By Mara Lee | July
28, 2017
For the third time in three days, a majority of Republicans failed
to coalesce around a way to repeal and replace Obamacare, as three centrist
Republicans voted no on a "skinny repeal."
Sens. John McCain (R-Ariz.), Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) broke party lines to shoot down the Health Care Freedom Act, which landed at a 49-51 vote. The bill would have eliminated the individual mandate, as well as temporarily suspending the employer mandate and temporarily raising the amount of money that can be contributed pre-tax to Health Savings Accounts.
McCain made his initial dissent public Thursday afternoon, holding a press conference with Sens. Lindsey Graham (R-S.C.) and Ron Johnson (R-Wis.) and saying the slimmed-down bill would "destroy" the health insurance marketplace. The three called for House Speaker Paul Ryan to guarantee the Senate proposal will go to conference rather than straight to that chamber's floor.
Ryan initially responded that the House was willing to work in conference with the Senate on the skinny bill, and further reassured the wary senators of his commitment in a phone call. Graham and Johnson said since that they will vote for the bill as a way forward, while McCain called Ryan's initial statement "not sufficient," casting his "no" vote to the applause of Democrats.
It's unclear how the Senate will move forward on healthcare reform, as this was seen as the last, best hope to find consensus in a party divided on how to handle Medicaid and reforms to individual insurance. McConnell said the Senate would focus on other legislation next week.
"This is a disappointment; a disappointment indeed," Senate Majority Leader Mitch McConnell said on the Senate floor after the vote failed. "I regret that our efforts simply were not enough this time."
After urging senators to reject the "toxic" skinny repeal bill in favor if a bipartisan ACA replacement, the American Medical Association Friday morning reiterated that plea.
"While we are relieved that the Senate did not adopt legislation that would have harmed patients and critical safety net programs, the status quo is not acceptable," said AMA president Dr. David Barbe in a statement. "The first priority should be to stabilize the individual marketplace to achieve the goal of providing access to quality, affordable health coverage for more Americans."
McConnell (R-Ky.) told a group in his home state a few weeks ago that if Republicans failed to pass a repeal, the party would turn to Democrats to cooperate on shoring up the individual markets. In some rural counties in some states, no insurers have signed up to sell policies on the exchanges in 2018.
However, on the floor, he said, "Bailing out insurance companies with no thought of any reform is not something I want to be a part of."
Sen. Mike Rounds (D-S.D.) said he expects premiums in 2018 on the exchanges will rise at least 20% and up to 40% because cost-sharing payments "will probably not be available." When asked if he'd support a bipartisan push to appropriate the cost-sharing payments, he said, "We can always start, but the problem is the timing.
Vice President Mike Pence was in the Senate chamber Thursday night, but Rounds said he did not hear from Pence that the White House would cut CSRs off.
Sen. Lamar Alexander (D-Tenn.) has scheduled a hearing in the Senate committee that handles health matters, and that may be where the process begins. But it's not clear there are 12 Republicans who would be willing to spend more money to shore up a bill they have excoriated for seven years.
Sen. Amy Klobuchar (D-Minn.) said she has faith in Alexander's ability to get complex legislation done. She noted that Minnesota and Tennessee had added reinsurance to their ACA markets, and she said that should be a priority nationally.
Sen. Tom Carper (D-R.I.) said Democrats are "hitting the pause button," but the actions to stabilize the exchanges are known. Reinsurance, cost-sharing subsidies and making sure the individual mandate is enforced are the key actions, he said.
That will take work from more than just the Senate, as the HHS and IRS have backed away from enforcing the mandate this year.
"It's not up to just the two of us in the Senate," Carper said, gesturing to himself and Klobuchar. "The governors need to be speaking out, and they have been. Insurers need to speak out."
Sens. John McCain (R-Ariz.), Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) broke party lines to shoot down the Health Care Freedom Act, which landed at a 49-51 vote. The bill would have eliminated the individual mandate, as well as temporarily suspending the employer mandate and temporarily raising the amount of money that can be contributed pre-tax to Health Savings Accounts.
