A member of the Senate Republican healthcare working group is working to build support for an alternative to the House-passed Obamacare repeal bill, one that allows for cross-state insurance purchases, and includes medical malpractice reform, health savings accounts and the expansion of association health plans.
Sen. Ted Cruz, R-Texas, also wants to pass just one bill to get the job done, not two, as currently planned by House Republican leaders.
Cruz said he has been working for weeks with the now-thirteen member group of GOP senators on an Obamacare repeal and replacement plan that would eliminate the need for a second phase of legislation to replace failing healthcare law. Instead of a limited repeal and replace bill followed by another bill later, the GOP wish-list for replacing Obamacare would be packed into a single budget resolution to repeal Obamacare that could pass with only GOP support using a tool called reconciliation.
"I believe the only meaningful healthcare reform will be through reconciliation," Cruz told the Washington Examiner in an interview.
Republicans have described a three-part plan to repeal and replace Obamacare, beginning with limited repeal and replace language passing under reconciliation.
The second phase would include the bulk of the GOP's proposal to replace Obamacare, while the third phase would reform healthcare through changes carried out administratively by the Trump administration.
But Cruz worries the second phase might never make it into law because the legislation would require hard-to-get by necessary Democratic support in the Senate.
"Senate Democrats are listening to their radical left wing base of their party and so no health care reform legislation will garner 60 votes because there are not eight senators who will vote for any of the legislation," Cruz said.
"I think the answer, very simply, is to put it all in one bucket," Cruz added. In other words, pass everything under reconciliation, which requires only 51 votes instead of the typical 60.
Cruz believes the provisions can be included in the reconciliation measure without running afoul of the Senate rules.
"Every one of the reforms reduces premiums and has a significant budgetary impact and therefore, under the terms of the statue, those reforms are permissible under reconciliation," Cruz said.
The Senate working group has been meeting weekly, Cruz said, but will likely be more active now that the House has passed a repeal and replacement measure.
Cruz said he has already been working "around the clock" with senators and House members, including the conservative House Freedom Caucus as well and senior Trump administration officials.
It's not clear how much of the House bill will be reflected in the Senate plan. The House bill allows states to waive Obamacare mandates and set up high-risk insurance pools aided with additional federal funds.
Cruz wants to repeal the Obamacare mandates, but there are many GOP senators who fear repealing the mandates would leave people without insurance coverage.
Cruz said there is "wide consensus" for "robust high risk pools" that would serve those who are sick or with pre-existing conditions.
Cruz said the healthcare group, which includes the GOP leadership and chairs of the committees overseeing healthcare, is working toward finding a consensus on a repeal and replace proposal.
"The objective here, the test for success should be, are we reducing the cost of premiums?" Cruz said. "And if we have succeeded, consumers will have more choices, more options, lower premiums and more ability to get health insurance and healthcare for their families."