WASHINGTON — Senate Republican leaders unveiled their long-awaited bill to replace Obamacare on Thursday and immediately ran into opposition from rank-and-file members over Medicaid cuts and tax credits to help people buy insurance.
“Obamacare isn’t working,” said Senate Majority Leader Mitch McConnell from the Senate floor.
“By nearly any measure, it has failed, and no amount of 11th-hour, reality-denying or buck-passing by Democrats is going to change the fact that more Americans are going to get hurt unless we do something,” McConnell said.
President Donald Trump told reporters the plan put out by Senate Republicans “is going to be negotiated,” signaling changes in the legislation before it hits the floor.
Vice President Mike Pence applauded GOP leaders and said “we look forward to working with the Senate majority to move this legislation forward.”
Yet within hours, four conservative GOP senators announced initial opposition to the bill, putting the measure in jeopardy.
Senate Democrats, meanwhile, remained united in their opposition to repealing the Affordable Care Act of 2010, also known as Obamacare, which was passed without one GOP vote in the House or Senate. They assailed the GOP bill for its cuts that would hurt the poor while providing tax cuts to the wealthy.
Sen. Catherine Cortez Masto, D-Nev., said the ACA is not perfect and Democrats were willing to improve the law.
“Fast-tracking a bill that makes devastating cuts to health coverage Nevadans rely on in an effort to hide the truth from the public is a reckless and unacceptable way to handle the lives of millions of Americans,” she said.
The 142-page Senate bill was drafted without hearings and in closed-door meetings,
It mirrors a House-passed version in some respects, mainly in ending mandates that Americans buy health insurance and allowing states to drop some of the benefits that the ACA required.
The Senate bill would phase out the ACA Medicaid expansion in four years, from 2020 to 2024, which would eliminate care for over 200,000 Nevadans who were enrolled when the program was broadened.
Medicaid expansion would be phased out in two years under the House plan.
The four-year phaseout is faster than the seven-year plan favored by moderate Republicans and those from 31 states and the District of Columbia that expanded Medicaid to take advantage of federal funding. Over 11 million people gained insurance nationwide through that expansion.
With a high-stakes vote on the Senate plan expected next week, the bill could have political consequences for vulnerable Republicans, like Sen. Dean Heller, R-Nev., who faces re-election in 2018.
Heller has vowed to repeal Obamacare, but said he remained undecided on how he would vote on the Senate bill. He said he would discuss the bill with Nevada Gov. Brian Sandoval, a Republican who has urged Congress to preserve Medicaid expansion.
Heller supported the longer seven-year phaseout of Medicaid to prevent the rug being pulled out from under those who signed up under the expansion.
“If the bill is good for Nevada, I’ll vote for it and if it’s not — I won’t,” Heller said.
But a likely Democratic challenger to Heller, Rep. Jacky Rosen, D-Nev., called the Senate bill “an assault on Nevadans’ health care.”
Rosen called the legislation “a cruel bill that implements a crushing age tax on older Americans, weakens essential health benefits protections, defunds Planned Parenthood, and strips away access for our most vulnerable citizens.”
For his part, Sandoval said his office is “reviewing the bill and will assess its potential effect on all Nevadans. … Preliminarily, it appears that the proposed bill will dramatically reduce coverage and will negatively impact our future state budgets, which causes me great concern.”
Although the bill drops mandates on insurance coverage, it would create a new system of tax credits for people to buy plans. It would allow states to drop requirements that include emergency services, maternity care and mental health treatment.
Conservatives said the Senate bill does not go far enough to repeal all provisions of the ACA.
“The current bill does not repeal Obamacare. It does not keep our promises to the American people,” said Sen. Rand Paul, R-Ky.
Paul and Sens. Ted Cruz, R-Texas, Ron Johnson, R-Wis., and Mike Lee, R-Utah, said they would vote against the bill in its current form, but remain open to negotiations on provisions that would further cut costs.
Senate Republicans now await a Congressional Budget Office analysis to determine the cost and savings of their repeal bill.
McConnell wants a vote on the legislation by July 4th, giving Republicans little time to settle their differences and find consensus on a bill that overhauls the nation’s health-care system.
Because of budget rules, the Senate can bring the legislation to the floor and pass it with a simple majority.
But the GOP holds a narrow 52-48 advantage in the Senate, and GOP leaders can afford to lose only two votes to pass the bill, with Pence casting a tie-breaking vote.
Rep. Dina Titus, D-Nev., urged both Nevada senators to “oppose the latest version of Trumpcare.”
“The Senate’s version is just as callous and shameless as the House’s disastrous bill,” Titus said. “The repercussions of this law, just to make the rich even richer, are unimaginable.”
Rep. Ruben Kihuen, D-Nev., charged the Senate GOP with a sleight-of-hand gimmicks on legislation that would have dire consequences for the country.
“Senate Republicans have spent weeks behind closed doors concocting this bill in secret, now they are rushing a vote on the floor just so they can skip out of town in time for the Fourth of July weekend,” Kihuen said.
Contact Gary Martin at 202-662-7390 or firstname.lastname@example.org. Follow @garymartindc on Twitter.
What’s next for health care bill
—Congressional Budget Office analysts review the bill and its effect, both on Americans and the nation’s finances. Report is expected early next week.
— Senate debates the bill and Majority Leader Mitch McConnell, R-Ky., said senators will have an opportunity to offer amendments to add to or change the bill. Dozens of amendments are expected, and the Senate schedules back-to-back-to-back votes known on Capitol Hill as a “vote-a-rama.”
— McConnell has the option of offering the final amendment, which could contain changes aimed at placating GOP holdouts.
— Senate Republicans are aiming for a final vote next Thursday, before lawmakers leave town for the weeklong July 4th recess.
The Associated Press