McConnell trying to revise the Senate health care bill by Friday

WASHINGTON — Senate Majority Leader Mitch McConnell is aiming to send a revised version of his health care bill to the Congressional Budget Office as soon as Friday as he continues to push for a vote before Congress' August recess.

The effort reflects the tight timeline McConnell faces in his attempt to hold a vote in July — and the pressure he is under to make changes to the bill that will garner enough support to pass. With both conservatives and centrists pushing different policy solutions, Senate leaders were still struggling to craft a rewrite of the Affordable Care Act that would attract votes without torpedoing the CBO's official score of how the legislation affects coverage levels and federal spending.

In between closed-door lunches and meetings with McConnell and his team, a number of Republicans flashed visible signs of frustration Wednesday even as they expressed reluctant optimism that a vote was still possible.

"This has been way more difficult than it needs to be," said Sen. Ron Johnson, R-Wis., who was among five senators whose opposition to the bill prompted McConnell to postpone a vote this week. "I'm doing everything I can to discipline a problem-solving process."

With Vice President Mike Pence prepared to cast the tiebreaking vote, and all Democrats opposed to repealing the 2010 law known as Obamacare, Republicans need the support of all but two of their 52 senators.

The draft bill would cut $772 billion from the nation's Medicaid program over the next decade, along with reducing federal payments further by applying a lower inflation rate to federal reimbursements starting in 2025. It would also repeal or delay $541 billion in taxes, primarily on wealthy Americans and insurers.

Sen. Bill Cassidy, R-La., one of more than half a dozen GOP senators who have raised concerns the impact of proposed Medicaid cuts in their states, said Wednesday that it remained impossible to predict if a refashioned bill could change enough members' minds.

"That is an existential question, and it's very hard for me to answer existential questions," Cassidy said.

While the legislation is likely to undergo further revisions after this next update, McConnell is trying to move quickly to produce a new CBO score by the time lawmakers return to Washington in mid July. That would give the Senate about two weeks to fulfill the majority leader's goal of voting before the August recess.

Sen. Rand Paul, R-Ky., suggested that Republicans hope to strike a new agreement by Aug. 1.

Asked whether a new bill could be finalized by Friday, Paul raised his eyebrows. "Of this week?" he said. "No, I think August 1 is the new deadline."

McConnell and his aides plan to continue negotiations through the end of the week and will be in frequent communication with the CBO, according to McConnell spokesman David Popp.

It remains unclear exactly what parts of the Better Care Reconciliation Act are being revised — or whether McConnell is trying to move the measure to the right, with greater savings or regulatory adjustments, or to the left, with more coverage protections. McConnell needs to bring on board about nine senators who have said they wouldn't vote for the bill in its current form. Moving to the right would appease conservatives in the Senate — but also in the House, where any Senate bill would also have to pass.