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Is this McConnell’s Dunkirk? As Washington braces for a flurry of votes ahead of an expected grand finale on Friday with some sort of “skinny repeal” bill, many on Capitol Hill are wondering: What is Senate Majority Leader Mitch McConnell’s ultimate strategy? There have been some puzzling moves along the way — McConnell rushed to vote this week on a “repeal and replace” bill that included a Cruz amendment on regulations that hadn’t been scored by the Congressional Budget Office, subjecting it to a 60-vote threshold that automatically doomed its passage. It’s not clear what would be in “skinny repeal,” whether it has the votes, or whether it can even meet the basic threshold to be passed with simple majority rules. Under the rules, the bill has to show sufficient deficit reduction, and repealing Obamacare’s individual and employer mandates along with eliminating the medical device tax would not get Republicans there, according to the latest CBO score. That means they’ll have to come up with additional ways to raise money, but we’re hearing that they have already told centrists that the “skinny repeal” would not touch Medicaid, where a bulk of the savings in previous versions of repeal came from. Even so, it isn’t clear whether whatever “skinny repeal” bill emerges is the end game, or just a vehicle to hash out a new, comprehensive repeal and replace bill in a conference with the House. There is another possibility: that this is McConnell’s Dunkirk moment. As negotiations dragged on, McConnell found himself backed in a bit of a corner — it didn’t seem he could forge a compromise on a repeal and replace bill that would lure both centrists and conservatives. Yet there was no appetite for “clean” repeal without a replacement. Meanwhile, there was pressure from President Trump to do something, and senators were facing the prospect of going back home and saying they couldn’t deliver on a seven-year promise. Instead of allowing things to drag on, perhaps McConnell is thinking in terms of a strategic retreat. If something emerges from this week’s crazy process, great. But if not, he will have held dozens of votes and given individual senators an opportunity to take a stand on various measures — the flurry of votes working to create the impression of a lot of activity. And if it all comes to nothing, well then, he can cut his losses. Instead of spending months negotiating without changing the ultimate outcome, he can move on to other items on the Republican agenda, such as tax reform, in hopes of delivering “wins” to write home about.
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Obamacare repeal bill fails in Senate. The Senate on Wednesday rejected an amendment to gut Obamacare without a replacement ready to go, a bill identical to a 2015 measure that passed Congress. Senators voted 45-55 on the measure, with seven Republicans and all Democrats voting no. The bill was expected to fail, as many Republican senators were uncomfortable with voting on repeal without an immediate replacement. The bill would have let Obamacare stay in place for two years while a replacement was crafted.
Republican flip-floppers on ‘repeal and delay’ say Obamacare is worse now. Several of the six Republican senators who switched their vote on the repeal-only bill said they flip-flopped because Obamacare’s marketplaces are worse now than in 2015, necessitating an immediate replacement.” Circumstances have changed dramatically in Ohio since then,” said Sen. Rob Portman, R-Ohio. “We had a competitive market then with multiple insurance companies in every county, and now we have 19 counties with zero and 27 counties with one.” The senators who switched their votes are Portman, Lamar Alexander of Tennessee, Shelley Moore Capito of West Virginia, John McCain of Arizona, Lisa Murkowski of Alaska and Dean Heller of Nevada. Susan Collins of Maine also voted against the measure, but she voted against it in 2015.
Cantor says he ‘never believed’ GOP rallying call to repeal Obamacare while Obama was in office. Former House Majority Leader Eric Cantor said on Wednesday that he never believed Republicans could repeal Obamacare under former President Barack Obama despite using repeal as a rallying cry in the 2014 midterm elections. “To give the impression that if Republicans were in control of the House and Senate, that we could do that when Obama was still in office … I never believed it,” Cantor said in an interview with the Washingtonian. Republicans were able to extend their majority in the House and take control of the Senate in the 2014 midterm elections running on the platform to repeal and replace Obamacare. Cantor lost his re-election bid in the GOP primary in 2014. “We sort of all got what was going on, that there was this disconnect in terms of communication, because no one wanted to take the time out in the general public to even think about ‘wait a minute — that can’t happen,'” Cantor said. He also said, “If you’ve got that anger working for you, you’re gonna let it be.”
