President Donald Trump told Senate Republicans Wednesday they should stay in Washington until they repeal Obamacare, sparking renewed negotiations just two days after GOP efforts to enact a new health-care law collapsed.
A group of about 20 Republican senators met at the Capitol Wednesday night with White House officials, including Health and Human Services Secretary Tom Price, to hash out possible paths forward, including reviving a measure proposed by Majority Leader Mitch McConnell.
The Congressional Budget Office is expected on Thursday to release its estimate of McConnell’s bill, according to a person familiar with the process. That report will let leaders know how much funding room they have to potentially woo holdout moderate lawmakers from states that chose to expand Medicaid under Obamacare.
Senator Dan Sullivan of Alaska told reporters earlier Wednesday that senators discussed at the White House the possibility of adding funding to the bill, as well as new authorities for Seema Verma, the administrator for Medicaid and Medicare.
Depending on the score, there could be $200 billion or so in flexibility given an earlier decision by GOP leaders to forgo tax cuts for high-earners. Adding significant funding could win over moderate holdouts such as Rob Portman of Ohio and Shelley Moore Capito of West Virginia, but it risks losing support from conservatives.
The renewed negotiating came after Trump urged senators to keep discussing a plan to repeal and replace Obamacare, as Republicans came under intense pressure to deliver on seven years of promises to undo the Affordable Care Act.
‘Shouldn’t Leave Town’
“We can repeal, but we should repeal and replace, and we shouldn’t leave town until this is complete — until this bill is on my desk and until we all go over to the Oval Office,” the president told senators at the beginning of a lunch meeting at the White House. “I’ll sign it and we can all celebrate to the American people.”
“Any senator who votes against debate is really telling America you are fine with Obamacare,” Trump said.
Public opposition from four Republicans on Monday sank McConnell’s most recent bill, which he drafted mostly in secret. The setback prompted McConnell to schedule a vote early next week to debate a bill that would simply repeal much of Obamacare with a two-year delay.
John Cornyn of Texas, the No. 2 Senate Republican, said Wednesday, “I think based on the discussions we had today that there’s more optimism that we could vote on a repeal and replace bill, rather than just a repeal bill.” He added, “But if there’s not agreement then we’ll still vote on the motion to proceed” to debate the simple repeal measure.
After meeting with Trump, McConnell told reporters he’s sticking with his plan to hold a procedural vote on health care early next week, likely aimed at debating a delayed repeal. The Senate Budget Committee posted the text of a repeal-only amendment Wednesday afternoon.
The CBO said Wednesday the repeal-only measure would result in 17 million more people without health insurance in 2018, rising to 32 million more without coverage by 2026. Premiums for individual policies would approximately double by 2026, while about three-fourths of the population would live in areas with no insurers in the individual market, according to the CBO.
Republicans came out of the Wednesday evening meeting with White House officials sounding cautious about the new talks.
Alaska Senator Lisa Murkowski said it was a discussion among “people who are very concerned and committed and trying to do the right things for the right reasons.” But she and some other lawmakers who emerged afterward indicated nothing had been settled.
Murkowski said she wasn’t able to say how she would vote on a motion to proceed with debate because there’s no legislation to consider.
“We’re not certain what we would be proceeding to,” she said.
Four Republican senators had previously said they’ll vote to block any repeal that lacks an adequate replacement. At least one of them, Capito, reiterated that position after the meeting with Trump. Portman said he’s “in the same position I’ve been in for weeks, which is trying to improve the bill.”
McConnell can afford to lose no more than two Republicans to advance a measure. That calculation became even more complicated Wednesday after the announcement that Republican Senator John McCain was diagnosed with a type of brain cancer and is receiving treatment in Arizona.
One of the biggest hurdles is addressing the concerns of Republicans from states that accepted Obamacare’s expansion of Medicaid.
Sullivan said that Verma made a pitch at the White House meeting for a proposal that the Alaska Republican said could help bridge the gap between senators from states that expanded Medicaid and those that didn’t.
Verma’s idea would combine Medicaid expansion funding, tax credits and state innovation funds to convert low-income people on the Medicaid expansion to private coverage on the exchanges, Sullivan said.
“I think that a lot of people want to do that,” Sullivan said. “Some people say that it’s not going to be as good a coverage, but as you all know, a lot of providers don’t take Medicaid. You might actually have a much more broad choice of providers for your health insurance.”
And by transitioning people from Medicaid to private insurance, it would expand the size of the insurance pools in the individual market.
Sullivan said this idea would work with both Medicaid expansion states as well as states that did not expand Medicaid.
Sullivan said Verma calls it a “wraparound” plan to provide extra help on the individual market for lower-income people.
The Senate was originally scheduled to go on its traditional August recess on July 29, but McConnell delayed it by two weeks. He didn’t respond to questions about whether he would keep the Senate in session until it passed a health-care bill, as Trump requested.
At the White House meeting, Trump directed some joking but pointed remarks to the senators whose opposition sunk McConnell’s plan. To Jerry Moran of Kansas and Mike Lee of Utah, he called them “my friends, they really were and are, they might not be very much longer.”
He also delivered a veiled threat to opponents. Speaking to Dean Heller of Nevada, who opposed the first version of McConnell’s bill, Trump suggested the voters in Nevada would appreciate him voting to replace Obamacare.
“He wants to remain a senator doesn’t he?” Trump asked.
The president’s approach to the issue has shifted wildly with tweets calling for various strategies in recent days.
After it became clear Monday that the Senate health-care bill did not have the 50 votes needed for passage, Trump said Republicans should vote to repeal Obamacare immediately then come up with a replacement plan later.
By Tuesday morning, Trump took to Twitter to support a different tactic: allowing the current health-care system to collapse before taking action to fix it.
On Wednesday, Trump was once again extolling the virtues of the Senate’s original repeal-and-replace bill, and his allies were saying the president was likely to rally Republicans around that legislation.
The Trump administration will make cost-sharing reduction payments for July, White House spokeswoman Sarah Huckabee Sanders told reporters at a briefing on Wednesday. The payments are made monthly to insurers, and help reduce out-of-pocket costs for low income people. Their legitimacy is the subject of a court dispute, and the administration has mulled cutting them off as a way of forcing Democrats to the negotiating table over the Affordable Care Act.