Tag Archives: Affordable Care Act

Republican effort to gut Obamacare crashes in U.S. Senate

The United States Capitol is seen prior to an all night round of health care votes on Capitol Hill in Washington, U.S., July 27, 2017. REUTERS/Aaron P. Bernstein

By Yasmeen Abutaleb, Amanda Becker and David Morgan

WASHINGTON (Reuters) – A U.S. Senate led by Donald Trump’s fellow Republicans failed by a single vote to pass a healthcare bill on Friday, delivering a stinging blow to the president as it undermined his campaign promise to dismantle Obamacare.

Three Republican senators – John McCain, Susan Collins and Lisa Murkowski – joined Senate Democrats in the dramatic early-morning 51-49 vote rejecting the bill. The outcome may spell doom for the party’s seven-year quest to gut a 2010 law that was Democratic former President Barack Obama’s signature domestic policy achievement.

For the moment the Affordable Care Act, which extended health insurance to 20 million people and drove the percentage of uninsured people to historic lows, remains in place and must be run by an administration that is hostile to it.

This leaves health insurers unsure how long the administration will continue to make billions of dollars in Obamacare payments that help cover out-of-pocket medical expenses for low-income Americans.

In Friday’s vote, Senate Majority Leader Mitch McConnell was unsuccessful in securing passage of even a stripped-down so-called skinny bill that would have repealed a few key parts of Obamacare. Broader legislation was defeated earlier in the week.

“It’s time to move on,” McConnell, whose reputation as a master strategist was in tatters, said on the Senate floor after the vote that unfolded at roughly 1:30 a.m.

“The American people are going to regret that we couldn’t find a better way forward,” McConnell added.

Republicans have long denounced Obamacare – which expanded the Medicaid health insurance for the poor and disabled and created online marketplaces for individuals to obtain coverage – as an intrusion by government on people’s healthcare decisions.

The Senate failure to move forward on dismantling it called into question the Republican Party’s basic ability to govern even as it controls the White House, Senate and House of Representatives.

Trump has not had a major legislative victory after more than six months in office. He had promised to get major healthcare legislation, tax cuts and a boost in infrastructure spending through Congress in short order.

“3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode, then deal. Watch!” Trump wrote on Twitter after the vote.

But McCain wrote on Twitter, “Skinny repeal fell short because it fell short of our promise to repeal & replace Obamacare w/ meaningful reform.”

Republicans released the skinny bill just three hours before voting began. It would have retroactively repealed Obamacare’s penalty on individuals who do not obtain health insurance, repealed for eight years a penalty on certain businesses that do not provide employees with insurance and repealed a tax on medical devices until 2020. The nonpartisan Congressional Budget Office estimated that if it became law, 15 million fewer Americans would be insured in 2018 than under existing law.

The Affordable Care Act was passed by a then-Democratic controlled Congress with no Republican support in 2010. But Republicans have failed to come up with a consensus plan to replace it at a time when they hold all the power in Washington.

UNCERTAINTY FOR HEALTHCARE INDUSTRY

Health insurers have until September to finalize their 2018 health plans in many Obamacare marketplaces.

Some insurers, including Humana and Aetna, have pulled out of such markets, citing the uncertainty over the payments. Others have raised rates by double digits and said that they will need to raise rates another 20 percent if the uncertainty does not ease. Anthem Inc, which has already left three of the 14 states where it sells Blue Cross Blue Shield plans, said this week it might pull out of more.

Wall Street traded lower on Friday with less focus on the news from the Senate overnight and more on key earnings from Amazon and Exxon. Shares of hospitals were mixed: Tenet Healthcare fell 2 percent, Community Health Systems was nearly flat and HCA Healthcare gained 1.2 percent. Shares of health insurers were also mixed. Aetna was off 0.2 percent, Anthem gained 0.4 percent and Humana was off 0.3 percent.

Democrats, and some Republicans, said the bill’s failure could present an opportunity for the two parties to work together to fix problematic areas of the Obamacare law without repealing it.

Top House Democrat Nancy Pelosi called on Republican House Speaker Paul Ryan to establish a process for moving forward on improving Obamacare, rather than repealing it.

After the House passed a bill to repeal and replace Obamacare in May, McConnell grappled to get Senate Republicans to agree on their version of the bill. Hard-line conservatives wanted a bill that would substantially gut Obamacare, while moderates were concerned over legislation that could deprive millions of people of their healthcare coverage.

Republicans hold a 52-48 majority in the 100-seat Senate and could afford to lose support from only two Republican senators, with Vice President Mike Pence ready to cast a tie-breaking vote on the Senate floor.

DRAMA OVER MCCAIN

As the vote on the skinny bill approached, all eyes in the Senate chamber were on McCain. The 2008 Republican presidential nominee flew back from Arizona earlier in the week after being diagnosed this month with brain cancer. McCain, an 80-year-old former prisoner of war in Vietnam who tangled with Trump during the 2016 election campaign and was disparaged by him, won praise for this from the president.

McCain, a veteran senator who has long been known for his independent streak, delivered a rousing speech on Tuesday calling for cooperation between the parties and then cast a decisive vote in allowing the Senate to take up the healthcare bill.

