Tag Archives: Healthcare

Senate Republicans struggle to salvage healthcare effort

A demonstrator heads home after protesting the Republican healthcare bill outside Republican Congressman Darrell Issa's office in Vista, California, June 27, 2017. REUTERS/Mike Blake

By Susan Cornwell and Yasmeen Abutaleb

WASHINGTON (Reuters) – The top U.S. Senate Republican struggled on Wednesday to salvage major healthcare legislation sought by President Donald Trump, meeting privately with a parade of skeptical senators as critics within the party urged substantial changes.

Republican leaders hope to agree on changes to the legislation by Friday so lawmakers can take it up after next week’s Independence Day recess.. Senate Majority Leader Mitch McConnell on Tuesday abandoned plans to seek passage of it this week because Republicans did not have 50 votes to pass the bill.

For seven years, Republicans have led a quest to undo the 2010 law known as Obamacare, Democratic former President Barack Obama’s signature legislative achievement. Trump made dismantling it a top campaign promise during last year’s presidential campaign but policy differences within the party have raised doubts Republicans can achieve a repeal.

Democrats have unified against the bill and Republicans control the Senate by a slim 52-48 margin, which means McConnell can afford to lose only two Republicans. So far at least 10 – including moderates and hard-line conservatives – have expressed opposition to the current bill, although some indicated they would vote for it with certain changes.

McConnell, with his reputation as a strategist on the line, met with a procession of Republican senators in his office on Wednesday. John Cornyn, the No. 2 Senate Republican, said party leaders will talk to every Republican senator who has concerns about the bill or is undecided.

The House of Representatives passed its healthcare bill last month, only after striking a balance between the center of the party and the right wing. Now McConnell must find a similar sweet spot.

During a lunch meeting on Wednesday Republicans made presentations on potential fixes. Senator Rand Paul called for jettisoning more parts of Obamacare to get conservatives on board.

TAX ISSUE

Senator Mike Rounds suggested keeping a 3.8 percent Obamacare tax on high earners’ investment income, which the current bill would eliminate. Rounds said the tax could pay for more Americans to receive the tax credits that help pay for health insurance.

Senator Bob Corker, who also supports keeping the tax, said one of the issues he was focused on was helping lower-income Americans pay for health plans.

“My sense is there’s a good chance that issue and other issues people are trying to get addressed can be addressed,” Corker told reporters.

Trump said the bill was moving along well and predicted a “great, great surprise” but did not elaborate.

Maine Senator Susan Collins, a moderate, said it would be “very difficult” to reach agreement by Friday. Collins and other centrists were put off by the nonpartisan Congressional Budget Office’s projection on Monday that 22 million people would lose medical insurance under the existing bill.

Finishing the legislation’s revisions by Friday would be “optimal,” Cornyn said, so the CBO can analyze the new version..

Even then, Democrats could mount a forceful resistance. They have repeatedly said they will not discuss a repeal but have expressed openness to negotiating improvements.

The Senate’s top Democrat, Chuck Schumer, proposed Trump call all 100 senators to Blair House across the street from the White House to craft a bipartisan bill fixing Obamacare but Trump said did not think Schumer’s offer was serious.

McConnell said Democrats had refused “to work with us in a serious way to comprehensively address Obamacare’s failures in the seven years since they passed it.”

The legislation has triggered protests at the Capitol and police said they arrested 40 people, including cancer survivors, on Wednesday for blocking Senate offices.

Obama’s 2010 Affordable Care Act, which passed without Republican support, expanded health insurance coverage to some 20 million people but Republicans call it a costly government intrusion.

The Senate bill rolls back Obamacare’s expansion of the Medicaid government insurance for the poor and cuts planned Medicaid spending starting in 2025. It also repeals most of Obamacare’s taxes, ends a penalty for not obtaining insurance and overhauls subsidies that help people buy insurance with tax credits.

For graphic on who’s covered under Medicaid, click: http://tmsnrt.rs/2u06kvB

(This story fixes attribution of quote in 10th paragraph to Senator Corker from Senator Rounds.)

