Senate Republicans still at impasse after late-night health care meeting


http://www.politico.com/story/2017/07/19/trump-congress-no-recess-health-care-240718

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A key group of Senate Republicans met late into the night Wednesday to try to salvage their health care bill, but emerged without any breakthroughs and still appeared far from finding the votes to repeal Obamacare.

Still, as GOP senators left the nearly three-hour meeting, they professed optimism.

The Republicans initially planned to bring in chiefs of staff and health care wonks to advance the negotiations. White House Chief of Staff Reince Priebus was expected to join and help push the disagreeing GOP senators to yes.

But as the senators kept talking, they reevaluated their plan and decided not to allow staff in and keep the room to members only. Priebus strolled out of Sen. John Barrasso’s office, as did White House legislative director Marc Short. The senators would keep talking amongst themselves.

Talks “narrowed down to try to figure out what is causing members not to be able to vote in favor or problems they have with the bill,” said Sen. Jerry Moran (R-Kan.), who opposes the GOP’s latest repeal and replace draft. “It had merit and it’s something that should have been taking place.”

Added Sen. John Kennedy (R-La.): “We’re at our best when we’re among ourselves.”

As the night dragged on, however, Republicans cited good progress but nothing to suggest they had overcome the obstacles that have stymied their previous efforts.

At least 20 Republicans, including leadership allies, moderates and conservatives, worked through the party’s myriad disagreements over Medicaid, coverage numbers, lowering premiums and cutting regulations.

Health and Human Service Secretary Tom Price and top Medicaid official Seema Verma were in the room too. And earlier at the White House, senators and administration officials discussed adding billions more to help states worried about Medicaid cuts under the bill.

Yet the conversation among senators focused on the broad contours of the issues.

“We weren’t getting into the specifics,” said Sen. Dan Sullivan (R-Alaska). “We weren’t tossing around numbers.”

Indeed, senators left uncertain of how a planned vote will go next week, or whether it should even occur while Sen. John McCain (R-Ariz.) is being treated for cancer.

Senate Majority Leader Mitch McConnell (R-Ky.) has pledged to hold a vote next week, but with McCain gone and Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine) opposing the repeal and replace plan and not even attending the meeting, success appears far off. Republicans said privately they doubt McCain will be back next week.

“Hard to say [if we’re closer]. I’m fine voting next week,” said Sen. Pat Toomey (R-Pa.). McCain’s absence “does complicate things. And I just don’t know if he’s going to be back.”

Privately, senators doubted they could get the 50 votes together for a health care overhaul despite the productive meeting. There was a feeling that while a session that occasionally turned into venting was therapeutic, the challenges facing the fractious 52-member majority may be too great to bridge.

“You understand the math. It just makes things kind of more difficult,” said Sen. Bob Corker (R-Tenn.).

“We do have work to do to get to a vote of 50,” Barrasso said.

The meeting followed a gathering with President Donald Trump, who ordered senators to stay in Washington until they pass a bill to repeal and replace the 2010 health law. Barrasso said the meeting was planned before the White House lunch.

But with a new flicker of optimism, GOP leaders are still pushing for a way to advance a health bill next week even after two different repeal plans fell apart. Republican senators left a health care meeting at the White House Wednesday sounding more optimistic that they could revive their bill to replace the Affordable Care Act.

“We’re discussing that,” Senate Majority Whip John Cornyn (R-Texas) said when asked whether some version of the Better Care Reconciliation Act was coming back. “I’m more optimistic that that would be the case. But if there’s no agreement, then we’ll still vote on the motion to proceed but it’ll be to the 2015 just-repeal bill.”

“We have at least momentum. Before there was none,” said Sen. Bill Cassidy (R-La.).

Sens. Mike Lee (R-Utah) and Paul say the bill isn’t conservative enough, making it difficult for McConnell to get the 50 votes he needs. And it was unclear if billions more for Medicaid will be enough to move the moderate holds outs, with one senator saying there’s an “outside chance” of success next week. At the White House Trump, the senator said, was more effective than he’s been on healthcare in weeks.

The Senate GOP’s latest attempt to craft a replacement for Obamacare fell apart earlier this week, as four Republican senators announced that they would oppose the current version of the bill. But Cornyn told reporters following the White House meeting that about 40 members of the GOP conference are prepared to vote on any health care deal replacing Obamacare, and the “differences are narrowing.” Trump also sounded a note of optimism during the meeting.

But centrist GOP senators like Sens. Rob Portman (R-Ohio) and Sen. Shelley Moore Capito (R-W.Va.) are not happy about future reductions to Medicaid spending, worried it would kick hundreds of thousands of their constituents off healthcare. GOP leaders threw more than $100 billion to lower premiums and fight drug addiction into the bill, but thus far it hasn’t been enough.

Cornyn said a key procedural vote to take up legislation will be held regardless of whether it will succeed. McConnell, speaking to reporters after the White House meeting, said he expected to be able to at least proceed to the bill.

But three Senate Republicans — Sen. Lisa Murkowski of Alaska, Capito and Collins — said they would oppose proceeding to a repeal-only measure on Tuesday, effectively tanking the prospects that a floor debate over getting a straight repeal of Obamacare can even begin.

And some key holdouts said their position is unchanged. Portman, who is undecided on a procedural vote but has signaled opposition to a repeal-only bill, said the legislation needs “to do more to show low-income people that they have options” and said the vote next week will fail unless those improvements were made.

Capito said she’ll still vote no on proceeding to a bill unless there’s a replacement plan she supports.

“The president emphasized repeal and replace. We’re still working on it. It’s moved a lot farther in terms of where it was in terms of congealing,” Capito said.

Murkowski said she wasn’t even sure what they would be voting on.

“It’s not clear whether there will be a motion to proceed to this repeal and replace. I think that’s still under consideration. There will be a vote on something that much is certain,” she said, adding that it was hard to answer “unless you know what the question is.”

Collins said she was not invited to the meeting and wouldn’t be attending.

“I guess it’s open invitation but I didn’t know that until it was brought up at the White House. I’m unfortunately committed to something else,” she said.

Earlier at the lunch, Trump said he was surprised to see his “friends” — “They might not be very much longer,” he quipped — oppose Senate GOP leaders’ plan.

Trump singled out Dean Heller, who is widely considered the GOP’s most vulnerable incumbent in 2018, suggesting he was once worried but is now confident the Nevada senator will come around to supporting a replacement bill.

“Look,” Trump told the room of Republicans, “he wants to remain a senator, doesn’t he? OK? And I think the people of your state, which I know very well, I think they’re gonna appreciate what you hopefully will do.”

A chuckling Heller said as he returned to the Capitol that those comments were “President Trump being President Trump.” And after the late-night Senate meeting, Heller seemed a bit more optimistic.

“It was probably one of the most productive meetings I’ve been to in a long time,” Heller said. “We have some real honest brokers in there who are really trying to solve the problem.”

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