GOP Gives Up on Obamacare Repeal Vote. Now What?
By Lisa Mascaro and Noam N. Levey
Members of Congress searched for a way forward on health care legislation Tuesday, but as they did, the wreckage of the latest Republican plan to repeal the Affordable Care Act continued to threaten to block the way for bipartisan progress.
Senate Republicans, emerging from their weekly policy lunch, said they would not move ahead with a vote on the most recent repeal legislation, sponsored by Republican Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina. The public opposition from three Republican senators _ John McCain of Arizona, Rand Paul of Kentucky and Susan Collins of Maine _ had doomed that bill to defeat.
"We haven't given up on changing the American health care system," said Senate Majority Leader Mitch McConnell, R-Ky. "We are not going to be able to do that this week. But it still lies ahead of us."
McConnell, Graham and other leading Republicans insisted the repeal effort would be revived later, likely next year.
"We're going to fulfill our promise," Graham said. "It took 18 months to pass Obamacare. It's going to take a while to repeal it."
President Donald Trump, who has repeatedly expressed frustration with the GOP failure to repeal and replace the health care law, responded tersely when reporters asked him what would happen next.
"It will happen," he said as he landed in New York for a high-dollar Republican fundraising dinner.
Even as the talk of repeal continued, however, a key Republican committee chairman said late Tuesday that he would seek to resume negotiations with Democrats on a more limited bipartisan package.
Congress faces at least two pressing deadlines: Federal money for the Children's Health Insurance Program, or CHIP, a politically popular program that provides health coverage to about 9 million children, expires Saturday. Some states, which administer the program, have sufficient reserves to continue coverage for a significant time, but others will begin to run out of money within weeks, forcing them to start knocking children off coverage or freeze their programs.
And premiums for Obamacare plans for next year need to be finalized this week, with insurers not knowing whether the federal government will continue payments that help make costs affordable.
Lawmakers have worked on bipartisan solutions for both problems, but it remained unclear Tuesday whether members of the Republican majority believed they could proceed on measures that many conservatives see as bailouts of a law they despise.
Senate Minority Leader Charles E. Schumer, D-N.Y., reiterated Democrats' offer to "roll up our sleeves and work to make the health care system better."
"The Cassidy-Graham bill would have been a health care disaster, and the American people saw it," Schumer said. "We hope that the Republicans don't come back to this bill."
House and Senate Republicans appeared deeply frustrated over their inability, as the majority in Congress, to fulfill their longtime campaign promise to end President Barack Obama's signature health care law. They are being pummeled by conservatives and on talk radio, and worry voters will punish incumbents in the midterm election for the failure to deliver.
Polls repeatedly have shown each of the GOP health care proposals this year to be deeply unpopular with most voters. But the same surveys have also shown that Republican voters, especially the conservatives who disproportionately vote in primaries, want their representatives to push ahead on repeal.
With Trump also leveling blame, McConnell gathered Republicans behind closed doors with Vice President Mike Pence to decide what to do next.
Several Republicans blamed defeat on the rushed and secretive process as they scrambled to meet a Sept. 30 deadline with just one public hearing and said that a more thorough debate would produce legislation that could win support.
"We ran out of time," said Sen. Ron Johnson, R-Wis. "I'm looking forward to a better process. We take the time _ I think we'll have success."
In the House, which passed its own health care bill earlier this year, conservatives also refused to give up.
Rep. Mark Meadows, R-N.C., said Tuesday that Republicans could try again in a matter of months, reviving special budget rules that allow for majority passage in the Senate after Congress dispatches with tax reform. That would probably push the health care debate into next spring, during the election year.
"Failure is not an option here," Meadows, chairman of the House Freedom Caucus, said at a Tuesday roundtable with conservatives. "Midterms are coming up. If we have not produced something on this," he said, Republican voters would punish lawmakers "at the ballot box."
Others suggested Congress should abandon its partisan approach and resume negotiations to stabilize the system and the other federal health programs now at risk of expiring.
Senate Finance Committee Chairman Orrin G. Hatch, R-Utah, and Sen. Ron Wyden, D-Ore., the panel's senior Democrat, had been closing in on a compromise this month to extend CHIP funding for five years. But committee staff members were pulled away to deal with the GOP repeal push.
On Monday evening, as his committee wrapped up a marathon hearing on the Graham-Cassidy repeal proposal, Hatch expressed a desire to get back to the CHIP bill.
But it appears increasingly unlikely that Congress will be able to act before the authorization for federal funds expires Saturday.
Republicans devoted no time to the CHIP issue at their Tuesday meeting, senators said. Democrats remained hopeful the issue could be considered by week's end.
Even more uncertain is the fate of a separate bipartisan effort to stabilize health insurance markets that have been buffeted by uncertainty over the fate of the health care law and continued threats by the Trump administration to undermine the markets the law created.
Senate Health Committee Chairman Lamar Alexander, R-Tenn., and the committee's senior Democrat, Patty Murray, D-Wash., held four hearings this month and were talking about a package of fixes that were broadly supported by state regulators, a bipartisan group of governors, insurers and others who work in health care.
But Alexander abruptly pulled out of the talks as Graham-Cassidy picked up steam, saying that a compromise wasn't possible.
On Tuesday, Alexander said in statement that he would return to the negotiations and "consult with Sen. Murray and with other senators, both Republicans and Democrats, to see if senators can find consensus on a limited bipartisan plan that could be enacted into law to help lower premiums" over the next two years.
Murray and other Democrats had urged Alexander to restart the process, as have Republican and Democratic governors and health care officials from around the country.
"Patty Murray is ready to get back to the negotiating table, and we're with her," Sen. Tammy Duckworth, D-Ill., said. Murray has told other Democrats that she and Alexander were close to a deal when the talks were shut down, Duckworth added.
A bipartisan group of 10 governors, led by Ohio's John Kasich, a Republican, and Colorado's John Hickenlooper, a Democrat, wrote to Senate leaders last week asking them to move ahead with the bipartisan approach.
"We ask you to support bipartisan efforts to bring stability and affordability to our insurance markets," they wrote.
The need for action is particularly urgent as 2018 premiums on insurance markets that use the federally administered HealthCare.gov exchange are supposed to be finalized Wednesday.
Many of those rates are slated to rise dramatically, in part because health plans say they must account for uncertainty.
If Congress can pass a stabilization package, some insurers have indicated they would not have to raise rates as much.
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