The Trump administration and Republican leaders in Congress are going all-in on a last-ditch effort to replace ObamaCare.
Earlier this month, the GOP effort was all but dead as Republican leaders pivoted to tax reform. But the health-care legislation has picked up a significant amount of momentum over the past several days.
“I’ve never felt better about where we’re at,” Sen. Lindsey Graham (R-S.C.), one of the bill’s sponsors, told reporters after senators met with Vice President Pence to discuss the new health-care proposal.
“At the end of the day, I really believe we’re going to get 50 Republican votes,” he added.
Other GOP senators said the measure has a real prospect of success.
“Our members are thinking about it, they’re studying it. They’re talking to the authors of the bill. But I think we’ve made good headway,” said Senate Republican Conference Chairman John Thune (S.D.).
The unexpected second wind for the ObamaCare repeal effort has been helped greatly by the deal President Trump struck with Democrats earlier this month to fund hurricane relief and postpone a battle over federal spending and the debt limit until December.
Republicans at the time panned Trump for cutting GOP leaders out of the loop, but now his decision looks like a master stroke as it has created time on the schedule to take a second shot at health-care reform.
The upcoming deadline of Sept. 30 has also played a leading role in the rising prospects of the legislation. If an ObamaCare replacement bill isn’t signed into law by then under budget reconciliation rules, it would need 60 votes to pass.
Under the special rules, 50 votes plus a tie-breaker from Pence would send it to the House, where leading Republicans have indicated they would pass it and send it to Trump’s desk before the end of the month.
The newest legislative effort, named after co-sponsors Graham and Sen. Bill Cassidy (R-La.), a physician, would largely dismantle ObamaCare and convert its funding to block grants to states, empowering them to design new programs.
Democrats warn the block grants would be too small and would lead to cuts in Medicaid and other health-care spending.
The bill would also allow states to waive ObamaCare rules, including the prohibition on people with pre-existing conditions being charged higher premiums.
Pence and Senate Majority Leader Mitch McConnell (R-Ky.) told GOP lawmakers at Tuesday’s meeting that this is their last chance to fulfill their promise to repeal ObamaCare.
Sen. Ron Johnson (R-Wis.), another one of the bill’s sponsors, described Pence’s message as “really strong.”
McConnell warned colleagues that “if we do nothing, ObamaCare continues” and “this is the last best chance for putting ourselves back on a path where states get greater control,” according to Johnson.
Pence and Graham discussed how to whip up support for the bill aboard Air Force Two Tuesday during a flight back to Washington from New York, where they watched Trump’s first address to the United Nations.
Pence told a pool reporter on the flight that the president and the entire administration strongly back the new measure and have called senators and governors to build political support.
Trump phoned Graham, a former rival in the 2016 presidential race, late Monday evening to encourage him and promise his backing.
Pence said ahead of the lunch that he would press wavering senators.
“This is the moment. Now is the time. We have 12 days,” he said, according to the pool report.
GOP leaders have no margin for error.
Conservative Sen. Rand Paul (R-Ky.) has already announced he will oppose the legislation because it does not fully repeal ObamaCare, and Sen. Susan Collins (R-Maine) — who is considering a run for governor — has signaled she is also a likely no. Paul backed the prior Senate health-care measure while Collins rejected the bill, which was defeated by one vote.
Collins has expressed concern that the Congressional Budget Office (CBO) will not be able to deliver a full analysis of the legislation before a possible vote next week and said Tuesday she did not receive any new information after meeting with Pence.
She has introduced her own bipartisan proposal with Sen. Bill Nelson (D-Fla.) that would help states create reinsurance programs for their insurance markets to lower health-care premiums.
The Senate Finance Committee is scheduled to hold a hearing on the legislation Monday and a truncated analysis is expected from the CBO early next week.
The non-partisan budget office has indicated it would take several weeks to draft a full report with projections on premium costs and the number of uninsured.
At least four other Republicans are undecided, including Sens. John McCain (Ariz.) and Lisa Murkowski (Alaska). Both voted to kill the pared-down ObamaCare repeal bill before the August recess.
Sens. Dan Sullivan (R-Alaska) and Shelley Moore Capito (R-W.Va.) said they are also undecided about the legislation, which would deliver big cuts in federal aid to their home states.
The effort suffered a setback Tuesday when several key governors — most importantly Alaska Gov. Bill Walker (I) — released a letter expressing opposition.
“We ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans,” Walker wrote, along with other governors, including John Kasich of Ohio and Brian Sandoval of Nevada. “Only open, bipartisan approaches can achieve true, lasting reforms.”
Murkowski said she is in close consultation with Walker.
Sen. Dean Heller (Nev.), who is the most vulnerable Republican senator facing reelection next year, was a swing vote during the health-care debate earlier this summer, but he is a co-sponsor of Graham-Cassidy.
The governors instead praised a bipartisan effort at an ObamaCare stabilization measure that had been under negotiation in the Senate Health Committee.
Pence on Tuesday, however, slammed the door on the alternative possibility of moving legislation to shore up the individual insurance markets, noting that Speaker Paul Ryan (R-Wis.) has pledged it doesn’t have enough votes to pass the House.
Pence and Ryan spoke by phone during Pence’s return flight to Washington.
Ryan has also told McConnell that a stabilization bill from the Senate Health Committee “isn’t viable” in the House, according to a source familiar with the discussion.
Sen. Lamar Alexander (R-Tenn.), who had been leading the talks on a stabilization bill, declared the effort over Tuesday.
Republicans are increasingly pointing to their latest ObamaCare repeal bill as the only option to avoid the single payer proposal championed by Sen. Bernie Sanders (I-Vt.) and 16 of his Democratic colleagues.
“Here’s the choice for America: socialism or federalism when it comes to your health care,” Graham told reporters after the lunch meeting.
Graham says the bill he’s co-sponsored would redistribute money now disproportionately being spent in four Democratic states — New York, California, Massachusetts and Maryland — to the rest of the country.
Sen. Dianne Feinstein (D-Calif.) accused Graham and Cassidy of unfairly targeting her state.
“It’s appalling that Senator Graham and Senate Republicans would take federal funds that provide health care to Californians to give them to Republican-leaning states,” she said in a statement.