(Additional reporting by Susan Heavey, Richard Cowan, Susan Cornwell, Steve Holland, Jeff Mason, Mohammad Zargham, Tim Ahmann and Jeff Mason; Writing by Lisa Lambert, Will Dunham and Frances Kerry; Editing by Bill Trott)

Facing revolt on healthcare bill, U.S. Senate Republicans delay vote

Protesters demonstrate the Republican healthcare bill outside Republican Congressman Darrell Issa's office in Vista, California, June 27, 2017. REUTERS/Mike Blake

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republican leaders postponed a vote on a healthcare overhaul on Tuesday after resistance from members of their own party, and President Donald Trump summoned Republican senators to the White House to urge them to break the impasse.

The delay put the future of a longtime top Republican priority in doubt amid concerns about the Senate bill from both moderate and conservative Republicans. With Democrats united in their opposition, Republicans can afford to lose only two votes among their own ranks in the Senate.

Senate Majority Leader Mitch McConnell had been pushing for a vote ahead of the July 4 recess that starts at the end of the week. The legislation would repeal major elements of Obamacare and shrink the Medicaid government healthcare program for the poor.

“We’re going to press on,” McConnell said after announcing the delay, adding that leaders would keep working to make senators “comfortable” with the bill. “We’re optimistic we’re going to get to a result that is better than the status quo.”

At the White House meeting with most of the 52 Republican senators, Trump said it was vital to reach agreement on the Senate healthcare measure because Obamacare was “melting down.”

“So we’re going to talk and we’re going to see what we can do. We’re getting very close,” Trump told the senators. But he added, “If we don’t get it done, it’s just going to be something that we’re not going to like, and that’s okay.”

McConnell, whose party has a razor-thin majority in the 100-member Senate, told reporters that Republican leaders would work through the week to win over the 50 senators needed to pass the bill, with a vote planned after the recess. Vice President Mike Pence could provide the crucial vote needed to break a tie.

“I think we can get 50 votes to yes by the end of the week,” Republican Senator Roger Wicker said after the White House meeting.

REPUBLICAN OPPOSITION GROWS

The House of Representatives last month passed its own version of a healthcare bill, but the Senate bill has been criticized from both the left and the right. Moderate Republicans worried millions of people would lose their insurance. Conservatives said the bill does not do enough to erase Obamacare.

The bill’s prospects were not helped by a Congressional Budget Office analysis on Monday saying it would cause 22 million Americans to lose insurance over the next decade, although it would reduce the federal deficit by $321 billion over that period.

The report prompted Senator Susan Collins, a Republican moderate, to say she could not support the bill as it stands. At least four conservative Republican senators said they were still opposed after the CBO analysis.

Three more Republicans, Rob Portman of Ohio, Jerry Moran of Kansas and Shelley Moore Capito of West Virginia, said after the delay was announced that they oppose the current draft.

Portman and Capito cited the bill’s Medicaid cutbacks and how that would hurt efforts to combat the opioid epidemic that has taken a heavy toll in their states. The Medicaid program was expanded under former President Barack Obama’s signature healthcare law.

“I think giving time to digest is a good thing,” Republican Senator Bob Corker said after the delay was announced.

“UNCERTAINTY” ON WALL STREET

U.S. stock prices fell, as the decision to postpone the vote added to investor worries about Trump’s ability to deliver on his promises of tax reform and deregulation, as well as changes to the health sector. Those expected changes have driven a rally in U.S. stocks this year.

The benchmark S&P 500 index closed down 0.8 percent, and the Dow Jones industrial average finished down 0.46 percent.

“The market likes certainty and now there’s uncertainty. What is this going to look like when this gets out of the next iteration?” said Peter Costa, president of trading firm Empire Executions Inc.

Passing the measure would be a win for Trump as he seeks to shift attention after weeks of questions over Russia’s role in last year’s U.S. presidential election.

McConnell has promised since 2010 that Republicans, who view Obamacare as a costly government intrusion, would destroy the law “root and branch” if they controlled Congress and the White House. Republicans worry a failure to deliver will cost them votes in next year’s congressional elections.

If the Senate passes a healthcare bill, it will either have to be approved by the House or the two chambers would reconcile the differences in a conference committee. Otherwise, the House could pass a new version and send it back to the Senate.

Lawmakers are expected to leave town by Friday for their July 4 holiday break, which runs all next week. The Senate returns to work on July 10, the House on July 11. Lawmakers then have three weeks in session before their month-long August recess.

(This story corrects Dow Jones industrial average’s percent loss in 16th paragraph.)