Rep. Buddy Carter on senators opposing Obamacare repeal: Somebody needs to ‘snatch a knot in their ass.’ “Somebody needs to go over there to that Senate and snatch a knot in their ass,” The Georgia Republican told MSNBC, when asked for his response to President Trump’s comments about Sen. Lisa Murkowski, R-Alaska. The phrase is apparently a reference to hitting someone. Carter told MSNBC the president’s comment on Twitter, saying Murkowski had let the country down, were “perfectly fair,” and said he was frustrated by the Senate’s failure to pass a bill overhauling the healthcare system. “It has gotten to the point where how can you say I voted for this last year, but I’m not going to vote for it this year?” he said. “This is extremely frustrating for those of us who have put so much into this effort.”
Trump encourages GOP Senate on healthcare: ‘This is your chance to shine!’ President Trump tried to encourage Republican senators Thursday with a friendly message that this is lawmakers’ “chance to shine” on healthcare reform. “Come on Republican Senators, you can do it on Healthcare. After 7 years, this is your chance to shine! Don’t let the American people down!” Trump tweeted Thursday morning.
Momentum for the ‘skinny repeal.’ The “skinny repeal” plan has begun to garner support among Senate Republicans. “We’ve got to produce an outcome, and if the first step is the so-called skinny repeal, then that is a good first step,” Sen. Thom Tillis, R-N.C., told the Washington Examiner. The GOP is seeking find a measure that can pass the Senate at the conclusion of 20 hours of debate and the introduction of what could be dozens of amendments. The bare-bones alternative is the skinny repeal. Republicans haven’t written an official proposal, but the skinny repeal would end the Obamacare mandate requiring people to purchase health insurance. It also would stop implementation of Obamacare’s medical device tax that has long been unpopular with both Democrats and Republicans who say the cost is being passed along to consumers and is stifling medical innovation. “I think there is broad agreement on the mandates and obviously medical device tax,” Senate Republican Conference Committee Chairman John Thune, R-S.D., told reporters after a closed-door GOP meeting Wednesday. Republicans told the Washington Examiner that voting for a skinny repeal would not be considered the final proposal. Instead, it would be used as a vehicle to bring the House and Senate together to work on an entirely new bill in a conference committee that would last into September.
CBO: ‘Skinny’ repeal increases uninsured by 16 million over a decade. The nonpartisan Congressional Budget Office estimated Wednesday that a Republican plan to repeal a few major parts of Obamacare would leave 15 million more people without insurance next year and 16 million over the next decade. Democrats who requested the analysis said they were also told that health insurance premiums would soar over the next decade.
Bipartisan governors not happy with ‘skinny’ repeal. A bipartisan group of governors wrote Wednesday to Senate leadership opposing Republicans’ new “skinny” plan. “The Senate should reject efforts to amend the bill into a ‘skinny repeal’, which is expected to accelerate health plans leaving the individual market, increase premiums, and resulting in fewer Americans having access to coverage,” the governors wrote in a letter, which included signatures from Republican Govs. John Kasich of Ohio, Brian Sandoval of Nevada, Larry Hogan of Maryland, Phil Scott of Vermont and Charles Baker of Massachusetts. The Democratic governors who signed the letter are John Hickenlooper of Colorado, John Bel Edwards of Louisiana, Steve Bullock of Montana, Tom Wolf of Pennsylvania and Terry McAuliffe of Virginia. Sandoval’s signature has major political meaning as he is very popular in Nevada and the state’s Sen. Dean Heller needs his support for a tight re-election race next year.
Chuck Schumer aims to gum up Senate if skinny repeal passes. The top Democrat in the Senate promised to hold up the chamber with scores of amendments if Republicans pass a bill that repeals a few big parts of Obamacare. He said Thursday that if the “skinny repeal” bill does not pass, the Senate can move on to the National Defense Act Authorization. However, if it passes, Democrats would have “an unlimited right after it passes to offer unlimited amounts of amendments.” Senate Majority Leader Mitch McConnell said afterwards that the plan after healthcare is to take up the NDAA. Schumer said Wednesday that Democrats would not offer any amendments on healthcare until McConnell releases the skinny repeal bill. “We don’t even have a final bill to amend,” Schumer said. “The idea this is an open amendment process defies credulity.”