McCain made his initial dissent public Thursday afternoon, holding a press conference with Sens. Lindsey Graham (R-S.C.) and Ron Johnson (R-Wis.) and saying the slimmed-down bill would "destroy" the health insurance marketplace. The three called for House Speaker Paul Ryan to guarantee the Senate proposal will go to conference rather than straight to that chamber's floor.
Ryan initially responded that the House was willing to work in conference with the Senate on the skinny bill, and further reassured the wary senators of his commitment in a phone call. Graham and Johnson said since that they will vote for the bill as a way forward, while McCain called Ryan's initial statement "not sufficient," casting his "no" vote to the applause of Democrats.
It's unclear how the Senate will move forward on healthcare reform, as this was seen as the last, best hope to find consensus in a party divided on how to handle Medicaid and reforms to individual insurance. McConnell said the Senate would focus on other legislation next week.
"This is a disappointment; a disappointment indeed," Senate Majority Leader Mitch McConnell said on the Senate floor after the vote failed. "I regret that our efforts simply were not enough this time."
After urging senators to reject the "toxic" skinny repeal bill in favor if a bipartisan ACA replacement, the American Medical Association Friday morning reiterated that plea.
"While we are relieved that the Senate did not adopt legislation that would have harmed patients and critical safety net programs, the status quo is not acceptable," said AMA president Dr. David Barbe in a statement. "The first priority should be to stabilize the individual marketplace to achieve the goal of providing access to quality, affordable health coverage for more Americans."
McConnell (R-Ky.) told a group in his home state a few weeks ago that if Republicans failed to pass a repeal, the party would turn to Democrats to cooperate on shoring up the individual markets. In some rural counties in some states, no insurers have signed up to sell policies on the exchanges in 2018.
However, on the floor, he said, "Bailing out insurance companies with no thought of any reform is not something I want to be a part of."
Sen. Mike Rounds (D-S.D.) said he expects premiums in 2018 on the exchanges will rise at least 20% and up to 40% because cost-sharing payments "will probably not be available." When asked if he'd support a bipartisan push to appropriate the cost-sharing payments, he said, "We can always start, but the problem is the timing.
Vice President Mike Pence was in the Senate chamber Thursday night, but Rounds said he did not hear from Pence that the White House would cut CSRs off.
Sen. Lamar Alexander (D-Tenn.) has scheduled a hearing in the Senate committee that handles health matters, and that may be where the process begins. But it's not clear there are 12 Republicans who would be willing to spend more money to shore up a bill they have excoriated for seven years.
Sen. Amy Klobuchar (D-Minn.) said she has faith in Alexander's ability to get complex legislation done. She noted that Minnesota and Tennessee had added reinsurance to their ACA markets, and she said that should be a priority nationally.
Sen. Tom Carper (D-R.I.) said Democrats are "hitting the pause button," but the actions to stabilize the exchanges are known. Reinsurance, cost-sharing subsidies and making sure the individual mandate is enforced are the key actions, he said.
That will take work from more than just the Senate, as the HHS and IRS have backed away from enforcing the mandate this year.
"It's not up to just the two of us in the Senate," Carper said, gesturing to himself and Klobuchar. "The governors need to be speaking out, and they have been. Insurers need to speak out."
Mara Lee covers developments in health care
policy in Congress and around Washington. This is her second time covering the
Hill. In a previous life, she covered Midwestern delegations for Scripps and
Gannett newspapers in Indiana and Michigan. Over her 20-year-plus-career, she’s
spent more time outside the Beltway, both as a business reporter for The
Hartford Courant and nine years in Ohio, mostly at the Dayton Daily News. She
won an award for coverage of Oxycontin addiction Ohio in 2003, as well as for Census,
business and breaking news coverage in Ohio and Connecticut. She’s a Virginia
native, and graduated from the University of North Carolina-Chapel Hill.
Twitter handle: MaraRhymesSarah
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