Early on Friday, he sat on the Senate floor talking to Collins, Murkowski, and Republican Senator Jeff Flake, also from Arizona. Collins and Murkowski both voted this week against broader Republican healthcare proposals, and both had concerns about the pared-down proposal.

McCain was approached before voting began by Pence and a close friend, Republican Senator Lindsey Graham. After speaking to them, McCain walked across the Senate floor to tell top Senate Democrat Chuck Schumer and other Democrats he would vote with them.

When McCain walked to the front of the Senate chamber to cast his deciding “no” vote, giving a thumbs down, Democrats cheered, knowing the bill would fail.

Trump had often expressed exasperation over the failure of congressional Republicans to overcome internal divisions to repeal Obamacare, but offered no policy specifics himself.

He has demanded at various times that Obamacare should be allowed to collapse on its own, that it should be repealed without replacement, and that it should be repealed and replaced.

(Additional reporting by Susan Cornwell, Richard Cowan and Eric Walsh in Washington, Saikat Chatterjee and Abhinav Ramnarayan in London; Writing by Will Dunham; Editing by Louise Ireland and Frances Kerry)

Senate poised for healthcare showdown

Senate Majority Leader Mitch McConnell, accompanied by Senator John Cornyn (R-TX) and Senator John Barrasso (R-WY), speaks with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington, U.S., July 25, 2017. REUTERS/Aaron P. Bernstein

By Amanda Becker and Yasmeen Abutaleb

WASHINGTON (Reuters) – U.S. Senate Republicans begin their final push on Thursday to unravel Obamacare, seeking to wrap up their seven-year offensive against former Democratic President Barack Obama’s signature healthcare law that extended insurance coverage to millions.

Republicans leaders hope a pared-down “skinny” bill that repeals several key Obamacare provisions can gain enough support to pass after several attempts at broader legislation failed to win approval earlier this week.

The skinny bill’s details will be released at some point on Thursday, before the Senate embarks on a marathon voting session that could extend into Friday morning. The legislation is expected to eliminate mandates requiring individuals and employers to obtain or provide health insurance, and abolish a tax on medical device manufacturers.

The effort comes after a chaotic two-month push by Senate Republicans to pass their version of legislation that made it out of the Republican-controlled House of Representatives in May.

Members of the party, including President Donald Trump, campaigned on a pledge to repeal and replace what they say is a failing law that allows the government to intrude in people’s healthcare decisions.

Republicans were optimistic about the skinny bill’s chances of receiving at least 50 votes in the Senate where they hold a 52-48 majority.

Senator John Cornyn, the chamber’s No. 2 Republican, said the bill, once approved, would go to a special negotiating committee of lawmakers from both chambers that would reconcile the House and Senate versions into a single piece of legislation.

Republican leaders had tapped a group to craft legislation largely behind closed doors, exposing rifts within the party. While conservatives said the group’s proposals did not go far enough, moderates said they could not support measures estimated to deprive tens of millions of health insurance.

The Senate voted 55-45 on Wednesday against a simple repeal of Obamacare, which would have provided a two-year delay so Congress could work out a replacement. Seven Republicans opposed the bill. On Tuesday, senators rejected the repeal-and-replace plan Republicans had been working on since May.

Senate Majority Leader Mitch McConnell can lose only two Republican votes to pass healthcare legislation. Even then, he would have to call on Vice President Mike Pence to cast a tie-breaking vote as head of the Senate. Democrats are united in opposition.

GOVERNORS SEEK INVOLVEMENT

A bipartisan group of 10 governors urged senators in a letter on Wednesday to start over and use a drafting process that includes governors from both parties. Governors of Nevada, Ohio, Louisiana, Pennsylvania and Colorado were among those who signed the letter, all of whose states have Republican senators.

The Congressional Budget Office, a nonpartisan research agency, estimated on Wednesday that a combination of provisions that might go into the skinny bill would lead to 16 million people losing their health coverage by 2026.

It had earlier estimated that the two other bills rejected by the Senate this week would have led to 22 million to 32 million people losing their health insurance by 2026.

Senate Democratic leader Chuck Schumer criticized Republican leaders for crafting a “yet-to-be-disclosed final bill” in secret.

“We don’t know if skinny repeal is going to be their final bill, but if it is, the CBO says it would cause costs to go up, and millions to lose insurance,” Schumer said on the Senate floor.

(Additional reporting by Susan Cornwell, Richard Cowan and David Morgan; Writing by Lisa Lambert; Editing by Peter Cooney)

Brawl over Obamacare repeal returns to Senate floor

Senate Majority Leader Mitch McConnell, accompanied by Senator John Cornyn (R-TX) and Senator John Barrasso (R-WY), speaks with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington, U.S., July 25, 2017. REUTERS/Aaron P. Bernstein

By Richard Cowan

WASHINGTON (Reuters) – After a months-long struggle, Republicans have succeeded in bringing Obamacare repeal legislation, a centerpiece of their 2016 election campaigns, to a debate on the U.S. Senate floor. Now the hard part begins.