(Additional reporting by Yasmeen Abulateb, Amanda Becker, Eric Walsh, Susan Heavey and Tim Ahmann; Writing by John Whitesides and Frances Kerry; Editing by Leslie Adler)

Republican leaders work to buoy Senate healthcare bill

FILE PHOTO: U.S. Vice President Mike Pence attends a healthcare listening session at the White House in Washington, DC, U.S. June 5, 2017. REUTERS/Joshua Roberts

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – Republican leaders are in a frenzied push to shore up support for a healthcare bill in the U.S. Senate after a non-partisan congressional office said on Monday it would cause 22 million Americans to lose insurance over the next decade.

Vice President Mike Pence is expected to travel to Capitol Hill on Tuesday to join Senate Republicans for a policy lunch before hosting a key conservative senator for dinner.

Senate Majority Leader Mitch McConnell will continue meeting on-the-fence senators facing questions from their governors and state Medicaid offices about the bill’s cuts to the government insurance program for the poor and disabled, lawmakers said.

The Congressional Budget Office (CBO) analysis on Monday prompted Senator Susan Collins, a key moderate vote, to say she could not support moving forward on the bill as it was written.

At least four conservative Republicans – Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee – said their opposition remained unchanged after the CBO analysis.

Further, Collins, Paul and Johnson, along with Senator Dean Heller, have all said they will oppose a procedural motion that would allow McConnell to move forward and bring the bill up for a vote. Heller, a moderate Republican up for re-election next year in Nevada, is already facing political fallout after a group started by former campaign aides to President Donald Trump and Pence promised to run ads against him.

The overlapping concerns and competing interests of the lawmakers highlights the balancing act facing McConnell as he tries to unify his party and deliver a legislative win to the president.

Trump – and most Republicans in Congress – were elected on campaign pledges to repeal and replace Obamacare, Democratic President Barack Obama’s signature 2010 law that extended insurance coverage to some 20 million Americans. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate.

McConnell’s goal was to vote on the bill before the July 4 recess that starts at the end of this week. He can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate to pass healthcare, with Pence casting the tie-breaking vote.

Moderate senators are concerned about millions of people losing insurance. Conservative senators have said the Senate bill does not do enough to repeal Obamacare.

The CBO is only able to assess the impact of legislation within a 10-year window, but it said insurance losses were expected to grow beyond 22 million due to deep cuts to Medicaid that are not scheduled to go into effect until 2025. The CBO estimated it would decrease the budget deficit by $321 billion between 2017 and 2026.

If the Senate passes a bill, it will either have to be approved by the House, which passed its own version last month, or the two chambers would have to reconcile their differences in a conference committee. Otherwise, the House could pass a new version and bounce it back to the Senate.

(Writing by Amanda Becker; Additional reporting by Yasmeen Abulateb, Amanda Becker and Eric Walsh; Editing by Paul Tait)

U.S. Senate Republicans to issue revised health bill to win support

Speaker of the House Paul Ryan (R-WI) speaks after Senate Republicans unveiled their version of legislation that would replace Obamacare on Capitol Hill in Washington, U.S.

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to issue a revised version of their healthcare bill on Monday, according to a Republican Senate aide, as the chamber’s leaders scrambled to get legislation passed ahead of a July 4 holiday recess starting on Friday.

The aide, who is familiar with the plan, did not provide details of changes in the works. Politico reported that a likely change to the bill would be to add a provision to encourage people, mainly those who are young and healthy, to enroll in insurance plans.

President Donald Trump and his fellow Republicans in Congress have been pushing to repeal and replace Obamacare, Democratic former President Barack Obama’s signature domestic legislation. The House of Representatives passed its version of a healthcare bill last month.

The Senate bill unveiled last week was immediately criticized by both conservatives and moderates in the party. With Republicans holding only a 52-seat majority in the 100-seat Senate, the bill was unlikely to win passage in its initial form.

At least four conservative Republicans have expressed opposition to the draft legislation, saying it does not go far enough in repealing Obamacare.

A spokesman for Senate Majority Leader Mitch McConnell would not comment on whether a vote on a bill would be held in the full Senate on Thursday, as originally anticipated.

The nonpartisan Congressional Budget Office later Monday might release its assessment of the bill’s cost and impact on future budget deficits. It was not clear whether the report will also estimate how many people might lose healthcare coverage under the legislation or whether that estimate would come later.

