WASHINGTON – Foes from left and right are using the delayed vote on the Republican health care bill to make it as politically toxic as possible for wavering GOP senators to support it. But the postponement also gives Majority Leader Mitch McConnell and the White House more time to cut the deals they need to rescue the imperiled measure.
“Look, we need to tackle this problem,” McConnell, R-Ky., said Monday, signaling that days of bargaining and persuasion with reluctant colleagues lay ahead. “The only way we’ll get there is with continued hard work, and that’s just what we intend to do.”
Democrats are pressuring Republicans to use the delay in the Senate to hold public hearings on the controversial GOP health care bill. All 48 members of the Democratic caucus – along with two Republicans – oppose the legislation.
The letter also asks that GOP leaders not move ahead with the bill until the nonpartisan Congressional Budget Office releases a “complete score” on it. The CBO had been expected to release its findings as soon as Monday. But a GOP aide said that would not happen. The aide, granted anonymity to speak candidly, said a release later this week was possible but not certain.
The CBO has been projecting what the bill would do to insurance coverage levels, premium costs and the federal budget deficit. Having an unfavorable report in the public domain for an extended period of time with an uncertain date for a vote would fuel critics’ argument against the bill, probably making it harder for McConnell to round up votes for it.
A CBO report on an earlier version of the legislation projected it would result in 22 million fewer Americans with insurance by 2026 compared with under current law. It predicted that measure would reduce the budget deficit by $321 billion over the same period. On average, premiums would first rise, then fall under the measure, the CBO projected.
Neither a McConnell spokesman nor the CBO immediately responded to requests for comment on when the report was expected and why it would not be released Monday.
AARP was continuing TV and radio ads aimed at undecided Republican senators in five states, warning, “Your family’s coverage could be taken away altogether.” Planned Parenthood, labor and liberal groups were holding rallies outside the Capitol. And the conservative Americans for Prosperity was urging members to pressure GOP senators to strengthen a bill that the group’s president, Tim Phillips, says doesn’t go “anywhere near far enough” to repeal President Barack Obama’s health care law.
From the other side, Republican Party Chairwoman Ronna Romney McDaniel said the GOP needs to prove that “we can tackle tough issues.” The conservative Faith and Freedom Coalition announced its support for a bill that its chairman, Ralph Reed, called “a giant step forward.” And White House spokesman Sean Spicer said some senators – he didn’t initially say who – were going to the White House on Monday to discuss health care.
“There’s no one better than Mitch McConnell when it comes to knowing how and when to make a bill successful in the Senate,” Spicer told reporters. “So we have every confidence in the majority leader’s ability to get this done. And the president will do whatever he has to to support those efforts.”
On balance, the delay seemed to put McConnell in the tougher spot. In Washington, conventional wisdom dictates that a controversial bill awaiting a vote and under attack from opponents resembles a rotten egg sitting in the sun – the longer it sits, the worse things get.
“What you don’t like is legislation just hanging out for every possible critic to criticize every jot and tittle,” said Josh Holmes, a GOP consultant and former McConnell chief of staff.
Underscoring that, the AARP ads targeted five moderate Republicans from states that would be hit hard by the GOP bill’s cuts in Medicaid, the health insurance program for the poor, disabled and nursing home patients.
They were Lisa Murkowski of Alaska, Colorado’s Cory Gardner, Rob Portman of Ohio, Shelley Moore Capito of West Virginia and Dean Heller of Nevada, perhaps the most vulnerable GOP senator in next year’s elections. All five have been under pressure from McConnell in recent days.
Administration officials including Vice President Mike Pence have pressed Ohio Gov. John Kasich and Nevada Gov. Brian Sandoval, both Republican critics of the GOP’s Medicaid cuts, in hopes of gaining an edge with Portman and Heller.
But Holmes said the postponement could give Republican leaders a chance to win over GOP senators with talks that might include a “whole range of issues outside of health care.” And Mike Leavitt, health secretary under President George W. Bush, said McConnell and Trump could use a short delay productively but warned of the impact of one lasting several weeks.
“It’ll be difficult. It gives the opponents longer,” Leavitt said.
The battle over the legislation entered extra innings after 80-year-old Sen. John McCain, R-Ariz., had surgery Friday to remove a blood clot above his left eye. His office said he’d recuperate in Arizona for a week, though it was uncertain when he would return to the Capitol.
Without a vote to spare, McConnell indefinitely postponed a critical roll call planned for this week. That prolonged the suspense over the GOP’s troubled effort to deliver perhaps its highest-profile promise.
“We hope John McCain gets better very soon,” Trump said. “Because we miss him. He’s a crusty voice in Washington. Plus we need his vote.”
Two of the 52 GOP senators – Maine’s Susan Collins and Kentucky’s Rand Paul – have said they’ll vote against even beginning debate on the legislation. Since Democrats uniformly oppose the bill, it will lose if any remaining Republicans vote against it.
As if the arithmetic alone wasn’t daunting enough, McConnell faced a difficult balancing at that plagued House GOP leaders until they eventually pushed a similar bill through their chamber in May.
Besides the Medicaid cuts, moderate Republicans were unhappy with language letting insurers sell inexpensive policies with scant coverage, now generally forbidden under Obama’s 2010 law. Critics said the proposal would drive up premiums for sicker people who must purchase more extensive plans.
But conservatives led by Sen. Ted Cruz, R-Texas, were insistent on allowing bare-bones plans as a sure way to lower premiums, and many of them seemed unwilling to yield on the Medicaid reductions.
The Washington Post contributed to this report.