Republicans, deeply divided over the proper role of the government in helping low-income people receive healthcare, eked out a procedural win on Tuesday when the Senate voted 51-50, with Vice President Mike Pence breaking a tie, to allow debate to start on legislation.

The outcome came as a huge relief to President Donald Trump, who has called Obamacare a “disaster” and pushed fellow Republicans in recent days to follow through on the party’s seven-year quest to roll back the law.

But hours later, Senate Republican leadership suffered a setback when the repeal and replace plan that they had been working on since May failed to get enough votes for approval, with nine out of 52 Republicans voting against it.

Usually, bills reach the floor with a predictable outcome: Senators have received summaries of the legislation to be debated that were written in an open committee process, leaders have counted the number of supporters and opponents, amendments are debated and everybody knows the likely outcome: passage.

All that is out the window now, as the Senate on Wednesday continues a freewheeling debate that could stretch through the week on undoing major portions of former Democratic President Barack Obama’s signature Affordable Care Act, which expanded health insurance to about 20 million people, many of them low-income.

Republican leaders have insisted they can devise a cheaper approach this week and with less government intrusion into consumers’ healthcare decisions than Obamacare.

Democrats and other critics of the Republican effort said it would deprive millions of health coverage.

“We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition,” Republican Senator John McCain said on Tuesday.

“I don’t think that is going to work in the end. And it probably shouldn’t,” he added.

The veteran Arizona lawmaker made his remarks after receiving a standing ovation from his colleagues, as he returned to the Senate just days after surgery and being diagnosed with brain cancer.

McCain appealed to Senate Majority Leader Mitch McConnell to start over by having a Senate committee, in a bipartisan way, craft new healthcare legislation.

His proposal was promptly ignored.

‘SKINNY’ BILL GETS TRACTION

As senators grind through potentially scores of amendments in coming days – in a process called a “vote-a-rama” – they will have more than McCain’s scorn to worry about.

Healthcare industry organizations are similarly troubled.

“We strongly oppose all plans so far to replace the Affordable Care Act and have no confidence lawmakers can overcome the flaws in these proposals,” said America’s Essential Hospitals, a group representing hospitals that treat poor people.

Like McCain, the group urged the Senate, narrowly controlled by Republicans, to halt its work on Obamacare repeal legislation and begin a bipartisan effort on healthcare.

The Republican drive to “repeal and replace” Obamacare has taken many unexpected turns since the House of Representatives began working on its version of legislation last March.

For now, many Republican senators are wondering whether they may end up going to a Plan B – a “skinny” healthcare bill that would simply end Obamacare’s penalties for individuals and employers that do not obtain or provide health insurance, as well as abolish a medical device tax.

It would then be up to a special Senate-House committee to come up with a final bill that could take many turns during the negotiation.

After Tuesday’s nail-biter Senate vote setting up the floor debate, McConnell may have best summed up the landscape facing the chamber’s 100 senators.

“This is just the beginning,” he told reporters.

(Reporting by Richard Cowan; additional reporting by Susan Cornwell; Editing by Mary Milliken, Peter Cooney and Michael Perry)

McCain to return for pivotal Senate vote on healthcare

FILE PHOTO: Senator John McCain (R-AZ) speaks to reporters after the Senate voted to remove the filibuster rule for Supreme Court nominees, on Capitol Hill in Washington, U.S., April 6, 2017. REUTERS/Joshua Roberts/File Photo

By James Oliphant

WASHINGTON (Reuters) – Senator John McCain will make a return to the U.S. capitol on Tuesday to play what could be a crucial role in keeping Republican efforts to repeal Obamacare afloat.

McCain, who is battling brain cancer at his Arizona home, is set to help decide whether the repeal push will move forward or perhaps be abandoned entirely.

Senators will be asked whether to begin debate on the Senate floor on a healthcare overhaul that would supplant the 2010 Affordable Care Act, better known as Obamacare.

A loss would force Senate leaders, who have struggled to amass support for their version of an overhaul, to find another strategy or move on to other legislative matters.

President Donald Trump has been increasingly critical of Republican senators and their failure to pass a bill. Trump held an event at the White House on Monday in which he chastised them, saying they “have not done their job in ending the Obamacare nightmare.”

The vote in the divided chamber was expected to be extremely tight, making McCain’s return critical to the repeal effort.

McCain has said that he typically votes to open legislative debates such as these, but has also voiced concerns about the Senate bill and said he would try to address them on the floor.

He was diagnosed with an aggressive form of brain cancer earlier this month after surgery to remove a blood clot and had not been expected to attend Tuesday’s vote. His office, however, released a statement late Monday announcing his return.

Should enough Republicans vote to move forward, senators would begin debating the bill that passed the U.S. House of Representatives in April. But that bill likely would be heavily modified through the amendment process.

Some senators said it was time to either tackle the issue on the Senate floor or move on to other matters.

“Now it’s time to fish or cut bait,” said Republican Senator Mike Rounds. “Let’s get on with it. We have a lot of other things to do.”

No Democrat is expected to vote in favor of opening debate, meaning that Republicans, who hold 52 seats in the 100-seat chamber, cannot afford to lose more than two of their own.