Meanwhile, some moderate Republicans have either withheld judgment or expressed doubts about replacing Obamacare with legislation that is similar to the House version.

They are concerned that the party’s approach to healthcare would cause too many people, and especially those with low incomes, to lose insurance. Trump touted passage of the House bill as a victory but later called it “mean.”

Republicans have targeted Obamacare since it was passed in 2010, viewing it as costly government intrusion and saying individual insurance markets are collapsing. The legislation expanded health coverage to some 20 million Americans, through provisions such as mandating that individuals obtain health insurance and expanding Medicaid, the government program for the poor.

TRUMP’S INVOLVEMENT

As he did during the House negotiations, Trump has personally pushed for a Senate bill, calling fellow Republicans to mobilize support.

In the efforts by Senate Republicans to push through a bill, the party has split over a provision in the draft bill ending federal funding of Planned Parenthood, the women’s healthcare provider, for one year.

Moderates are wary of this, while conservatives have called for an end to federal funding of Planned Parenthood because it provides abortions, even though they are not performed with taxpayer dollars.

Health insurance companies are concerned about the bill’s plan to cut Medicaid and any impact on state governments as well as the prospect of losing Obamacare’s mandate on individuals to buy insurance without creating alternative incentives for people to stay in their plans.

If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate.

The House is also controlled by Republicans but faced a similar balancing act between moderates and conservatives to pass its version.

A Republican leadership aide in the House said if the Senate manages to pass a healthcare bill this week, no decision has been made on when the House might schedule a vote on it or whether House Republicans might seek any changes to the Senate measure.

(Writing by Richard Cowan and Frances Kerry; Editing by Jeffrey Benkoe)

Trump reaches out to lawmakers on healthcare as another says ‘no’

U.S. President Donald Trump delivers remarks as he hosts a Congressional picnic event, accompanied by First Lady Melania Trump, at the White House in Washington, U.S., June 22, 2017. REUTERS/Carlos Barria

By Jeff Mason and Yasmeen Abutaleb

WASHINGTON (Reuters) – President Donald Trump made calls to fellow Republicans in the U.S. Senate on Friday to mobilize support for their party’s healthcare overhaul while acknowledging the legislation is on a “very, very narrow path” to passage.

Five Republican senators have announced they will not support the bill, which is designed to repeal and replace Obamacare, in its current form.

White House officials said on Friday that Trump has been in touch with Senate Majority Leader Mitch McConnell and made calls on Thursday and Friday to other lawmakers.

Trump’s role is expected to become more pronounced in coming days as the vote nears. Senate Republican leaders may rely on the deal-making former businessman to lean on conservative senators who are balking at the bill.

“We’re pleasantly surprised with a lot of the support that’s already come out and I think we’ll continue to work through (it,) in particular the four individuals who have expressed some ideas and concerns,” White House spokesman Sean Spicer told reporters at a White House briefing.

With all Democrats expected to oppose the measure, the Republicans can afford to lose the support of only two of their 52 members if they want to pass the legislation.

After Spicer spoke, Republican Senator Dean Heller became the fifth Republican opponent on Friday, saying he would not support the bill in its current form.

“This bill that’s currently in front of the United States Senate is not the answer,” Heller, a moderate who is up for re-election in 2018, said at a news conference in Las Vegas.

That could add Heller’s name to Trump’s call list. A White House official said the Trump has pushed his team to stay involved and plans to flex his negotiating muscle, the official said.

An outside political group aligned with the White House, America First Policies, said it is planning an advertising campaign targeting Heller for his opposition to the bill.

Healthcare stocks closed down 0.1 percent on Friday, clawing back some losses after the sector dropped sharply late in the session on Heller’s announcement.

The Senate’s 142-page proposal, worked out in secret by a group led by McConnell, aims to deliver on a central Trump campaign promise to undo former President Barack Obama’s signature healthcare law, which has provided coverage to 20 million Americans since it was passed in 2010.

Republicans view the law, formally known as the Affordable Care Act, as a costly government intrusion and say individual insurance markets created by it are collapsing.

FOUR CONSERVATIVES OPPOSE BILL

On Thursday, four of the Senate’s most conservative members said the new plan failed to rein in the federal government’s role.

Rand Paul, who has rejected the plan along with fellow Republican Senators Ted Cruz, Mike Lee and Ron Johnson, said fundamental problems remained that would leave taxpayers subsidizing health insurance companies.

