The legislation faces opposition from both conservatives for not doing enough and from moderates for cutting too much.
The Senate will not consider a GOP health reform bill this week after the latest round of bad reviews from the Congressional Budget Office spooked wary Republicans and majority leader Mitch McConnell canceled a procedural vote that was scheduled for Tuesday.
The Better Care Reconciliation Act, like the House-passed American Health Care Act before it, will now undergo further deliberation before being reconsidered sometime after Congress’s weeklong July 4 recess. Leadership previously had identified the legislature’s August break as the deadline to act.
“We’re still working toward getting at least 50 people in a comfortable place,” McConnell told reporters Tuesday afternoon. He and fellow GOP senators were to meet at the White House later in the evening for discussions with the president, he said.
A handful of members had indicated they would vote against a motion to proceed to the legislation in its current form. They were Sens. Rand Paul, Mike Lee, and Ron Johnson, who represent the more conservative opposition to the bill and Dean Heller Susan Collins, who are more moderate. After McConnell announced the vote would be delayed, Ohio senator Rob Portman and West Virginia senator Shelly Moore Capito released a statement detailing their opposition, which cited concerns about Medicaid cuts. Just three of the lawmakers would have been enough to stop the measure from advancing.
The disparate politics of the senators reflect the difficulties Republicans face in pulling together the 50 yea votes necessary to pass the bill. Paul and Lee long have advocated for full repeal of Obamacare, and Johnson, a surprising no, has laid out extensively this week his issues with the legislation. “The bill’s defenders will say it repeals Obamacare’s taxes and reduces Medicaid spending growth. That’s true. But it also boosts spending on subsidies, and it leaves in place the pre-existing-condition rules that drive up the cost of insurance for everyone,” he wrote in the New York Times. Those rules, however, actually are favored by many Republicans reluctant to mess with a feature of Obamacare a significant majority of Americans like.
Collins, Portman, Capito, and Heller, who is one of the GOP’s most vulnerable incumbents in 2018, have a different set of concerns. The Maine Republican wrote in abbreviated fashion on Twitter that the “CBO says 22 million people lose insurance; Medicaid cuts hurt most vulnerable Americans; [and] access to healthcare in rural areas threatened.” Heller, whose popular Nevada governor, Brian Sandoval, also opposes the Senate measure, highlighted the BCRA’s changes to Medicaid as a chief reason for his disapproval
Several other members have been skeptical or quiet about the bill, including Sen. Ted Cruz. McConnell directly dismissed any possibility that the Obamacare repeal effort was finished.
“No, no. We’re continuing to talk about it. It’s a complicated subject,” he said, a point he reiterated multiple times while giving mostly brief answers in a press conference about the decision to pull the legislation.
House speaker Paul Ryan made a similar decision about the American Health Care Act in March, after the same type of conservative-moderate tension left the Republican rank-and-file with insufficient numbers to pass the bill. The measure underwent several modifications to satisfy both wings and eventually was approved in early May.
The Senate GOP barely has a similar timeframe with which to work if it is to move its legislation before the longer August recess. Majority whip John Cornyn, McConnell’s top deputy, told Politico Aug. 1 was a “drop-dead line.”
