Action Alert: Final push to defeat ‘Obamacare’ repeal and ‘Trumpcare’ replacement

Tea-Publican leaders are frantically pushing for a vote on the Senate’s ailing “Trumpcare” bill next week. Evil GOP bastard Mitch McConnell is racing to placate warring moderates and conservatives with a new draft due within days, POLITICO reports. GOP struggles to revamp ailing Obamacare repeal bill:

New bill text could be unveiled to senators as soon as Thursday, according to sources familiar with the proposal. A Congressional Budget Office score is likely to follow as soon as next Monday.

“My gut assessment is we need to start voting. … We need to get started, and the goal continues to be to do that next week,” said Senate Majority Whip John Cornyn (R-Texas). Pressed on whether his party will be successful, he said: “I never want to fight to lose. I want to fight to win. And that remains the goal.”

Senate Republicans have offered increasingly dour assessments of the bill’s prospects due to a push from conservative Sens. Ted Cruz of Texas and Mike Lee of Utah to drag the bill rightward and distaste from more moderate senators for future Medicaid spending cuts. Sen. John McCain of Arizona predicted Sunday the effort would be “dead,” yet Cornyn said he feels “pretty good about where we are.”

Other leaders said Republicans’ opposition was based on the first discussion draft of the bill, which drew opposition from all corners of the party for leaving 22 million fewer people with insurance and not doing enough to lower premiums, in the view of some in the GOP.

“This will hopefully address some of the concerns by individual members,” Sen. John Thune (R-S.D.) said of new changes to the bill. He said he hoped Republicans could reach an “understanding” to at least advance the bill on a procedural vote next week and begin consideration of the legislation. McConnell needs 50 senators to support opening debate on the bill and 50 to pass it, with Vice President Mike Pence able to serve as a tie-breaker.

The party spent Monday sniping over the future of the Lee and Cruz amendment, which would allow the sale of cheap insurance plans (i.e., Junk health insuranceDemocrats slam Cruz amendment for allowing ‘junk insurance’) outside Obamacare’s regulatory structure.

GOP critics like Sens. Chuck Grassley of Iowa, Susan Collins of Maine and Shelley Moore Capito of West Virginia have worried that Cruz’s and Lee’s amendment would make it harder for people with pre-existing conditions to get covered — arguments being amplified by Democrats. Opposition from those senators alone would tank the amendment.

“I’m not sure it has the oomph to make it,” Senate Finance Committee Chairman Orrin Hatch of Utah told Politico, referring to the measure’s level of support.

Two GOP senators, Bill Cassidy of Louisiana and Mike Rounds of South Dakota, said they were hoping for changes to the amendment so that Cruz’s and Lee’s effort to lower premiums could be accommodated while not scaring off other Republicans by segmenting sicker people into one risk pool and healthy people into another.

“The original amendment I did not care for. But my understanding is they’re taking a look at connecting the pooling,” Rounds said. “If they put that provision in, I have a real interest in seeing the amendment move forward.”

Lee said of those sentiments: “News to me.”

Still, several more GOP senators joined in backing Cruz’s and Lee’s amendment on Monday evening, including Sens. Marco Rubio of Florida and Jeff Flake of Arizona. Flake is up for reelection, and the amendment is increasingly a referendum on the right.

“I do like that Cruz proposal,” Flake said.

Well ain’t that special: Sen. Jeff Flake likes junk health insurance plans with huge coverage holes that leave people vulnerable to medical expenses that could lead to finacial ruin and bankruptcy. It also segregates people with preexisting conditions into “high risk pools” which have always proven to be underfunded crappy insurance coverage as well. What a swell guy.

Though Republicans are aiming to have a new CBO report of their latest proposal by early next week, it may not include an analysis of that amendment. Several Republicans said the so-called Consumer Freedom Act was not fully transmitted to CBO before the Fourth of July recess, which could result in the incomplete analysis.

A conservative aide familiar with the negotiations said GOP leaders had sent only a summary of the legislation “for reasons unknown to us,” leaving supporters to answer other questions for CBO late last week. Allies of leadership, however, argued the conservatives had been unresponsive.

The White House continues to talk up the Cruz-Lee amendment. Pence told Rush Limbaugh on Monday that it was an example of “what freedom looks like.”

On Tuesday and Wednesday, McConnell is expected to brief the full 52-member caucus on proposed alterations sent to CBO regarding the Senate’s draft bill, which is far from the requisite 50 votes needed.

Republicans are leaning toward keeping some of Obamacare’s taxes to help lower premiums for low-income people, plowing $45 billion into fighting opioid addiction and allowing people to pay premiums with pre-tax money. How to get the support of senators from Medicaid expansion states is also unsolved.

Thune said the Cruz-Lee amendment will get a vote at some point next week, either to strip it out of McConnell’s substitute if it is included in the GOP’s draft, or to include it if leaders spurn it. A proposal to blunt some future spending reductions to Medicaid will likely receive similar treatment.

A McConnell spokesman had no announcements on timing for consideration of the bill.

* * *

Another aide said the negotiations aren’t expected to move significantly until the new CBO scores are released. The score on the Cruz-Lee amendment, if CBO can finish it, could show premiums spiking high enough to kill the proposal. The amendment does not currently have the support to pass the Senate.

“They’ll give Cruz every opportunity to sell his solution this week,” said a person familiar with the negotiations. “He’s going to be the one making the sell this week. The question is whether the Cruz-Lee amendment costs you votes. The votes are clearly not there right now.”