Trump, in an interview with Fox News that aired on Friday morning, called the group of conservative lawmakers “four very good people.”

“It’s not that they’re opposed,” he said. “They’d like to get certain changes. And we’ll see if we can take care of that.”

Trump said getting approval would require traveling a “very, very narrow path” but that “I think we’re going to get there.”

“It’s going to be a good bill,” Trump said in a separate Fox News interview to air on Sunday.

For the House of Representatives’ version of healthcare, Trump held regular meetings with representatives at the White House. He celebrated the bill’s narrow passage last month in a Rose Garden event with House Republican leaders.

Trump later criticized the House bill privately as “mean” and this week called for a health plan “with heart.” He indicated the Senate plan met that request.

McConnell said in an interview with Reuters last month that he told Trump early on in the process that he did not need his help but that there may be a role for him later.

The Senate bill maintains much of the structure of the House’s but differs in key ways. It would phase out Obamacare’s expansion of the Medicaid program for the poor more gradually, waiting until after the 2020 presidential election, but would enact deeper cuts starting in 2025. It also would provide more generous tax subsidies than the House bill to help low-income people buy private insurance.

(Reporting by Jeff Mason, Richard Cowan, Susan Cornwell, Yasmeen Abutaleb, Caroline Humer, Lewis Krauskopf, Ginger Gibson and Susan Heavey; Editing by Kevin Drawbaugh and Bill Trott)

Senate Republicans unveil Obamacare replacement bill, but fate uncertain

U.S. Capitol is seen after the House approved a bill to repeal major parts of Obamacare and replace it with a Republican healthcare plan in Washington, U.S., May 4, 2017. REUTERS/Yuri Gripas

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans on Thursday unveiled legislation that would replace Obamacare with a plan that scales back aid to the poor and kills a tax on the wealthy, but the bill’s fate was quickly thrown into question as several senators voiced skepticism.

Four conservative lawmakers said they could not support it in its current form, leaving Republicans short of the votes they need for passage. Democrats are united in opposition.

The 142-page proposal, worked out in secret by a group led Senate Majority Leader Mitch McConnell, aims to deliver on a central campaign promise of President Donald Trump by rolling back former President Barack Obama’s signature healthcare law, which has provided coverage to millions of Americans since it was passed in 2010.

Republicans view the law, formally known as the Affordable Care Act, as a costly government intrusion into the private marketplace.

Trump welcomed the bill but indicated that changes may be in store.

“I am very supportive of the Senate #Healthcarebill. Look forward to making it really special!” he wrote on Twitter.

Trump urged the House of Representatives to pass a similar bill in May, only to criticize it in private as “mean” once it passed. He said on Wednesday he wanted a health plan “with heart.”

Democrats immediately attacked the legislation as a callous giveaway to the rich that would leave millions without coverage.

“The president said the House bill was mean,” said Senate Democratic leader Chuck Schumer. “The Senate bill may be even meaner.”

Obama weighed in on Facebook. “If there’s a chance you might get sick, get old, or start a family – this bill will do you harm,” he wrote.

The Senate’s most conservative members said the plan did not do enough to scale back the U.S. government’s role.

“This current bill does not repeal Obamacare. It does not keep our promises to the American people,” said Senator Rand Paul, who along with fellow Republican Senators Ted Cruz, Mike Lee and Ron Johnson said they could not support it in its current form.

Shares of hospital companies and health insurers rose on the bill’s release, with the overall S&P 500 healthcare sector closing up 1.1 percent at an all-time high.

“The initial proposal I think is more generous and more positive to the industry than expected,” said Jeff Jonas, a portfolio manager with Gabelli Funds.

SHARPER CUTS TO MEDICAID

Over months of often bitter debate, Republicans have struggled to craft legislation that lowers costs and reduces government involvement, while minimizing the inevitable disruptions that would come with a revamp of a sector that accounts for one-sixth of the world’s largest economy.

The nonpartisan Congressional Budget Office found that the House bill would kick 23 million Americans off their health plans, and the legislation is unpopular with the public. Fewer than one in 3 Americans supports it, according to Reuters/Ipsos polling.

The Senate measure maintains much of the structure of the House bill, but differs in several key ways.

The Senate bill would phase out Obamacare’s expansion of the Medicaid program for the poor more gradually than the House version, waiting until after the next presidential election in 2020, but would enact deeper cuts starting in 2025. It would also allow states to add work requirements for some of the 70 million Americans who depend on the program.

