Senate Republicans plan to dramatically overhaul the House ObamaCare replacement bill that passed Thursday and are warning the process could take weeks.
The House bill, the American Health Care Act, has raised an array of concerns among Senate Republicans, chiefly among lawmakers from swing states who are opposed to the cap on ObamaCare’s Medicaid expansion that would take effect in 2020.
GOP senators are also troubled by analyses that the legislation would significantly cut federal subsidies for people between the ages of 50 and 65, especially in rural areas such as Maine, Montana, Nebraska and North Carolina.
Senate Republican Whip John Cornyn (R-Texas) announced Thursday that there would no “arbitrary deadlines” for the healthcare legislation, setting up an open-ended process.
“We’re going through the issues methodically,” he said. “The House passing the bill gives us a little bit more of a sense of urgency, but it’s going to take a while.”
Senate Republicans say the bill in its current form cannot pass, and some of them privately question whether it will ever get a floor vote. There’s also skepticism in the conference that they will be able to cobble together 51 votes behind any plan.
“I think it needs a lot of improvement,” Sen. Shelley Moore Capito (R-W.Va.), who is concerned about the Medicaid provisions, said about the House bill.
West Virginia has been one of the biggest beneficiaries under ObamaCare’s Medicaid expansion, with 175,000 new people signing up under the law’s more generous guidelines as of 2015.
Capito said she is also worried about the reductions in subsidies for older, less affluent people under the House plan.
For example, a person who is 60 years old earning $30,000 a year in Kanawha County, W.Va., would see a subsidy reduction of nearly $9,000 a year under the House proposal.
Sens. Rob Portman (R-Ohio) and Dean Heller (R-Nev.), two Republicans who have sounded the alarm about the potential Medicaid rollback, issued statements Thursday afternoon opposing the House bill.
Portman said he doesn’t support the measure “because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population.”
Portman said on Wednesday that he would like to see “a longer runway” for reforming Medicaid instead of abruptly capping the program two and a half years in the future.
Heller said “the current bill falls short” and “we cannot pull the rug out from under states like Nevada that expanded Medicaid.”
The House bill could also face resistance from some of the Senate’s most conservative members.
Sen. Rand Paul (R-Ky.) said that while changes to the legislation insisted on by members of the House Freedom Caucus improved the legislation, he’s still not satisfied.
“I really frankly am not too excited about subsidizing the profit of insurance companies,” Paul told Fox News in an interview Thursday.
“There’s about $300 or $400 billion in this bill for insurance company profit,” he added. “It boggles my mind how that became a Republican idea.”
Senate Majority Leader Mitch McConnell (R-Ky.) cautioned Tuesday that getting a healthcare bill through the Senate would be “a real big challenge.”
He has convened a working group that includes members of his leadership team, moderates who are worried about the Medicaid rollback, conservatives and two key committee chairman — Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Senate Health, Education, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) — to work out a compromise.
The group met Tuesday and again on Thursday.
“The majority leader has pulled together a working group of people that represent different approaches, trying to get consensus there, and we’re going through the issues methodically,” Cornyn later told reporters.
Alexander has been working for weeks on a healthcare reform bill that could pass the Senate with only Republican votes.
He has begun working closely with Sen. Ted Cruz (R-Texas), a conservative who earlier this year voiced misgivings about the House healthcare reform bill but who could emerge as the key to getting a deal.
McConnell initially hoped to pass the House healthcare reform bill through the Senate quickly.
He first eyed the last week of March for the job, but the political calculations changed after Speaker Paul Ryan (R-Wis.) failed to muster enough votes for the legislation on March 24 and pulled it from the floor.
As it’s become increasingly clear how much opposition there is within the Senate to the bill, McConnell has opted for a less ambitious timeline.
Twenty House GOP lawmakers voted against the legislation Thursday, and some of them criticized it in harsh terms.
Rep. Ileana Ros-Lehtinen (R-Fla.) said the bill “has the potential to severely harm the health and lives of people in South Florida.”
McConnell initially planned to bring the House bill directly to the floor, but now he wants to vet it through the working group he has assembled to make sure it can get 51 votes.
Senate Republicans control 52 seats and so can afford only two defections, as Vice President Pence could break a 50-50 tie.
The expected plan is to use the working group instead of the primary committees of jurisdiction, the Finance and Health panels, to negotiate the bill.
“I think what you’re going to see is more of a working group approach, which has already started to meet,” Cornyn said.
But not all Republicans are thrilled about bypassing the committees.
“My hope is that we treat the bill seriously, that we have hearings, that we have witnesses,” said Sen. Jerry Moran (R-Kan.). “I want the regular order to work.”
Not a single House Democrat voted for the ObamaCare repeal legislation in the House, and Democratic leaders said Thursday that it would not get any support from their conference in the Senate.
“The proposal that is coming from the House doesn’t have a pulse in terms of Senate Democrats,” said Sen. Ron Wyden (Ore.), the senior Democrat on the Finance Committee.