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Senate leaders try to appease members as support for health bill slips

 
Sen. Rand Paul of Kentucky, speaking to reporters on Capitol Hill on Thursday, is one of the five Republican senators who announced they cannot support the health care bill as drafted.
Sen. Rand Paul of Kentucky, speaking to reporters on Capitol Hill on Thursday, is one of the five Republican senators who announced they cannot support the health care bill as drafted.
Published June 25, 2017

WASHINGTON — Senate Republican leaders scrambled Sunday to rally support for their health care bill, even as opposition continued to build outside Congress and two Republican senators questioned whether the bill would be approved this week.

President Donald Trump expressed confidence that the bill to repeal the guts of the Affordable Care Act would pass.

"Health care is a very, very tough thing to get," Trump said Sunday on Fox News. "But I think we're going to get it. We don't have too much of a choice, because the alternative is the dead carcass of Obamacare."

Over the weekend, senators and their aides were poring over the bill, drafting possible amendments, preparing speeches and compiling personal stories from constituents whom they portrayed as either beneficiaries or victims of the Affordable Care Act.

The bill was drafted in secret by the Senate majority leader, Mitch McConnell of Kentucky, who unveiled it Thursday. McConnell wants a vote this week, before lawmakers take a break for the Fourth of July holiday.

But the bill's supporters were battling a dire internal threat: reluctant Republicans. Sen. Ron Johnson, R-Wis., said Sunday that "there's no way we should be voting" on the legislation this week. "No way."

"I have a hard time believing Wisconsin constituents or even myself will have enough time to properly evaluate this for me to vote for a motion to proceed" to the legislation, Johnson said on NBC's Meet the Press.

And Sen. Susan Collins, R-Maine, appearing on ABC's This Week, said: "It's hard for me to see the bill passing this week, but that's up to the majority leader. We could well be in all night a couple of nights."

The forces arrayed against the Republican push to dismantle President Barack Obama's signature domestic achievement are formidable. Much of the nation's $3 trillion health care industry opposes the bill. And McConnell has done little to woo the health care stakeholders who were assiduously courted by Obama from his first months in office as he fought for his legislation.

The outside forces against the bill also appear to be growing: Top lieutenants in the conservative Koch brothers' political network sharply criticized the legislation over the weekend, saying it was insufficiently conservative and did not do enough to rein in the growth of Medicaid. And a number of Republican governors have joined doctors, hospitals and patient advocacy groups in opposing the bill, in part because of its cuts to Medicaid.

McConnell has only a few days to wheel, deal and cajole reluctant senators to get behind legislation that has grown less popular with more exposure. He has considerable firepower to win votes, by guaranteeing amendments that would address the concerns of individual Republican senators, playing on their loyalty to him and their fealty to conservative voters still demanding an end to the Affordable Care Act. At the same time, Democrats say, he has striking liabilities. Trump has endorsed the bill, and Democrats say they will take every opportunity to link the legislation to an unpopular president.

Republicans have endlessly cataloged problems with the Affordable Care Act, which they deride as "Obamacare," but party leaders face a bigger challenge now as they try to convince wavering Republican senators and a skeptical public that they have a better plan. Democrats have met that push with withering criticism, saying "Trumpcare" is far worse.

And the Democratic wall of opposition is backed by less partisan voices. Senators are being flooded with appeals like this from the advocacy arm of the American Cancer Society: "Cancer is scary enough. Don't take away our coverage."

The American Childhood Cancer Organization, a charitable group formed by parents, is mobilizing a small army of grass-roots lobbyists with the message that the Senate Republican bill, with its deep cuts in Medicaid, "will threaten the lives of children battling cancer."

So far, five Republican senators have announced they cannot support the health care bill as drafted: Dean Heller of Nevada, who says the measure cuts coverage too deeply, and four conservatives: Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Johnson, who say it does not do enough to lower health costs. Other Republicans, like Collins and Sen. Lisa Murkowski of Alaska, have expressed misgivings.

Republicans have assembled reams of data to show that premiums are soaring and choices are shrinking as insurers withdraw from markets in many states. They assert that Democrats have no constructive solutions. And they will use Sen. Bernie Sanders of Vermont as a punching bag.

Sanders has long advocated a single-payer health care system, what he calls "Medicare for all," and he repeated that position on Meet the Press on Sunday. The No. 2 Senate Republican, John Cornyn of Texas, said Sanders had become "the chief spokesman for the Democrats in the Senate" on solutions to "the failures of Obamacare."

But that criticism comes amid a striking shift in public opinion. Fifty-one percent of Americans now have favorable views of the Affordable Care Act, according to a monthly tracking poll by the Kaiser Family Foundation. "That's the first time in our 79 tracking polls over seven years that this share has topped 50 percent," said Craig Palosky, a spokesman for the foundation.