The legislation also provides more generous tax subsidies than the House bill to help low-income people buy private insurance.

Those subsidies would be based on income, rather than the age-based subsidies contained in the House bill – a “major improvement,” according to Republican Senator Susan Collins, a key moderate who has expressed concern over the bill’s impact on the poor.

The Senate legislation provides less money, however, for the opioid epidemic, allocating $2 billion in 2018, compared with $45 billion over 10 years in the House version.

Both versions would repeal the 3.8 percent net investment income tax on high earners, a key target for Republicans.

They also would repeal a penalty imposed on large employers that do not provide insurance to their workers, and remove the fine that Obamacare imposes on those who choose to go uninsured.

Policy experts said that would keep more young, healthy people out of the market and likely create a sicker patient pool.

The Senate bill would provide money to stabilize the individual insurance market, allotting $15 billion a year in 2018 and 2019 and $10 billion a year in 2020 and 2021.

It proposes defunding Planned Parenthood for a year, but abortion-related restrictions are less stringent than the House version because of uncertainty over whether they would comply with Senate rules. They could be included in another Senate bill.

McConnell said Democrats chose not to help frame the bill, which Republicans say would fix a collapsing health marketplace.

“Republicans believe we have a responsibility to act, and we are,” he said.

Democrats say they offered to help fix Obamacare but were rebuffed.

The bill’s real-world impact is not yet known, but the CBO is expected to provide an estimate early next week.

As lawmakers spoke about the legislation on the Senate floor, a protest erupted outside McConnell’s personal office, with many people in wheelchairs blocking a hallway, holding signs and chanting: “No cuts to Medicaid.” U.S. Capitol Police said 43 protesters were arrested and charged with obstruction.

Aside from the quartet of conservatives, none of the other 48 Republican senators appeared to reject the bill out of hand. But several said they would check with home-state constituents before taking a position.

“I expect there’s going to be a number of changes between now and the final vote,” said Senator John Barrasso of Wyoming.

(Additional reporting by Yasmeen Abutaleb, Caroline Humer and Lewis Krauskopf; Writing by Andy Sullivan and Steve Holland; Editing by Jonathan Oatis and Peter Cooney)

Obamacare replacement bill to take center stage in Senate

U.S. Capitol is seen after the House approved a bill to repeal major parts of Obamacare and replace it with a Republican healthcare plan in Washington, U.S., May 4, 2017. REUTERS/Yuri Gripas

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – A seven-year push by U.S. Republicans to dismantle Obamacare and kill the taxes it imposed on the wealthy will reach a critical phase on Thursday when Senate Republican leaders unveil a draft bill they aim to put to a vote, possibly as early as next week.

Senate Majority Leader Mitch McConnell and his lieutenants have worked in secret for weeks on the bill, which is expected to curb Obamacare’s expanded Medicaid help for the poor and reshape subsidies to low-income people for private insurance.

Those subsidies are expected to be linked to recipients’ income in the Senate bill, a “major improvement” from a measure approved last month by the U.S. House of Representatives that tied them solely to age, Republican Senator Susan Collins of Maine said.

Some of the Senate bill’s provisions could be political land mines, with individual senators’ reactions to it crucial to determining whether or not the Affordable Care Act, popularly known as Obamacare, survives a Republican attack that has been under way since its passage in 2010.

The Washington Post reported on Wednesday that the bill would seek to repeal most of the taxes that pay for Obamacare, give states more latitude to opt out of its regulations and eliminate federal funding for Planned Parenthood, a healthcare provider that offers abortion services.

Former Democratic President Barack Obama’s signature domestic policy achievement has been a target of Republican wrath for years. But even with control of both chambers of Congress and the White House since January, the party has struggled to make good on its bold campaign promises to repeal and replace Obamacare.

The law is credited with expanding health insurance to millions of Americans. Republicans say it costs too much and involves the federal government too much in healthcare. President Donald Trump made Obamacare repeal a centerpiece of his 2016 campaign and celebrated the House-passed bill.

Democrats accuse Republicans of sabotaging Obamacare, and say the Republican bill will make healthcare unaffordable for poorer Americans while cutting taxes for the wealthy.