Senator Susan Collins has been the only Republican who has publicly said she will vote against opening debate, but it remained possible that she could be joined by other Republicans concerned about the form the legislation might ultimately take.

Vice President Mike Pence, a Republican who is expected to be on Capitol Hill on Tuesday, would step in the case of tie and vote to move forward.

(Reporting by Amanda Becker, Susan Cornwell, Richard Cowan and James Oliphant; Writing by James Oliphant; Editing by Mary Milliken and Michael Perry)

Republicans’ push to roll back Obamacare faces crucial test

President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, May 4, 2017.

By Amanda Becker

WASHINGTON (Reuters) – A seven-year Republican effort to repeal and replace Obamacare faces a major test this week in the U.S. Senate, where lawmakers will decide whether to move forward and vote on a bill whose details and prospects are uncertain.

The Senate will decide as early as Tuesday whether to begin debating a healthcare bill. But it remained unclear over the weekend which version of the bill the senators would ultimately vote on.

President Donald Trump, after initially suggesting last week that he was fine with letting Obamacare collapse, has urged Republican senators to hash out a deal.

“Republicans have a last chance to do the right thing on Repeal & Replace after years of talking & campaigning on it,” Trump tweeted on Monday.

Republicans view former President Barack Obama’s signature 2010 health law, known as Obamacare, as a government intrusion in the healthcare market. They face pressure to make good on campaign promises to dismantle it.

But the party is divided between moderates, concerned that the Senate bill would eliminate insurance for millions of low-income Americans, and conservatives who want to see even deeper cuts to Obama’s Affordable Care Act.

The House in May passed its healthcare bill. Senate Republicans have considered two versions but have been unable to reach consensus after estimates showed they could lead to as many as 22 million fewer Americans being insured. A plan to repeal Obamacare without replacing it also ran aground.

If the Senate approves a motion to begin debating a healthcare bill, Majority Leader Mitch McConnell will determine which proposal has the most Republican support and move forward to a vote, Republicans said.

Republicans hold 52 of 100 Senate seats. McConnell can only afford to lose two Republican votes as Democrats are united in opposition.

Senator John Barrasso, a member of the Republican leadership, acknowledged on Sunday that there remained a lack of consensus among Republicans.

“Lots of members have different ideas on how it should be best amended to replace what is really a failing Obama healthcare plan,” Barrasso said on CBS’s “Face the Nation.”

The Republican effort has also been complicated by the absence of Senator John McCain, who has been diagnosed with brain cancer and is in his home state of Arizona weighing treatment options.

 

(Reporting By Amanda Becker; Additional reporting by Susan Heavey; Editing by Caren Bohan and Nick Zieminski)

 

Republicans meet late into night as Trump demands new healthcare plan

Senate Majority Leader Mitch McConnnell, R, and Senator Richard Shelby, L, (R-AL) listen as U.S. President Donald Trump speaks during a meeting with Senate Republicans to discuss healthcare at the White House in Washington, U.S., July 19, 2017. REUTERS/Kevin Lamarque

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – Republicans struggling to agree on healthcare legislation to overhaul Obamacare obeyed U.S. President Donald Trump’s orders to try to swiftly reach a deal but were unable to resolve their differences in a long, late-night meeting.

Earlier on Wednesday, Trump took Senate Republicans to task for failing to agree on how to dismantle Obamacare, as a new report showed 32 million Americans would lose health insurance if senators opt to repeal the law without a replacement.

Trump gathered 49 Republican senators for a White House lunch after a bill to repeal and replace the 2010 Affordable Care Act collapsed on Monday amid dissent from a handful of the party’s conservatives and moderates.

After Trump’s exhortation to keep trying, party members met with Health and Human Services Secretary Tom Price behind closed doors on Wednesday night to try to finally come together on a major Republican promise of the past seven years – undoing former Democratic President Barack Obama’s signature legislation, popularly known as Obamacare.

There was no immediate breakthrough.

“We still have some issues that divide us,” said Senator Ted Cruz, a conservative who has proposed letting insurers offer cheaper bare-bones plans that do not comply with Obamacare regulations.

Republicans attending the late meeting sent their staff away in order to talk frankly and Senator John Kennedy said everyone was negotiating in good faith but he added he did not know if they would reach agreement.

Almost all the other senators rushed off after the meeting without comment.

As it was getting underway, the nearly two dozen Republican senators were shaken by news that their colleague, veteran Senator John McCain, had been diagnosed with brain cancer.

McCain’s absence from the Senate makes the job of passing a healthcare bill more difficult because leaders need every Republican vote they can get.

“Obviously, I think more people are worried about his health than thinking about the math. You understand the math. Obviously it makes things difficult,” Senator Bob Corker said as he left the meeting.

Trump had taken a hands-off approach to the healthcare debate last week and suggested on Tuesday that he was fine with letting Obamacare fail. Then on Wednesday he switched course and demanded senators stay in Washington through their planned August recess until they find common ground on healthcare.

“We can repeal, but we should repeal and replace, and we shouldn’t leave town until this is complete,” Trump said at the meeting.

Trump made the repeal and replacement of Obamacare, which he has called a “disaster,” a central promise of his 2016 campaign.

