Senate Majority Leader McConnell Faces High Stakes with Healthcare Vote

The Associated Press
The Associated Press

Senate Majority Leader Mitch McConnell faces increasing pressure to pass the Senate healthcare bill, the Better Care Reconciliation Act (BCRA), through the Senate before the Fourth of July recess.

Many pundits expect the Senate to make changes to the bill to gain the necessary support before it comes to a vote later this week, facing opposition from both conservative and moderate senators.

Senate Majority Whip John Cornyn (R-TX) previously said that the “drop-dead line” to vote on the BCRA was before the August recess. However, he tweeted on Monday that the Senate needs to vote on the bill before health insurers announce premiums increases for next year.

The Senate added a provision to the Senate bill that will encourage consumers to maintain continuous coverage. The amendment will block individuals from purchasing health insurance for six months for those who sign up for health insurance outside of the normal enrollment period, an attempt to limit the costs of those who sign up for health insurance when they get sick.

Sens. Ron Johnson (R-WI), Ted Cruz (R-TX), Rand Paul (R-KY), and Mike Lee (R-UT) came out against the BCRA for not repealing enough of Obamacare.

Sen. Paul told Breitbart News that the bill “looks too much like Obamacare.”

The Kentucky senator explained to Breitbart News that the BCRA creates “a new entitlement program that gives out over $100 billion to insurance companies.” He also said that the bill retains most of Obamacare’s Medicaid expansion and many of the Obamacare insurance regulations that cause insurance premiums to spiral upwards.

Sen. Johnson criticized the Senate bill, saying that it does not do enough to bring down premiums. In an op-ed for the New York Times, Johnson wrote, “Once again, a simple solution is obvious. Loosen up regulations and mandates, so that Americans can choose to purchase insurance that suits their needs and that they can afford.”

Sen. Dean Heller (R-NV) came out as the fifth Republican senator against the BCRA. Heller remains concerned about the bill’s rollback of Obamacare’s Medicaid expansion. The BCRA rolls back the Medicaid expansion over seven years and places per capita caps on Medicaid spending.

Heller said, “You have to protect Medicaid expansion states. That’s what I want. Make sure we’re taken care of here in the state of Nevada.”

Other moderate senators such as Lisa Murkowski (R-AK) and Susan Collins (R-ME) also expressed reservations about the BCRA. Murkowski and Collins want to protect Obamacare’s Medicaid expansion, and Sen. Collins remains wary about defunding Planned Parenthood.

The Congressional Budget Office (CBO) released its analysis of the BCRA, estimating that if the Senate passes the legislation, 22 million fewer Americans would have health insurance than under current law. According to the CBO, the BCRA would also reduce the deficit by $321 billion over the next ten years and reduce average premiums by 20 percent. McConnell and other members of Senate leadership said that they would not hold a vote on the Senate bill if they did not have a CBO score of the bill.

Majority Leader McConnell maintains a slim majority in the Senate. McConnell can only afford to lose two senators in the upper chamber and then have Vice President Mike Pence break the tie. Balancing the competing interests of the moderate wing comprised of Sens. Collins, Murkowski, and Heller, and conservatives senators such as Paul, Cruz, and Lee, will be a difficult task for McConnell. McConnell remains adamant that the upper chamber will vote on the BCRA by the end of the week so that Congress can have more time to focus on other priority issues such as tax reform, infrastructure, and the budget.

If the Senate manages to pass the Better Care Reconciliation Act, then the House can pass the BCRA with no changes and then send the bill to President Donald Trump to sign. However, if the House does not approve the changes, then both chambers of Congress can resolve it through a conference committee to reconcile the differences between the House and the Senate versions of the healthcare bill. If they agree to the resolve the differences, then Congress will send the bill to the president’s desk to sign.

However, health care reform does not end with signing Congress’s health care overhaul bill. Speaker Paul Ryan previously explained that replacing Obamacare will happen through three phases. In phase one, Congress will repeal Obamacare’s individual and employer mandate, most of Obamacare’s taxes, and some Obamacare insurance regulations through a budgetary reconciliation bill. In phase two, Health and Human Services (HHS) Secretary Tom Price has the discretion to unwind 1,442 provisions of Obamacare.

Speaker Paul Ryan said that phase three will include subsequent legislation to reform the healthcare market, although he admitted that will serve as a difficult task. He explained, “And then phase 3, pass those other bills we very much believe in, like shopping across state lines, like medical liability reform. Those things will pass here in the House because it only takes a majority. We’re going to send it to the Senate. We’re going to pressure the Senate to pass it, but they can filibuster that.”

President Donald Trump tweeted that Senate Republicans will do their best to reform health care, despite the obstruction from Democrats.

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