TOUGH SELL

But McConnell may have a tough job convincing enough Republican senators that the Senate bill improves on the House version. A Reuters/Ipsos poll found nearly 60 percent of adults believed the House bill would make insurance costlier for low-income Americans and people with pre-existing conditions. Only 13 percent said it would improve healthcare quality.

The non-partisan Congressional Budget Office estimated the House bill would kick 23 million people off their healthcare plans. Healthcare is a top priority for voters and many Republicans fear a legislative misstep could hurt them.

Collins said she would weigh the CBO’s upcoming assessment of the Senate bill’s impact on costs and coverage.

Conservative Republican Senator Rand Paul, who wants a full repeal of Obamacare, said he feared that with the legislation being developed, “we’re actually going to be replacing Obamacare with Obamacare,” referring to the continuing role of government.

If legislation is to prevail in the Senate, McConnell can lose the support of only two of his 52 Republicans, assuming all 48 Democrats and independents oppose the bill, as expected.

(Reporting by Richard Cowan and Susan Cornwell; Editing by Kevin Drawbaugh and Peter Cooney)

After weeks of secrecy, U.S. Senate to unveil healthcare bill

FILE PHOTO - U.S. President Donald Trump (C) acknowledges House Speaker Paul Ryan (3rdL) as he gathers with 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, in Washington, U.S., May 4, 2017. REUTERS/Carlos Barria

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to unveil the text of their draft healthcare bill on Thursday as senators struggle over issues such as the future of the Medicaid program for the poor and bringing down insurance costs.

Republicans in the chamber have been working for weeks behind closed doors on legislation aimed at repealing and replacing major portions of the Affordable Care Act, former Democratic President Barack Obama’s signature healthcare law, popularly known as Obamacare.

The effort has been plagued from the start by tensions between moderates and conservatives, which surfaced again on Tuesday. Democrats have also criticized the behind-the-scenes meetings, staging a protest on the Senate floor on Monday.

“Republicans are writing their healthcare bill under the cover of darkness because they are ashamed of it,” Senate Democratic leader Chuck Schumer charged.

President Donald Trump campaigned on a promise to repeal Obamacare. The 2010 law extended insurance coverage to millions of Americans through both subsidized private insurance and an expansion of Medicaid.

The Republican-controlled House of Representatives narrowly approved its version of repeal last month.

Trump has urged the Republican-led Senate to pass a more “generous” bill than that approved by the House, whose version he privately called “mean,” according to congressional sources.

An estimated 23 million people could lose their healthcare under the House plan, according to the non-partisan Congressional Budget Office. Senate Majority Leader Mitch McConnell said on Tuesday the Senate healthcare bill would be different from the House version, but he did not elaborate.

In the Senate, moderates including Senator Shelley Moore Capito have argued for a long, seven-year phase-out to the Medicaid expansion that happened under Obamacare. But Senator John Thune, a member of the Republican leadership, said on Tuesday the phase-out in the bill might just be three years.

Capito said on Tuesday she was also concerned the Senate healthcare plan might cap Medicaid spending and shift it to a lower growth rate in 2025. “That’s an issue,” she said.

CONSERVATIVES WARY

Senate conservatives also seemed wary of the emerging bill. Ted Cruz, a member of a core group of 13 Republicans who have been working on the legislation, told reporters the bill did not yet do enough to lower health insurance premiums. “If it is going to pass, the bill is going to have to make meaningful steps to reduce premiums,” he said.

Given the opposition of all Senate Democrats to repealing Obamacare, Republican leaders will need the support of at least 50 of the chamber’s 52 Republicans to ensure passage.

McConnell announced a discussion draft would be laid out on Thursday. The bill will be brought to the Senate floor once the CBO has assessed its cost and impact, “likely next week,” McConnell said.

Thune said the bill was not yet finalized, saying: “We’re trying to get definitive determinations” on a range of issues.

Vice President Mike Pence predicted that new healthcare legislation would be enacted this summer.

“I want to assure you, before this summer is over … President Donald Trump and this Congress will keep their promise to the American people, and we will repeal and replace Obamacare,” Pence told a meeting of the National Association of Manufacturers.

(Editing by Caren Bohan and Peter Cooney)

Democrats protest Senate Republican healthcare secrecy

FILE PHOTO - U.S. President Donald Trump (C) turns to House Speaker Paul Ryan (3rdL) as he gathers with 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, in Washington, U.S., May 4, 2017. REUTERS/Carlos Barria

By Susan Cornwell

WASHINGTON (Reuters) – U.S. Democrats took to the Senate floor on Monday to throw a spotlight on behind-the-scenes efforts by the Republican majority to repeal former President Barack Obama’s healthcare law, known as Obamacare.