Even with Trump’s new push, Republican leaders in the Senate face a difficult task getting moderates and conservatives to agree on an overhaul that can pass.

Senate Majority Leader Mitch McConnell had planned to hold a straight repeal vote next week, but several Republican senators have already said they oppose that approach.

Thirty-two million Americans would lose their health insurance by 2026 if Obamacare is scrapped without an alternative in place, the nonpartisan Congressional Budget Office reported on Wednesday, while 17 million would become uninsured next year alone.

At the same time, premiums on individual insurance plans would rise 25 percent next year and double by 2026.

The CBO’s estimates were unchanged from a previous report that assessed the impact of a 2015 bill to repeal Obamacare that passed the House of Representatives and Senate and was vetoed by Obama.

‘TRUE DEATH SPIRAL’

Democrats were swift to highlight the CBO’s assessment, while Republicans remained silent.

“President Trump and Republicans have repeatedly promised to lower premiums and increase coverage, yet each proposal they offer would do the opposite,” Senate Democratic leader Charles Schumer said in a statement.

Insurers and hospitals have lobbied against straight repeal, saying the limbo would increase uncertainty and their costs.

“CBO projects half the country would have no insurers in the individual market by 2020 under the new repeal bill. That’s a true death spiral,” tweeted Larry Levitt, vice president at the Kaiser Family Foundation, a healthcare research group.

Republicans say Obamacare is a costly intrusion into the healthcare system.

But the party is divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to Obamacare, which boosted the number of Americans with health insurance by 20 million through mandates on individuals and employers, and income-based subsidies.

Moderate Republican Senators Susan Collins, Lisa Murkowski and Shelley Moore Capito said they opposed McConnell’s plan for a repeal that would take effect in two years. All three attended the lunch with Trump.

With Democrats united in opposition to repeal, McConnell can only lose two votes from the Republicans’ 52-48 majority in the 100-seat Senate to pass healthcare legislation.

Opponents of repeal protested throughout Senate buildings on Wednesday afternoon, leading to 155 arrests, police said. Demonstrators returned in the evening to yell as senators arrived for the meeting.

Party fractures also emerged in the House of Representatives. The chamber passed a plan to repeal and replace Obamacare in May. But on Wednesday, the House Freedom Caucus, the Republican Party’s conservative wing, filed a petition to vote on a straight repeal.

House Speaker Paul Ryan’s spokeswoman, AshLee Strong, said: “The House passed an Obamacare repeal-and-replace bill we are proud of and we hope the Senate will take similar action.”

(Writing by John Whitesides and Lisa Lambert; Additional reporting by Susan Cornwell, Richard Cowan, Yasmeen Abutaleb and Susan Heavey; Editing by Leslie Adler, Peter Cooney and Richard Pullin)

Trump chides Senate Republicans on healthcare, says it is time for action

Seated between Senators Dean Heller (R-NV), L, Tim Scott (R-SC), U.S. President Donald Trump meets with Senate Republicans to discuss healthcare at the White House in Washington, U.S., July 19, 2017. REUTERS/Kevin Lamarque

By Steve Holland and Amanda Becker

WASHINGTON (Reuters) – U.S. President Donald Trump scolded Senate Republicans on Wednesday for failing to reach agreement on repealing or overhauling Obamacare, demanding they keep their campaign promises and find a new healthcare approach.

Trump told 49 senators who came to a White House lunch that they should not leave Washington for a planned August recess until they can find common ground on healthcare.

“We’re close. We’re very close,” Trump said at the start of the lunch meeting, a day after the seven-year Republican quest to repeal and replace Democratic former President Barack Obama’s signature healthcare law seemed to collapse in the Senate.

“For seven years you promised the American people you would repeal Obamacare. People are hurting and, frankly, inaction is not an option,” Trump told the Republican lawmakers. “Any senator who votes against starting debate is really telling America that you’re fine with Obamacare.”

Senate Majority Leader Mitch McConnell has vowed to go ahead with a vote early next week on a repeal of the Affordable Care Act, popularly known as Obamacare, despite indications it will fail after the defections on Tuesday of at least three Republican senators.

Moderate Republican senators Susan Collins of Maine, Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia said they oppose McConnell’s plan for a repeal that would take effect in two years, giving Congress time to develop a replacement. All three attended the lunch.

With Democrats united in opposition to repeal, McConnell can only lose two votes from his 52-48 majority in the 100-seat Senate to pass healthcare legislation.

Trump, who had not been heavily involved in lobbying the Senate on the issue until this week, said he wanted more than a straight repeal vote and wanted the Senate to pass a replacement measure as well.

“We can repeal, but we should repeal and replace and we shouldn’t leave town until this is complete,” he said.

Capito, speaking to reporters ahead of the meeting on Wednesday, expressed some doubts the Senate vote on a repeal-only healthcare bill would actually occur next week. “It’s changing so quickly,” she said.

“I think we’re probably going to air what our differences are again. The president has taken a lot of time to try to call us all individually,” said Capito. “I don’t think anyone’s mind is going to get changed sitting right there, but it gives us a chance to frame it where we have our differences.”

