Washington
Senate Majority Leader Mitch McConnell, R-Ky., said on Tuesday that GOP leaders will produce a “discussion draft” on Thursday and hinted that a final vote could come next week — even as key senators expressed concern about the emerging legislation, the lack of transparency surrounding it and the disagreement that remains.
McConnell’s desire to wrap up before the Fourth of July recess reflects the sense of urgency among Republicans, including President Donald Trump, to show progress on health care after years of vowing to “repeal and replace” the Affordable Care Act.
But McConnell’s strategy for achieving that goal — writing a bill with a handful of aides behind closed doors — has come at a cost that reached new heights on Tuesday: anger among Republicans who feel shut out of the process.
“Do you know what the health-care bill looks like?” Sen. Lisa Murkowski, R-Alaska, asked reporters Tuesday, her frustration evident. “Because I don’t.”
McConnell told reporters that he would “lay out a discussion draft Thursday morning; you’ll be able to take a look at it” — but he declined to discuss the specifics. He said the Senate would take up the bill on the floor once it receives a score from the nonpartisan Congressional Budget Office — possibly on Monday.
Trump has sent mixed signals to Capitol Hill and has played a more hands-off role in Senate deliberations than he did in the House. While the president has pushed for swift action on health care and celebrated the passage of the House bill in May, he also “wants a bill that has heart in it,” press secretary Sean Spicer said at the White House on Tuesday. And at a private meeting with senators recently, Trump called the version that passed the House “mean.”
Senate Republicans have vowed to repeal and replace key parts of the ACA, commonly known as Obamacare, the 2010 law that has provided insurance to about 20 million additional Americans through a combination of expanded Medicaid coverage and private insurance, much of which is federally subsidized.
But even among Republicans — no Democrats are expected to support the bill — competing ideological goals have complicated Senate negotiations. Among the challenges in a messy drafting process: how to lower insurance premium costs and eliminate what some view as burdensome coverage mandates without increasing the number of uninsured Americans. It has become both a political and a substantive question for some GOP senators — many of whom campaigned on a promise to “repeal and replace” but now face strong evidence that their constituents like their coverage and insurance protections under the ACA.
The more contentious issues have included how to slow spending growth in Medicaid and reducing requirements for health plans, such as mandated coverage for certain diseases or preexisting conditions.
Senate leaders hope to start debate by Tuesday or Wednesday of next week, said two senior GOP aides who spoke on the condition of anonymity to describe strategy — yet it remains unclear whether McConnell has the 50 votes he needs (plus the tiebreaking vote of Vice President Mike Pence) to pass the bill. Democrats and Republicans will each have 10 hours to debate the bill before being allowed to offer an unlimited number of relevant amendments in what is commonly known as a “vote-a-rama.” If all goes as planned, a final vote could occur by the end of next week, the aides said.
Even lawmakers who have supported the idea of moving swiftly said they don’t know what will be in the bill.