just not sure the votes are there to do it right now.”