‘HONOR OUR PROMISE’

Repealing and replacing Obamacare was a top campaign promise for Trump and Republicans in Congress, who say it is a costly intrusion into the healthcare system.

But the reality has been difficult for a party divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to Obamacare, which boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies.

“We have to honor our promise,” Republican Senator Ted Cruz told reporters. “For seven years Republicans have told the voters, if you elect us, we’ll repeal Obamacare. I think we will look like fools if we can’t deliver on that promise.”

Republican Senator Orrin Hatch said it was a tough issue for Trump, but “I suspect he could be a little bit more forceful and I hope he will be. I think he needs to.”

Democrats, clearly delighted with the turn of events, have welcomed the Republicans’ failure to replace Obamacare as an opportunity to work together. Republicans conceded their other options may be exhausted.

The No. 2 Senate Republican, John Cornyn, told reporters it was “unfortunate” that he expected bipartisan talks to begin.

“Democrats are strongly committed to Obamacare and are unwilling to admit structural problems, which create the problems we are having in the individual market today,” Cornyn said. “But we’ll do the best we can with the hand we’ve been dealt.”

If senators try to shore up Obamacare, an initial hurdle in coming weeks will be boosting faltering state insurance markets by ensuring that insurers keep receiving subsidies that help lower the cost of insurance for low-income individuals.

The Trump administration will continue making the subsidy payments through August while a related Republican lawsuit is pending. The uncertainty beyond that has rattled insurers.

Republican senators have acknowledged the need to address the unstable markets but resisted Democratic calls to fund the subsidies without accompanying reforms, calling it a “bailout” for insurance companies.

Funding for the Children’s Health Insurance Program, a part of the Medicaid government health insurance program for the poor and disabled, known as CHIP, expires on Sept. 30 and will require reauthorization.

Bills to address the subsidy payments and CHIP would likely require 60 votes for passage, acting as a barometer of how inclined Republicans and Democrats are to work together, industry lobbyists and experts said.

Trump suggested on Tuesday that Republicans should allow the insurance markets to fail before working with Democrats. But Republican Senator Lamar Alexander, the head of the Senate Committee on Health, Labor and Pensions, said he would begin holding hearings on the issue in the next few weeks.

(Writing by John Whitesides; Additional reporting by Susan Cornwell, Richard Cowan, Yasmeen Abutaleb and Susan Heavey; Editing by Jonathan Oatis and Nick Zieminski)

Senate Republicans reluctantly consider bipartisan healthcare talks

Healthcare activists with Planned Parenthood and the Center for American Progress protest in opposition to the Senate Republican healthcare bill on Capitol Hill in Washington, June 28, 2017. REUTERS/Joshua Roberts

By Amanda Becker and Susan Cornwell

WASHINGTON (Reuters) – As their seven-year effort to repeal and replace Obamacare derailed in the U.S. Senate, Republicans faced the prospect of doing the once unthinkable: working with Democrats to make fixes to former President Barack Obama’s 2010 healthcare law.

Bipartisan breakthroughs would likely come in the form of individual bills targeted at issues such as stabilizing insurance markets or lowering prescription drug costs. A wholesale overhaul of healthcare, senators say, is a bridge too far for the two parties, locked for years in an ideological battle on that issue and many others.

Democrats, clearly delighted with the turn of events, welcomed the Republicans’ failure to replace Obamacare as an opportunity to work together. Republicans conceded their other options may be exhausted.

“This is our moment, we have been waiting for this moment for months and months and in fact for years,” Democratic Senator Amy Klobuchar said at a Tuesday news conference.

Democrats are united in opposing repeal of the Affordable Care Act, popularly known as Obamacare, which boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies.

The No. 2 Senate Republican, John Cornyn, told reporters it was “unfortunate” that he expected bipartisan talks to begin.

“Democrats are strongly committed to Obamacare and are unwilling to admit structural problems, which create the problems we are having in the individual market today,” Cornyn said. “But we’ll do the best we can with the hand we’ve been dealt.”

President Donald Trump invited all Republican senators to have lunch at the White House on Wednesday to discuss healthcare and other priorities, an administration official said, adding without elaboration: “There is movement on healthcare.”

Repealing and replacing Obama’s signature healthcare law was a top campaign promise for Trump and Republicans in Congress, who say it is a costly intrusion into the healthcare system.

Senate Majority Leader Mitch McConnell, working for the first time on major legislation with Republican control of both chambers of Congress and the White House, conceded on Monday night that there was not enough Republican consensus around his revised bill to replace Obamacare. He said he would instead hold a straight repeal vote sometime next week.

But at least three Republican senators have already said they oppose repealing Obamacare without an agreement on replacement legislation, likely dooming its prospects. McConnell can only lose two votes from his 52-seat majority in the 100-seat Senate to pass healthcare legislation.

Senate Republicans passed a straight repeal bill two years ago, but Obama vetoed it. The upcoming repeal vote will include a two-year delay, McConnell said.

That would “give us an opportunity to build something better on a bipartisan basis, that’s what I sense most of our members would like to vote on now, and we’ll be doing that in the near future,” McConnell told a news conference on Tuesday.