In a series of floor motions, inquiries and lengthy speeches, Democrats criticized the closed-door meetings that Republicans have been holding to craft a replacement for Obamacare, formally known as the Affordable Care Act. They called for open committee hearings and more time to consider the bill before a Senate vote, which Republicans say could come in the next two weeks, although a draft bill has yet to emerge publicly.

Lacking the votes to derail or change the Republican process, the maneuvers by the Democratic minority seemed more aimed at highlighting Republican efforts on a controversial issue. Polls have said that a majority of Americans disapprove of the Obamacare replacement that has passed the House of Representatives and that Senate Republicans are now considering.

Senate Democratic Leader Chuck Schumer said that the closed-door Republican meetings on healthcare amounted to “the most glaring departure from normal legislative procedure that I have ever seen.”

“Republicans are writing their healthcare bill under the cover of darkness because they are ashamed of it,” Schumer charged. The resulting legislation would likely throw millions out of health insurance, he said, while granting “a big fat tax break for the wealthiest among us.”

Senators are not obligated to hold meetings in the open, but Democrats pointed out that there were lengthy committee meetings and many days of floor debate on Obamacare before it passed in 2010.

Several Democrats moved for the healthcare legislation to be referred to Senate committees for hearings, but Senate Majority Leader Mitch McConnell refused.

McConnell said all Republican senators have been involved to some degree in healthcare meetings and that Democrats would have a chance to amend the legislation they produce, once it is brought to the Senate floor.

“We’re going to have a meeting on the Senate floor, all hundred of us, with an unlimited amendment process,” McConnell said. “So there will be no failure of opportunity.”

Senate Republican leaders would like a vote on healthcare legislation in July, before the July 4 recess if possible. But Republicans have struggled to coalesce around a bill, with moderates and conservatives pushing in different directions.

Senate Republicans also face pressure from the right. In the House, conservatives have written to McConnell to express concern about reports that say the Senate may water down the House bill.

(Reporting by Susan Cornwell; Editing by Jonathan Oatis and Leslie Adler)

California to give health clinics $20 million to counter possible Trump cuts

FILE PHOTO: Demonstrators protest over the repeal and replacement of Obamacare outside the offices of Republican congressman Darryl Issa in Vista, California, U.S., March 7, 2017. REUTERS/Mike Blake

By Lisa Lambert

WASHINGTON (Reuters) – California on Monday will announce plans to award $20 million in emergency grants to local health and Planned Parenthood clinics in anticipation of possible U.S. healthcare funding cuts, according to State Treasurer John Chiang’s office.

California and more than a dozen other Democratic-leaning states are fighting against regulatory changes and policies coming from Republican President Donald Trump and the Republican-controlled Congress.

The grants are intended to buy time for state lawmakers to address potential shortfalls caused by federal attempts to undo the Affordable Health Care Act, commonly called Obamacare, and to eliminate funding for women’s health and for contraception, the state said.

A California financing program will provide money for the grants, said Treasurer spokesman Marc Lifsher.

“The Community Clinic Lifeline Grant Program will help small or rural nonprofit clinics, including Planned Parenthood clinics, keep their doors open and provide critical services,” according to an announcement the Treasurer’s office posted on Friday.

Planned Parenthood, a national non-profit that provides contraception, health screenings and abortions, and the country’s long-standing divide over abortion are at the heart of the state’s move. Planned Parenthood representatives will join Chiang in unveiling the grant program, the announcement said.

Republicans generally oppose abortion. Recently, they approved a measure in Congress to allow states to block Planned Parenthood from receiving federal reproductive health funds. By law the funds cannot be used for abortions, but former Democratic President Barack Obama had ensured some money would go to Planned Parenthood clinics.

Actual federal funding reductions are still a while off.

In his recent proposed budget President Donald Trump called for slashing health and human services spending, and the Obamacare repeal the House of Representatives passed in April would eliminate federal funds for Planned Parenthood. But those moves do not have the force of law yet.

No other state appears to be developing a similar grant program.

(Reporting by Lisa Lambert; Editing by Cynthia Osterman)