A path is emerging for Senate Republicans to pass their ObamaCare repeal bill, even though there are major obstacles ahead.
Critically, Senate moderates are indicating that they can agree to ending the additional federal funds for ObamaCare’s expansion of Medicaid, albeit on a slower timetable than other Republicans want.
A compromise on Medicaid funding would remove one of the biggest obstacles for the bill.
The moderates want the phaseout of the Medicaid funding to take seven years, while Senate Majority Leader Mitch McConnell (R-Ky.) proposed three years on Tuesday.
“Mitch is listening to everybody’s concerns and there’s a back and forth. I think we’re slowly getting closer,” Sen. Dean Heller (R-Nev.) said Thursday. “It’s moving in the right direction.”
{mosads}Sen. Richard Burr (R-N.C.), who made headlines over the Memorial Day recess by saying it was “unlikely” that the Senate could pass an ObamaCare repeal bill, declined to repeat that assessment this week. “It’s hard for me to handicap,” he said.
McConnell is speeding toward a vote, with the goal of passing a healthcare bill the last week of June, before the Fourth of July recess.
Republicans have said there will be no committee hearings or markups for the bill, a major departure from the standard Senate process. Instead, the bill will go straight to the floor for a vote.
Democrats fear the legislation will be kept secret until just a couple of days before the vote, to minimize time for opposition to build.
“13 Republican men are meeting in secret to make a healthcare plan,” Sen. Brian Schatz (D-Hawaii) wrote on Twitter on Friday. “Their plan is to do it so fast we can’t stop them. Stop them.”
While some moderate Republican senators have spoken more favorably of the bill in the past week, objections from conservatives remain a sticking point.
By changing the healthcare bill to win over more moderate members, Senate GOP leaders risk creating a revolt on the right.
Conservatives are worried about both the longer Medicaid expansion phaseout and a move to dial back the waivers that would allow states to repeal ObamaCare regulations.
The Senate bill is poised to allow states to be exempt from the ObamaCare rules on what an insurance plan must cover, known as essential health benefits, but not from the rules preventing people with pre-existing conditions from being charged more, known as community rating. That is a departure from the healthcare bill passed by the House.
“There has to be a give and take, and right now it seems like conservatives are being told just to take it all and not get anything,” Dan Holler, a spokesman for Heritage Action for America, a conservative group, said on Thursday.
Still, some of the members seen as most likely to vote against the bill were on the moderate side of the spectrum, and the change in their rhetoric is noticeable.
Sen. Bill Cassidy (R-La.), who was vocal about the need to protect people with pre-existing conditions, said this week he thinks the emerging bill passes his test.
“It’s very cognizant of pre-existing conditions, which is a good thing,” Cassidy said on Tuesday.
“We haven’t seen the final details, but simple answer … yes,” he added when asked if he could support the proposal.
Even Sen. Susan Collins (R-Maine), a leading GOP centrist, had positive words.
“From the outline of the Senate bill that I’ve seen — and there are a lot of specifics that I’m not yet aware of — it is a far more thoughtful and appropriate bill than the House version,“ Collins said Tuesday, “but there are a lot of unanswered questions yet.”
Still, there are plenty of unexpected disruptions that could occur.
For example, the Senate parliamentarian has warned Republicans that a provision preventing tax credits from being used on insurance plans that cover abortion is unlikely to be allowed under Senate rules. If that provision were not allowed, it could cause a major drop in conservative support from anti-abortion Republicans and require a workaround to be found.
And the Medicaid negotiations are continuing.
“We have a proposal out there for seven years,” Sen. Rob Portman (R-Ohio) told reporters Wednesday. “And we’ll see where we end up.”