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Trump tries to save Trumpcare: Will this be the day that the Republican healthcare bill becomes Trumpcare? With the Republican healthcare push on the brink of failure, President Trump has invited all the Republican senators to lunch at at the White House to try to cobble together some sort of path forward. He’ll have his work cut out for him. To recap, on Monday night the third and fourth senators came out against the Senate healthcare bill, destroying its chances of passage. Senate Majority Leader Mitch McConnell swiftly announced that the votes were not there to repeal and replace Obamacare, so instead, he would hold a vote on a bill that repeals major portions of Obamacare without tackling a replacement. By Tuesday afternoon, it became apparent that there weren’t enough votes to pass that, either. All signs pointed toward a failed Wednesday vote that would drive a stake into Republican repeal efforts. But then, Trump convinced McConnell to put off a vote until next week, giving Trump a chance to talk to the senators at lunch today. On Tuesday afternoon, Trump phoned Utah Sen. Mike Lee, whose opposition from the right appeared to deal a fatal blow to the bill. According to a Lee spokesman, the senator reiterated his position that unwinding Obamacare’s regulations was the key to his vote, and Trump was receptive. There’s no obvious solution to the fundamental problem, which is that Republicans have a narrow majority, divided at the poles among those eager to repeal all of Obamacare and pursue a free-market approach and those who want to leave much of the law intact. If the bill shifts to the right to win over Lee, it likely would lose additional centrists. If it tries to keep more of Obamacare to win over centrists, more conservatives would defect. The changes being demanded by skeptical centrists are fundamental. “I will be having lunch at the White House today with Republican Senators concerning healthcare,” Trump tweeted this morning. “They MUST keep their promise to America!” He vowed that the healthcare bill would “get even better” after the lunch.

34 hours of Trump healthcare tweets: 

July 17, 10:17 p.m. “Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in! 

July 18, 7:53 a.m. “We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!”

July 18, 7:58 a.m. “As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!”

July 18, 9:26 a.m.  “The Senate must go to a 51 vote majority instead of current 60 votes. Even parts of full Repeal need 60. 8 Dems control Senate. Crazy!”

July 19, 8:30 a.m. “I will be having lunch at the White House today with Republican Senators concerning healthcare. They MUST keep their promise to America!” 

July 19, 8:46 a.m. “The Republicans never discuss how good their healthcare bill is, & it will get even better at lunchtime.The Dems scream death as OCare dies!” 

Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19).  Email dailyonhealthcare@washingtonexaminer.com for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.

White House sidesteps 'nuclear option' possibility on Obamacare insurer payments. Trump said Tuesday that he believed Republicans should let Obamacare fail, but it is not clear whether he plans to help it along by cutting off the law's federal funding to insurers. Trump did not specifically refer to the funds, called cost-sharing reduction subsidies but tweeted: "As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!" At other times when Trump has proposed allowing the law to collapse he has raised the possibility of cutting off the subsidies to bring Democrats to the table to negotiate healthcare. The funds help insurance companies reduce out-of-pocket medical expenses for low-income people who buy coverage on Obamacare's exchanges. Though they are being distributed to insurance companies now, their future remains uncertain because of ongoing litigation about whether they were illegally distributed as well as lack of clarity from Republicans on the future of Obamacare.

White House blames Democrats for failure of Republican healthcare bill. Democrats should bear responsibility for the failure of Senate Republicans' healthcare reform bill, White House deputy press secretary Sarah Sanders said Tuesday. "They're responsible for being unwilling to work with Republicans in any capacity" on fixing Obamacare's flaws, Sanders told reporters at the White House. "The failure of Obamacare, I think, rests solely on the shoulders of Democrats," Sanders said.


Trump: 'I'm not going to own' Obamacare collapse. He said Tuesday that Republicans should allow Obamacare to collapse and wait for Democrats to seek the GOP's help fixing it now that the Republican effort to repeal and replace the Affordable Care Act has failed. Trump told reporters at the White House that his preference is "to let Obamacare fail," an approach he said "will be a lot easier." "And I think we're probably in that position where we'll let Obamacare fail. We're not going to own it. I'm not going to own it," Trump said. "I can tell you the Republicans are not going to own it. We'll let Obamacare fail and then the Democrats are going to come to us."

Flashback: Trump told Republicans in 2013 if they don't defund Obamacare 'THEN THEY OWN IT.' A little less than four years ago he warned that failing to defund the Affordable Care Act meant Republicans own it. "NO GAMES! HOUSE @GOP MUST DEFUND OBAMACARE! IF THEY DON'T, THEN THEY OWN IT!" Trump wrote in a tweet posted Sept. 12, 2013.

McConnell sending a message with repeal and delay vote. So why is Senate Majority Leader Mitch McConnell pressing for a vote on a bill that doesn’t have enough support? The Washington Examiner’s David Drucker writes that he aims to send a message to the Republicans that after four elections and seven years of promising to repeal Obamacare that it is time to choose.