SHORING UP STATE MARKETS

An initial hurdle in coming weeks will be shoring up faltering state insurance markets by ensuring that insurers keep receiving subsidies that help lower the cost of insurance for low-income individuals.

The Trump administration will continue making the subsidy payments through August while a related Republican lawsuit is pending. The uncertainty beyond that has rattled insurers.

Republican senators have acknowledged the need to address the unstable markets but resisted Democratic calls to fund the subsidies without accompanying reforms, calling it a “bailout” for insurance companies.

Funding for the Children’s Health Insurance Program, a part of the Medicaid government health insurance program for the poor and disabled, known as CHIP, expires on Sept. 30 and will require reauthorization.

Bills to address the subsidy payments and CHIP would likely require 60 votes for passage, acting as a barometer of how inclined Republicans and Democrats are to work together, industry lobbyists and experts said.

Trump suggested on Tuesday that Republicans should allow the insurance markets to fail before working with Democrats. But Republican Senator Lamar Alexander, the head of the Senate Committee on Health, Labor and Pensions, said he would begin holding hearings on the issue in the next few weeks.

Senator Patty Murray, the top Democrat on the panel, said it would be “very smart” for lawmakers to work together to stabilize the markets by funding the subsidies.

“It would send a very strong message to the market, if Congress passes a bill. … I think that would do a lot to create some stabilization that is much needed,” Murray told Reuters.

(Additional reporting by Yasmeen Abutaleb; Editing by Mary Milliken and Peter Cooney)

One more Republican defection would doom Senate healthcare bill

Senate Majority Leader Mitch McConnell speaks with reporters about the Senate health care bill on Capitol Hill in Washington, U.S., July 13, 2017. REUTERS/Aaron P. Bernstein

By Susan Cornwell and David Alexander

WASHINGTON (Reuters) – President Donald Trump turned up the heat on Friday on fellow Republicans in the U.S. Senate to pass a bill dismantling the Obamacare law, but with their retooled healthcare plan drawing fire within the party even one more defection would doom it.

Majority Leader Mitch McConnell has planned for a vote next week on revised legislation, unveiled on Thursday, and he has his work cut out for him in the coming days to get the 50 “yes” votes needed for passage. Republicans control the Senate by a 52-48 margin and cannot afford to lose more than two from within their ranks because of united Democratic opposition, but two Republican senators already have declared opposition.

“After all of these years of suffering thru Obamacare, Republican Senators must come through as they have promised,” Trump, who made gutting Obamacare one of his central campaign promises last year, wrote on Twitter from Paris, where he attended Bastille Day celebrations.

The top U.S. doctors’ group, the American Medical Association, on Friday called the new bill inadequate and said more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of healthcare. Hospital and medical advocacy groups also have criticized the bill.

“The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage,” AMA President Dr. David Barbe said, referring to the government insurance program for the poor and disabled.

A major test for McConnell’s legislation expected early next week is an analysis by the nonpartisan Congressional Budget Office, which last month forecast that the prior version of the bill would have resulted in 22 million Americans losing insurance over the next decade.

A day after that CBO analysis was issued, McConnell postponed a planned vote on the legislation because of a revolt within his own party, including moderates and hard-line conservatives.

While the bill’s prospects may look precarious, the same could have been said of healthcare legislation that ultimately was passed by the House of Representatives. Republican House Speaker Paul Ryan called off a vote in March in the face of a rebellion involving the disparate factions of the party but managed to coax enough lawmakers to back it and engineered narrow approval on May 4.

PENCE SEEKS SUPPORT

Vice President Mike Pence sought to shore up support among the nation’s governors at a meeting in Rhode Island, but a key Republican governor, Ohio’s John Kasich, came out strongly against the revised bill, saying its Medicaid cuts were too deep and it does too little to stabilize the insurance market.

Kasich’s opposition could put pressure on Rob Portman, a Republican senator from Ohio, who has not yet taken a position on the bill.

If the current Senate legislation collapses, some lawmakers have raised the possibility of seeking bipartisan legislation to fix parts of Obamacare but leaving intact the structure of the Affordable Care Act, Democratic former President Barack Obama’s signature legislative achievement, commonly known as Obamacare.

“There are changes that need to be made to the law,” Dick Durbin, the No. 2 Senate Democrat, told MSNBC, citing “a bipartisan appetite to tackle this issue.”

Moderate Susan Collins and conservative Rand Paul already oppose the revised Senate bill. Other Republican senators have either expressed concern or remained noncommittal, including Portman, Mike Lee, Shelley Moore Capito, John McCain, Dean Heller, John Hoeven, Lisa Murkowski, Jeff Flake, Ben Sasse, Cory Gardner, Todd Young and Thom Tillis. Republican Senators Lindsey Graham and Bill Cassidy floated an alternative plan.

The new version was crafted to satisfy the Republican Party’s various elements, including moderates worried about Americans who would be left without medical coverage and hard-line conservatives who demand less government regulation of health insurance.

A provision championed by Republican Senator Ted Cruz and aimed at attracting conservatives would let insurers sell cheap, bare-bones insurance policies that would not have to cover broad benefits mandated under Obamacare.