Sen. John McCain lists demands for final health bill. He wants a 10-year phase-out of Obamacare’s Medicaid expansion and changes to the entitlement program’s growth rate, according to several amendments he plans to file. McCain, R-Ariz., said his timeline would give states more time to alter their budgets. “Under current proposals, the federal matching rate would be dramatically reduced, leaving states to pick up the tab without the time necessary to prepare,” according to a statement from his office. Another amendment would change the growth rate for Medicaid. McCain noted that Arizona operates “one of the least costly Medicaid programs in the country.” “However, under current proposals, changes in the growth rate for Medicaid would punish states like Arizona, which has spent decades reforming its Medicaid program by cutting costs and streamlining services,” the statement said. “Senator McCain’s amendment would correct this inequity by ensuring the growth rate for Medicaid is adequately adjusted for inflation.” His third amendment would repeal a provision that wouldn’t punish Arizona for expanding Medicaid before Obamacare was created.
Democrat says Obamacare debate ‘accelerated the move toward single-payer.’ A future Democratic-controlled Congress will be able to establish a single-payer healthcare system about 10 years sooner than they thought, according to Rep. Earl Blumenauer, D-Ore. He said he believes that the internal Republican debate over a repeal of the Medicaid expansion created by Obamacare has greased the skids for a single-payer program modeled on Medicaid or Medicare. That’s a far cry from the 2009 healthcare debate, when Democrats took pains to avoid the perception of government-run healthcare, but it builds on Schumer’s promise of a renewed progressive agenda. “They’ve accelerated the move toward single-payer, probably advancing it by a decade,” Blumenauer said Wednesday at a healthcare policy event hosted by The Hill. Former President Barack Obama rejected conservative claims that the healthcare overhaul represented a step toward single-payer healthcare during the debate. “What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system,” he said in 2009. “So, when you hear the naysayers claim that I’m trying to bring about government-run healthcare, know this – they are not telling the truth.”
Republican Sen. Steve Daines to make Democrats vote on single payer. He’s proposing an amendment to the Republican healthcare bill that would implement a government-run, single-payer insurance system in the U.S. The Montana Republican doesn’t support single-payer healthcare. But in a bit of political gamesmanship often seen in Congress, Daines wants to force vulnerable Democratic senators running for re-election in red states in 2018 to take a position on the liberal healthcare policy, which is gaining currency on the Left. The vote will happen during the amendment phase known as vote-a-rama, when senators can offer hundreds of proposals to alter the underlying bill. Daines’ single-payer amendment is a carbon copy of one offered in the House by Rep. John Conyers, D-Mich.
Sen. Bernie Sanders not falling for single-payer amendment. Sanders, I-Vt., will not support a “sham” amendment to the healthcare bill that would implement a single-payer healthcare insurance program. “The Democratic caucus will not participate in the Republicans’ sham process. No amendment will get a vote until we see the final legislation and know what bill we are amending,” Josh Miller-Lewis, a spokesman for Sanders, said in a text sent to Vox.
RUNDOWN
Politico Skinny repeal can have big implications for Obamacare markets
Associated Press Analysis: GOP disunity painfully clear in Senate debate
Talking Points Memo Senate GOP is taking ‘leap of faith’ skinny repeal won’t become law
Roll Call Some GOP skepticism of sending Obamacare repeal to conference
CNN Skinny repeal would wreck insurance markets
NBC News First editing of human embryos performed in the United States
Kaiser Health News Seema Verma runs Medicaid. Her husband’s practice won’t accept it
Calendar
THURSDAY | JULY 27
Senate continues debate on healthcare bill, with vote-a-rama expected.
FRIDAY | JULY 28
Possible vote on “skinny repeal.”
SATURDAY | JULY 29
Our Lives on the Line, a coalition of healthcare advocates and liberal groups, will hold 125 rallies in 36 states against Obamacare repeal.