So what’s plan C? It doesn’t appear likely that repeal and delay of Obamacare is going to get enough support in the Senate. So what happens next on healthcare? Republicans have some options, chief among them is working with Democrats on a bipartisan fix to Obamacare’s exchanges. The Senate Health, Education, Labor and Pensions Committee plans to hold hearings on what to do about stabilizing the individual market, which includes the law’s exchanges. Several Republican senators have advocated reaching across the aisle, and Democratic senators have said they are open to working on bipartisan fixes to the law. But Democrats have hinted that any bipartisan fix is going to have to include more money to stabilize markets, which Republicans may not be able to stomach so soon after an effort to repeal Obamacare failed. Some Democrats have called for providing more money to federal insurers to lower premiums through avenues such as reinsurance, which provides funding to pay for more costly enrollees. Any bipartisan package could include appropriations for cost-sharing payments to insurers to reimburse them for lowering copays and deductibles for low-income Obamacare customers. President Trump has not committed to paying them in 2018. That has caused headaches for insurers that have been trying to decide for months whether to participate in Obamacare exchanges next year. 

Hugh Hewitt: GOP should “go for big deal” with Dems. Conservative radio host Hugh Hewitt argued Wednesday that Republicans need to reach a deal with Democrats on healthcare reform since they can’t pass a bill on their own. The radio talk show host wrote in the Washington Post that Trump's "watch it fail" approach to Obamacare is "not just bad politics; it is also immoral." Fixing Obamacare would be "risky," but "not impossible." Hewitt said Republicans could have a stronger hold on the Senate after 2018. He expects Sen. Dean Heller, R-Nev., to lose next year as a result of his leading role as a repeal and replace doubter. But some of Hewitt’s “must-haves” for any bill are nonstarters for Democrats. Those include the repeal of the insurance mandates.

Senate Minority Leader Chuck Schumer proposes compromise with GOP on healthcare. The New York Democrat, in an interview with the Washington Post Tuesday, said a bipartisan compromise on healthcare can be reached "if our Republican colleagues here in the Senate do what their instincts and heart tell them to do as opposed to what the president tells them to do." But he also expressed some doubt, noting that he hasn't spoken with Trump in months and Vice President Mike Pence in weeks. "He's tweeted at me much more than he's talked to me lately," Schumer said of Trump. Schumer criticized Trump for saying he's "not going to own" potential failures associated with Obamacare. Trump "is running away from a difficult problem instead of trying to solve a difficult problem, which is what the American people hired him to do," Schumer said. "It's also not going to work. And that's because he's the president — he has a Republican House and Senate. If, God forbid, they sabotage healthcare, it'll be on their watch and their plate. It's small, it's lack of leadership, but it's also politically counterproductive."

Centrist Republicans and Democrats meet to devise bipartisan healthcare plan. Centrist Republicans and Democrats in the House met Tuesday to discuss a way forward on healthcare and the two camps are considering developing a working group on the issue. Shawn Moran, the communications director for Rep. Charlie Dent, R-Pa., told the Washington Examiner the centrist GOP's Tuesday Group, which Dent heads, and the New Democrat Coalition met in the Capitol to discuss healthcare. Dent did not participate in the meeting because he was tied up with the markup of appropriations bills. The meeting was part of regular gatherings between the two groups, but healthcare took on a greater emphasis after the failure of the Senate GOP's bill to repeal and replace parts of Obamacare. Moran said the concept of a bipartisan healthcare group in the House has been part of discussions between members and that no decision has been made on creating one.

Ron Johnson blames Senate leadership for Obamacare repeal failure. "This was the responsibility of Senate leadership," the Wisconsin Republican told reporters Tuesday, making a point not to blame Senate Majority Leader Mitch McConnell, R-Ky., by name. "It was in our court and we should have handled this." Johnson defended Trump from charges of being disengaged and, without naming the Kentucky Republican, repeatedly directed blame to the majority leader's office. "Who wrote the bill?" he asked rhetorically when reporters tried to get him to blame McConnell. Johnson then said Tuesday it was time for Republicans to temporarily forego their efforts to repeal and replace the Affordable Care Act and turn their attention to tax reform. "I think we need to move on, probably pretty quickly," Johnson told reporters at the Capitol. "We've been at this. It did not, unfortunately, end in success ... Now we've got to move on to tax reform so we have a competitive tax system."

Sen. Jerry Moran leaps across subway tracks to escape reporters after he sinks healthcare bill. Several journalists tweeted about the Kansas Republican running across the subway tracks to get away from reporters on Tuesday. Moran's office said it was an exaggeration to say the senator was running, but it did say he "leapt" across the tracks. Moran spoke with reporters for a few minutes before bolting, a spokesman told the Washington Examiner. "The senator stopped and answered a number of questions from reporters before crossing the tracks because he had to go vote. He even spoke to reporters again after he crossed the tracks. This was simply a light-hearted display of athleticism, in an effort to not push his way through dozens of reporters and get to votes," Tom Brandt said in a statement.

