WASHINGTON ― The Senate health care bill isn’t dead, but it has started giving away its belongings to the grandchildren.
GOP leaders are scrambling just to convince reluctant Republicans to open debate on their health care legislation, with the new language released Thursday doing little to change the dynamic Republicans have faced all along: They don’t have the votes ― at least not yet.
Majority Leader Mitch McConnell (R-Ky.) appears to have lost two Republicans right out of the gate: Susan Collins (R-Me.) and Rand Paul (R-Ky.). With only 52 Republicans in the conference, he can’t afford to lose anyone else if the bill is just to get to the floor. And there are a number of Republicans who report being undecided ― like Shelley Moore Capito (R-W.V.), Rob Portman (R-Ohio) and John Hoeven (R-N.D.) ― as well as senators who have staked out even harder positions to back away from, like Dean Heller (R-Nev.) and Lisa Murkowski (R-Alaska).
All five of those senators were in McConnell’s office Thursday afternoon, following a GOP conference meeting in the old Senate chamber and a members-only lunch. The holdouts still seem to have reservations over the bill’s provisions on Medicaid. Despite changes to the legislation to keep more of the taxes from the Affordable Care Act, and to put another $70 billion toward lowering premiums, the revised measure still unwinds the funding for the Medicaid expansion.
“My position remains the same,” Portman told reporters Thursday. “I want to make sure that, with regard to the people who are currently getting coverage under the Medicaid expansion, that they have some options.”
Portman did say he was happy about an additional $45 billion for states to fight opioid addiction ― up from $2 billion ― and he said leadership was still talking about more changes to soften the blow of the Medicaid cuts.
Still, a large mission of the bill is to do away with the Medicaid expansion. A slightly longer runway for those cuts may win over some senators, but sinking the Republican bill would keep the expansion in place.
At this point, any one of those five senators could functionally kill the bill by declaring his or her opposition. Heller, who said in June that he would oppose the bill and the motion to proceed, told reporters on Thursday he was now undecided, though Nevada’s Republican Gov. Brian Sandoval ― from whom Heller seems to be taking at least some of his cues ― didn’t seem to be won over by the latest changes. Heller is up for re-election in 2018, and he would likely be helped politically by voting against the bill.
Another strong candidate to deal the health care bill its kill shot is Murkowski. Murkowski told Politico on Wednesday that the GOP health care bill ought to just set Medicaid aside as an issue, and she has expressed concerns over protecting people with pre-existing conditions.
The revised bill would fundamentally undermine protections for people with pre