* * *

On Sunday, Cruz argued that his amendment is a compromise, not a shot from the right that should drive other Republicans away.

“The Consumer Freedom Amendment was designed to be a compromise, to bring together both conservatives and moderates to unify the party. How does it do that? Because it maintains preexisting conditions protections,” Cruz said on ABC’s “This Week.”

Yet if there is no CBO score on the provision, it would be impossible to evaluate whether the proposal would lower premiums and how it would affect insurance coverage numbers and the stability of insurance markets. Republicans must have a CBO score for their proposal to pass muster with the Senate parliamentarian.

Republicans are now wondering whether the conservative duo would accept something else as a condition for their support. A spokesman for Lee said he needs significant regulatory cuts in the Senate bill to support it.

The Washington Post adds today, The Senate health bill is almost an orphan with few real supporters:

On Tuesday, after a roughly 90-minute huddle with his caucus, Senate Majority Leader Mitch McConnell (R-Ky.) began his weekly news conference on “the news of the day” — the struggling effort to pass health-care legislation that would repeal and replace portions of the Affordable Care Act.

For less than 25 seconds, McConnell gave a basic update on the timing of the legislation, never made the case for why Republicans should support it and then moved on for another minute to attack Democrats on unrelated issues.

That’s the way it has gone for the Better Care Reconciliation Act ever since it was unveiled nearly three weeks ago. In public appearances, and often in private GOP meetings, Republican after Republican outlines the reasons that they stand opposed to the legislation, as written, with almost no one taking up the mantle of defending a proposal that was unpopular from Day One.

* * *

Part of the Republicans’ hesi­ta­tion to directly promote their own health proposal is its uncertain fate, its unpopularity in repeated public polling and the sense that it might die on the Senate floor in what will be a politically embarrassing defeat for a party that promised to repeal the ACA the moment that Democrats approved it seven years ago.

Another problem is that McConnell chose a process to craft the legislation that has literally left the proposal orphaned.

By not going through the Senate’s precedent-bound process of “regular order,” the bill has bypassed committee hearings as well as the loving care that a legislative sponsor would normally provide. As a result, it has no real parent figure, no one invested in its success, no one primarily responsible for promoting it to other colleagues and the media.

* * *

Now there is so little investment in the legislation by rank-and-file Republicans that the questions continue to pile up about what changes need to be made. By late last week, the discourse had turned into a feeding frenzy, with even the most loyal Republicans openly questioning the measure while they were home over the Fourth of July.

* * *

There is no buy-in among Republicans in the Senate.

That was on display during the nearly 12 minutes they spent in front of the press Tuesday, with McConnell and five of his lieutenants rarely referencing the underlying legislation that they are trying to pass later next week.

They instead chose to continue to ridicule the ACA, warning that its insurance exchanges were imploding and that something must be done.

Two Republicans didn’t even bother talking about health care, opting instead to accuse Democrats of slow-walking President Trump’s nominees to sub-Cabinet positions — and to blame them for McConnell’s decision to cut down by two weeks a planned 40-day recess over August and early September.

McConnell delays August recess to complete work on health-care bill, other issues (the Senate will delay the start of the August recess until the third week of August):

The fate of the Senate’s health-care bill remained uncertain Tuesday, although McConnell told reporters he plans to release a revised bill by Thursday morning and hopes to receive a Congressional Budget Office analysis of the new version by the beginning of next week so the chamber can vote quickly.

McConnell’s announcement appeared designed to give Republicans time to move to other matters, such as raising the federal debt ceiling, after dispatching with a health-care vote.

“The debt ceiling must be raised,” McConnell told reporters.

* * *

Douglas Holtz-Eakin, a former CBO director, said it appears that Cruz’s amendment would send all of the young, healthy people who are cheaper to cover into one insurance pool — and leave sicker, older people “in a glorified high-risk pool.”

“It would be expensive and possibly not particularly stable,” Holtz-Eakin said in an interview. “If the public-policy goal is to give people access to affordable insurance options, there’s a set of people who would just not have access to that.”

Holtz-Eakin said he would expect insurers to flee the exchanges even faster than they are under current policy, driving up premiums and forcing the federal government to increase subsidies to keep up with the skyrocketing rates.

Eliot Fishman, Families USA’s senior director of health policy, and Cheryl Fish-Parchman, the group’s director of access initiatives, wrote in a blog post Tuesday: “Bottom line: If you create one pool for healthy people and one pool that only covers sick people — those with pre-existing conditions — you are thrusting sick people into a pool that is the very definition of a death spiral.”

David Atkins at the Poliical Animal blog reminds us that TrumpCare Is In Big Trouble, But the Normal Rules Don’t Apply:

But we’re not fully on the other side of the looking glass yet. There are still just enough Republican Senators who are susceptible to fear of ballot box recrimination, combined with enough raw ideological die hards who won’t settle for less than a libertarian’s dystopia in the healthcare psuedo-market, that Obamacare repeal is now in deep trouble in the Senate.

But just as with the House version of the same, it’s important not to underestimate the pressure of tax cut fervor and partisan zeal. Organized resistance by the left has made a huge difference in pushing the bill to the edge of defeat. But it’s not over until it’s over.

The normal political rules many Americans expect don’t apply anymore. It’s a different world than most people thought they lived in. Mobilization is key. Expect the worst, hope for the best, and never underestimate the fervent cruelty of the opposition.

Keep pressuring your senators to oppose “Obamacare” repeal and replacement with a horrific “Trumpcare” plan.

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