Conservative group threatens to fund challengers to GOP senators who oppose Obamacare repeal. "Republicans have promised to repeal Obamacare for years and now with President Trump in the White House, there is no excuse for them to break their promise," Ken Cuccinelli, president of the Senate Conservatives Fund, said in a statement. "Working with the grassroots across the country, we will seek to identify, recruit and fund conservative challengers against Republican senators who vote against repeal. If they won't keep their word and if they can't find the courage to repeal a liberal takeover of our healthcare system that has hurt so many American families, they should be replaced by someone who will," Cuccinelli continued.

Freedom Partners joins chorus of outside groups pushing repeal and delay. The Koch-backed Freedom Partners agreed with the new strategy from the White House and McConnell to repeal Obamacare and then make a fix later. “Now that BCRA is off the table, the Senate should move quickly to repeal the law with all the regulations and taxes the reconciliation process will allow,” said President Nathan Nascimento in a statement.

Support for an effort to repeal the law and immediately replace it collapsed on Monday due to insufficient support. President Trump and McConnell then sought a vote on a 2015 bill that repealed Obamacare’s laws and taxes but not insurer regulations, and leave Obamacare in place for two years while a replacement is drafted. But support quickly fell apart for that approach too. Freedom Partners joins other conservative groups such as Heritage Action and Club for Growth in supporting the 2015 repeal bill.

Virginia Gov. Terry McAuliffe: Trump has 'abdicated his responsibility as president' on healthcare. "They have failed," McAuliffe, a Democrat, said of Trump and Republicans, in an interview with MSNBC's Chris Matthews Tuesday night. "I find it morally repugnant what the president said today that potentially 30 million Americans can lose their health insurance, and he's like a little spoiled kid who picks up his marbles and walks away." McAuliffe said Trump should push to work with Democrats in a bipartisan way to improve Obamacare. "Where is the leadership? We have a void of leadership today," McAuliffe said. “[Trump] ought to stand up and be a statesman. He ought to pull together. This is how negotiations [used to be] done. Parties came together for the good of the country. Donald Trump has abdicated his responsibility as president of the United States. He is now hurting Americans, and he is going to pay the price politically."

Rep. Ron DeSantis: Lobbyists knew what was in GOP healthcare bills before members of Congress. DeSantis, R-Fla., said the Senate bill had "K Street's fingerprints on it."

"A lot of the lobbyists knew what was in both the House and Senate bill before members of Congress knew what was in the bill," DeSantis said in a Tuesday interview with the Washington Examiner. He supported the House version of the bill when it passed in May. "It wasn't like it was a clean break from what goes on in Washington," he said. "In the healthcare bill, it was clear that there was a lot of work with the insurance companies on this bill, and the insurance companies have benefited from Obamacare. "They really support a government-centered system where government is keeping competition out of their marketplace." DeSantis later said that the central problem with Obamacare repeal is that a few Republicans like the healthcare law they pretend to hate. "The underlying problem has been that Republicans ran on repealing and replacing Obamacare for years and years," DeSantis, R-Fla., argued during a recent interview in the Washington Examiner newsroom. "But the real divide was that we didn't have a majority in either chamber that actually want to repeal the law."

RUNDOWN

Bloomberg Balance of Power: Did Trump’s first year just end?

Wall Street Journal Odd position for the GOP: Working to boost the healthcare law, not kill it

The Hill Conservatives target Congress, not Trump, after healthcare bill’s collapse

Kaiser Health News Analysis: GOP failure to replace healthcare law was years in the making

Politico Medicaid shows its political clout

Washington Post With health bill collapse, Repubilcans face an uncertain electoral future in 2018

NPR Trump’s big repealing deal: 8 takeaways on the Senate’s healthcare meltdown moment

Roll Call Senate healthcare failure prompts GOP soul searching



Calendar

WEDNESDAY | JULY 19

House Ways and Means hearing on “Efforts to Combat Waste, Fraud and Abuse in the Medicare Program.” Began 10 a.m. Details. 

Noon. 485 Russell. The American Association for Cancer Research and the Society for Immunotherapy of Cancer will host a congressional briefing on “Progress in Immunotherapy: Delivering Hope and Clinical Benefit to Cancer Patients.”  

1:45 p.m. National Press Foundation Webinar on “Preventive Health – What’s Next?” Details.  

12:30 p.m. President Trump to meet with Senate healthcare bill holdouts.

MONDAY | JULY 24


Noon. 529 14th St. NW. National Press Club lunch even with the House Freedom Caucus. Details.

TUESDAY | JULY 25

Noon. 2103 Rayburn. The American College of Preventive Medicine lunch briefing on "Transforming Medical Education to Prevent Chronic Disease." Register.