The odds are slim, but the White House still hopes for action on a bill drafted by Lindsey Graham and Bill Cassidy.
President Donald Trump and some Senate Republicans are refusing to give up on Obamacare repeal, even after this summer’s spectacular failure and with less than a month before a key deadline.
The president and White House staff have continued to work with Republican Sens. Lindsey Graham of South Carolijna and Bill Cassidy of Louisiana over the summer on their proposal to block grant federal health care funding to the states. And though the bill is being rewritten and Congress faces a brutal September agenda, Trump and his allies on health care are making a last-gasp effort.
“He wants to do it, the president does. He loves the block grants. But we’ve got to have political support outside Washington,” Graham said in an interview. He said the bill needs to have a “majority of the Republican governors behind the idea” to gain momentum in the Senate.
But there’s far more work to do even than that. Senate Majority Leader Mitch McConnell would need to find room on the packed calendar this month to hold another uncertain push to repeal Obamacare on party lines. The Senate has only until the end of the month to pass the measure using powerful budget reconciliation procedures, but is also planning to fund the government, raise the debt ceiling, write a new defense policy bill and extend a host of expiring programs.
Cassidy said he hopes to have the bill text finalized by this week and has declined to reveal details about what changed in the bill during August.
“We are still refining the legislative language — just things you got to clear up,” he said. “We think we have good legislation, good policy.”
The Congressional Budget Office would also still need time to analyze the cost of the bill, a process that could take several weeks.
Trump berated McConnell and the Senate GOP over the summer for falling one vote short of sending repeal into conference with the House in July, when Sen. John McCain of Arizona voted down the GOP’s “skinny” repeal bill. So the White House has continued to work on the Graham-Cassidy bill behind the scenes, seeing it as the best option to make progress, according to several administration officials.
The bill would keep most of Obamacare’s taxes and devolve many spending decisions to the states. It was submitted as an amendment to the repeal bill in July but did not receive a vote; aides say it could not pass the Senate in its current form.
Trump has intermittently told aides he wants progress on health care and is still frustrated that the bill failed. The White House’s legislative team has talked with Republican governors in recent weeks and is planning to bring more to the White House, according to one of the officials. Internally, White House officials say they have listened to concerns from governors and tried to tweak the state block grant formulas.
Hill leadership hasn’t played a central role in the effort.
McConnell said in Kentucky last month that the path forward is “somewhat murky” and pointed to efforts by Sen. Lamar Alexander (R-Tenn.) to stabilize insurance markets as one avenue forward, though he doubted Democrats’ resolve on the bipartisan effort.
“We’re going to see what Sen. Alexander and his team can do on a bipartisan basis. The Democrats have been pretty uninterested in any reforms. They’re really interested in sending money to insurance companies but not very interested in reforms,” McConnell said then.
Inside the White House, there is little hope that a health care bill can happen quickly, with a stacked legislative agenda. And some close to the president prefer he would focus on tax reform and other immediate fiscal issues.
The Senate parliamentarian has ruled that the chamber’s reconciliation instructions, which allow the GOP to evade a Democratic filibuster and the chamber’s 60-vote requirement, expire at the end of the month. Republicans are planning to use their next budget measure to pass tax reform via a simple majority. But Graham insisted there’s a short window to fulfill the party’s seven-year promise if the GOP goes into overdrive, starting this week.
“It’s possible, yes. But you’ve got to do it quickly … introduce it this week, have a hearing soon about the bill, then the process is set to actually take it to floor and vote,” Graham said. “Everything has to fall in place.”