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Dawn of the dead healthcare bill: This week, we said goodbye to film director George Romero, who was most famous for inventing the idea of zombies in his “Living Dead” franchise. We also witnessed the reanimation of the Senate healthcare bill. While Senate Majority Leader Mitch McConnell, R-Ky., still faces an uphill battle when it comes to getting legislation passed, there’s no doubt that the bill is more alive than it seemed Monday night, when he said he didn’t have the votes to move forward on a replacement bill, or on Tuesday afternoon, when a critical mass of senators came out against a straight repeal bill. By Wednesday, President Trump, who had tried on several healthcare positions over the week, eventually settled on pushing Republicans back to the bargaining table to reach a compromise on a replacement bill. After leaving the White House, senators continued discussions and held a late-night meeting to discuss the difficult task ahead. Although there was talk of McConnell offering to inject more money into Medicaid to woo centrists, according to a source familiar with the meeting, the discussion was more general. It was an opportunity for senators to present their issues with the legislation and to bat around some ideas for possible paths forward. Sen. John Barrasso, R-Wyo., walked out of last night’s meeting to say that it was “lengthy and productive” but also relented to reality. “We still do have work to do to get to a vote of 50 but people are committed to continuing that work,” he said. Other senators echoed similar sentiments: that they were making progress but couldn’t reach 50 votes yet. Some senators were genuinely confused about the GOP leadership’s next steps. When asked whether she would vote on the motion to proceed to debate on either repeal and replace or on a repeal-only bill, Sen. Lisa Murkowski, R-Alaska, was flummoxed. “We don’t have a clear determination as to what it is we are voting for,” she responded as she left the meeting. Leadership is still indicating that there will be a vote, on something, next week.
CBO to issue updated score for Obamacare repeal and replace ‘soon,’ it announced Thursday. A former score of the bill, before its most recent changes of added funding for opioid addiction treatment and additional state stabilization funds, projected that 22 million more people would be uninsured by 2026. The new score is expected to reflect increases in spending and taxes relative to the earlier bill, with perhaps a slight dent in the uninsured number. But importantly, it is not expected to include an assessment of an amendment offered by Sen. Ted Cruz, R-Texas, that would allow insurers to offer plans that get out of most Obamacare regulations as long as they offer plans that meet the requirements. The CBO is believed to need more time to game out the complex interactions involved, meaning Republicans may end up relying on analysis from the Department of Health and Human Services. The analysis, first obtained by the Washington Examiner, found that the Cruz amendment would reduce premiums and boost enrollment. It was quickly assailed by critics who questioned its methodology and assumptions.
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Sen. John McCain diagnosed with brain cancer. The Arizona Republican has been diagnosed with brain cancer, and it is unclear when he will return to work in the Senate, his office said in a statement issued Wednesday evening. McCain, 80, was recently operated on to remove a blood clot from above his left eye. Tissue extracted during the procedure, described as successful, proved to be cancerous, according to a statement from the Mayo Clinic in Phoenix, where the senator is being treated, that was publicized by his office. Treatment options, including chemotherapy, are being reviewed. An additional statement, from McCain’s Senate office said there was no timetable for his return to work in Washington. “Senator McCain appreciates the outpouring of support he has received over the last few days. He is in good spirits as he continues to recover at home with his family in Arizona,” the statement said. McCain tweeted Thursday morning: “Unfortunately for my sparring partners in Congress, I’ll be back soon, so stand-by!”
McCain’s absence complicates repeal effort. GOP senators leaving their meeting said that their focus is obviously on the health of their ailing comrade. “That was not part of any of the discussions,” said Sen. John Barrasso, R-Wyo. “We prayed for him.” But some hinted that McCain’s departure complicates the path for Obamacare repeal. “Obviously I think more people are worried about his health than thinking about the math,” said Sen. Bob Corker, R-Tenn., as he left the meeting. “But you understand the math. Obviously it makes things difficult.” When asked if Republicans can go forward on healthcare without McCain present, Sen. John Hoeven, R-N.D., said that “we are really working to try to get agreement but it is more challenging.” The GOP needs 50 votes to repeal Obamacare. The Senate leadership doesn’t have the votes to pass a repeal and delay bill and possibly for a bill to repeal and replace the law.
Trump to continue Obamacare insurer payments, for now, the Washington Examiner confirmed with a White House official. Payments for July went out today. “It is a good thing that they have made these premium and cost-reducing payments one more time, but until they make them permanent, markets will not be as stable and premiums will not be as low as they could be,” Senate Minority Leader Chuck Schumer said. “Insurance markets need certainty.”