But two major health insurance groups, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, called on McConnell to drop the Cruz proposal, saying it would undermine protections for pre-existing medical conditions, raise insurance premiums and destabilize the individual insurance market.

The bill retained certain Obamacare taxes on the wealthy that the earlier version would have eliminated, a step moderates could embrace. But it kept the core of the earlier bill, including ending the expansion of Medicaid that was instrumental in enabling Obamacare to expand coverage to 20 million people, and restructuring that social safety-net program.

John Thune, a member of the Senate Republican leadership, said in order to complete work on the bill by the end of next week, Senate leaders would have to try to formally begin debate on Tuesday or Wednesday, a move that requires a majority vote.

(Reporting by Susan Cornwell and David Alexander; Writing by Will Dunham; Editing by Bernadette Baum and Jonathan Oatis)

Senate may vote on revised healthcare bill next week

Senate Majority Leader Senator Mitch McConnell (R-KY) attends a new conference following party policy lunch meeting at the U.S. Capitol in Washington, U.S. July 11, 2017. REUTERS/Carlos Barria

By Yasmeen Abutaleb and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans said Tuesday they will seek to bring their healthcare overhaul to the Senate floor next week after a lengthy intraparty struggle, but it remained unclear whether they had the votes to pass the measure or even what form it would finally take.

With his reputation as a master strategist on the line, Senate Majority Leader Mitch McConnell laid out a timetable for Senate consideration of legislation to fulfill President Donald Trump’s campaign promise to dismantle the 2010 Affordable Care Act, also known as Obamacare.

In a departure from Republican orthodoxy on tax-cutting, the legislation likely will retain some of the taxes that were imposed on the wealthy under Obamacare, Senate sources said.

But it was unknown whether a revised version of the bill to be announced on Thursday morning can satisfy both moderates and hard-line conservatives in the Republican majority who voiced opposition to a draft unveiled last month on very different grounds.

With Trump urging the Senate to act before taking the August break, McConnell pushed back the Senate’s planned August recess by two weeks to allow senators more time to tackle the measure that would repeal key parts of Obamacare, as well as pursue other legislative priorities.

McConnell’s announcement drove a turn-around in stock prices in afternoon trading on Wall Street after an earlier sell-off, on hopes that a shortened recess could mean progress on the stalled Republican legislative agenda.

A dark mood lingered among some Republicans over the healthcare subject, with party leaders appearing to act because of the need to dispense with healthcare and turn to other issues, among them increasing the U.S. debt ceiling.

“I think we’ve narrowed down now to where we know where the decision points are, and we just have to make those decisions,” Senator John Thune, a junior member of the Republican leadership, told reporters. Leaders were still trying to “figure out how we get to 50” votes, he said.

Republicans, who hold 52 seats in the 100-seat Senate, would need 50 votes to pass the bill, with Vice President Mike Pence providing the tie-breaking vote.

“I am very pessimistic” about the prospects for Republican healthcare legislation, Chuck Grassley, a senior senator, told Fox News on Tuesday. Another Republican senator, Lindsey Graham, was working on his own healthcare proposal and will unveil it this week, a Graham aide said.

KEEPING OBAMACARE TAXES

McConnell said the plan was to vote on the healthcare bill next week, and said he hoped to have a fresh analysis of the bill from the nonpartisan Congressional Budget Office at the start of the week. He did not reveal any of the planned changes to the draft, on which he postponed action last month after it failed to gather enough support.

But Senate sources said it is likely that two Obamacare taxes on the wealthy will be kept in place – a 3.8 percent net investment tax and a 0.9 percent payroll tax that helps finance Medicare – which would appeal to moderates who have balked at the prospect of cutting taxes for the wealthy while reducing benefits for the poor.

“Obviously that’s the direction I think that a lot of our members want to move, is to keep some of those (taxes) in place and be able to use those revenues to put it into other places in the bill,” Thune said, while stressing that no decisions were final.

Republicans could also retain Obamacare’s limit on corporate tax deductions for executive pay in the health insurance industry, one Senate source said.

It was unclear whether the bill would include a proposal by conservative Republican Ted Cruz that would allow insurers to offer basic low-cost healthcare plans that do not comply with Obamacare regulations.

Cruz argues it would help to lower premiums, but critics say it would allow insurers to offer skimpier plans that may not cover essential health benefits while also charging more for more comprehensive, Obamacare-compliant plans.

The Senate Republican healthcare bill unveiled last month would phase out the Obamacare expansion of Medicaid health insurance for the poor and disabled, sharply cut federal Medicaid spending beginning in 2025, repeal many of Obamacare’s taxes, end a penalty on individuals who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

Democrats are united in opposition to the bill and at least 10 Republicans have said they oppose the existing draft. The House of Representatives passed its own version in May.

Moderate Republicans are uneasy about the millions of people forecast to lose their medical insurance under the draft legislation, and hard-line conservatives say it leaves too much of Obamacare intact.

Democrats call the Republican legislation a giveaway to the rich that would hurt the most vulnerable Americans.

(Additional reporting by David Morgan and Amanda Becker; Writing by Susan Cornwell and Tom Brown; Editing by Mary Milliken and Leslie Adler)