Senate Republicans got a broad outline Tuesday of their still-evolving legislation to replace Obamacare, as time dwindles and pressure mounts from the White House to put the contentious measure to a vote before the summer recess.
After weeks of behind-closed-door meetings, the members of the Senate team charged with crafting the compromise bill offered no legislative text, no timeline for completion and no signal that the group had reached a consensus on what should stay or go from the widely panned Obamacare replacement bill that passed the House in May.
Sen. Dean Heller, R-Nev., whose state expanded Medicaid under former President Barack Obama’s Affordable Care Act, said the talk Tuesday was more “big umbrella” than concrete details: “The big print giveth, the small print taketh away. I’m looking for the small print at this point,” he said.
Sen. Bill Cassidy, R-La., a key moderate in the GOP’s health debate, said that he was more optimistic about the Senate plan than he had been. “I’m very encouraged, very encouraged. It’s not everything that I want, but that’s life, right?”
He said that he doesn’t believe states can afford to keep Medicaid expansion under current law.
“We’ve got to do something about it, both from the state standpoint but also from the federal taxpayer,” Cassidy said. “On the other hand, I like the coverage and I know that’s been instrumental in expanding coverage.”
Sen. Ron Johnson, R-Wisc., said the Senate is “making progress,” and dismissed the notion that the body has a deadline to get a new health bill done.
Senate and House leaders met with Trump later on Tuesday at the White House, but the meeting provided no breakthrough moment.
Trump, who earlier this year lashed out at House Republicans for initially balking at a repeal effort, put light pressure on the Senate during the meeting. He noted that since the House had passed its measure "the Senate I'm sure will follow suit and get a bill across the finish line this summer that will be great health care for Americans."
On Tuesday, Senate Majority Leader Mitch McConnell offered only vague optimism for meeting Trump’s lofty goal.
He was non-committal about when that would happen. “We’re getting closer to bringing up a proposal that we can bring up in the near future,” McConnell told reporters.
Republicans have 52 members in the Senate and could lose only two in order to pass the bill under budget reconcilation rules that block Democrats from filibustering tax and health care legislation. In the event of a 50-50 vote, Vice President Mike Pence would cast the tiebreaker.
Repealing and replacing the Affordable Care Act is the centerpiece of Trump’s legislative agenda, but congressional Republicans have been unable to coalesce around a suitable plan to do so.
Various media reports suggest the Senate proposal will adhere closely to the House measure, which the Congressional Budget Office estimated would cause 23 million people to lose health coverage over the next decade.
Senators are reportedly weighing details about how to address people with pre-existing conditions, how best to phaseout the Medicaid expansion and how to stabilize the insurance market in the first few years of a new law.
Although encouraged by the meeting, many GOP senators did not appear ready to embrace the budding plan.
Sen. Rob Portman, R-Ohio, said the Senate was “getting there, but it still needs to work for me.”
Sen. Shelly Capito, R-W.Va., called it a “good discussion with much more detail. I look forward to a further one,” she said
And Sen. John McCain, R-Ariz., said he believed the Senate plan was a “good start,” but he declined to discuss it further.
The legislative uncertainty and the Trump administration’s refusal, thus far, to reimburse Obamacare insurers for $9 billion in cost-sharing subsidies to low-income plan members has contributed to a destabilized individual insurance market.
Uncertainty over the funding is making it hard for insurers to forecast their premiums for next year and some carriers are leaving the industry altogether.
On Tuesday, Anthem Blue Cross and Blue Shield announced plans to stop offering coverage in all but one Ohio county because of the market upheaval.
Trump said insurers are “fleeing and leaving” the markets. “The last statewide insurer in the great state of Ohio is leaving,” Trump said. “That means another 20 counties in the state of Ohio will have no health care plan.”
Senate Minority Leader Charles Schumer, D-N.Y., on Tuesday accused Trump of holding the subsidies “hostage.”
“The way to get companies to come back to these counties is to say you’re going to do cost-sharing permanently,” Schumer said.