Trump shames GOP senators on their ‘promise’ to repeal Obamacare. The president on Wednesday delivered a blunt, 12-minute speech to Republican senators aimed at reminding them that they have campaigned for years on the idea of repealing Obamacare and that they need to stay at work as long as it takes to deliver that promise. “We’re in this room today to deliver on our promise to the American people to repeal Obamacare and to ensure that they have the healthcare that they need,” he said in a televised address in a White House meeting with almost every GOP senator. “We have no choice. We have to repeal and replace Obamacare. We can repeal it, but the best is repeal and replace, and let’s get going,” he stressed. “I intend to keep my promise, and I know you will too.” The Senate historically prides itself on being the “cooling saucer” that can more carefully consider legislation passed by the House. But Trump called for immediate action from the Senate and said it makes no sense that repeal legislation would suddenly stall with Trump in the White House after the GOP Senate managed to pass a repeal bill in 2015. “I have pen in hand, believe me,” Trump said. “I’m sitting in that office. I have pen in hand. You never had that before.” He added: “Inaction is not an option, and frankly, I don’t think we should leave town unless we have a health insurance plan.”
Trump asks Dean Heller if ‘he wants to remain a senator’ while sitting next to him. “This was the one we were worried about. You weren’t there. But you’re going to be, you’re going to be. Look, he wants to remain a senator, doesn’t he?” Trump said gesturing to Heller. Heller is facing a challenging 2018 re-election in Nevada, a state Hillary Clinton won by more than 2 percent in the 2016 presidential election. A pro-Trump group launched an ad against Heller in June, after he opposed the first draft of the GOP Senate healthcare bill. “I think the people of your state, I think they are going to appreciate what you hopefully will do. Any senator who votes against starting debate is really telling America that you are fine with Obamacare,” Trump said.
CBO: Repeal and delay’ would leave 32 million more uninsured by 2026, and premiums would double by then as well. Under this approach, Republicans would leave Obamacare in place for two years while a replacement is crafted and implemented. According to CBO, the number of uninsured people under the repeal-only bill would increase by 17 million next year compared to the number under Obamacare and would rise to 27 million more by 2020 when Obamacare’s Medicaid expansion would be eliminated as well as tax credits for paying down insurance. The number of uninsured would then increase to 32 million in 2026. Average premiums would rise by 25 percent next year and 50 percent by 2020. The CBO also estimated that under the bill about half of the nation’s population would not have an insurer on the individual market by 2020 because of “downward pressure on enrollment and upward pressure on premiums.”
Schumer’s statement on the score: “The latest CBO score of the Senate Republican ‘repeal and run’ bill confirms: it was a horrible idea in January and it’s a horrible idea now. President Trump and Republicans have repeatedly promised to lower premiums and increase coverage, yet each proposal they offer would do the opposite. Instead of careening towards a plan that would devastate the American healthcare system, Republicans should work with Democrats to pass real solutions to lower premiums, stabilize the market and improve coverage for millions of Americans.”
One in four voters approve of latest bill that would repeal and replace Obamacare, according to the results of a Fox News poll released Wednesday. The survey results show 60 percent of voters think Congress should keep Obamacare and work to improve it, with 33 percent saying it would be better to repeal it and create a new healthcare plan. Just 4 percent said that Obamacare should remain in place and unchanged.
House conservatives will try to force new Obamacare repeal vote. The House Freedom Caucus wants to revive a bill the House passed in 2015 that would repeal Obamacare after two years. To get a vote, conservatives plan to introduce a discharge petition on the House floor. With 218 signatures, a majority of the House, Republican leaders would be forced to bring it up for a vote. But it’s unlikely they will secure enough signatures.
RUNDOWN
Washington Post Trump threatens electoral consequences for senators who oppose health bill
Axios Senate GOP has only bad options on healthcare
Politico Republicans lament an agenda in quicksand
Kaiser Health News Fraud and billing mistakes cost Medicare and taxpayers tens of billions last year
NPR Her own medical future at stake, a child storms Capitol Hill
Wall Street Journal Hospitals fight to keep Medicare drug subsidies
STAT News What to know about John McCain’s brain cancer diagnosis
The Hill Report: Republican says Trump doesn’t even scare Senate pages
Calendar
THURSDAY | JULY 20
4 p.m. 1000 Massachusetts Ave NW. Cato Institute event on “The Search for Truth in Regulatory Science. Details.
MONDAY | JULY 24
Noon. 529 14th St. NW. National Press Club lunch even with the House Freedom Caucus. Details.
TUESDAY | JULY 25
10 a.m. 1225 I St NW. Bipartisan Policy Center event on “The Future of Comparative Effectiveness Research.” Details.
Noon. 2103 Rayburn. The American College of Preventive Medicine lunch briefing on “Transforming Medical Education to Prevent Chronic Disease.” Register.
WEDNESDAY | JULY 26
8:30 a.m. 660 North Capitol St. NW. Urban Institute event on “Addressing Housing and Health: How Cities Are Making a Difference. Details.
9:30 am. Dirksen 106. Special Committee on Aging hearing on ““Progress Toward a Cure for Type I Diabetes: Research and the Artificial Pancreas.” Details.
10:15 a.m. 2322 Rayburn. House Energy and Commerce hearing on “Examining the Extension of Special Needs Plans.” Details.
