Sen. John McCain, a Republican who may hold a pivotal vote in the last-ditch GOP effort to make major changes to the Affordable Care Act, is withholding his support as leaders stare down a final deadline to act by the end of the month.
“I am not supportive of the bill yet,” the Arizona senator told reporters Monday, adding that he wants a more thorough legislative process.
A number of other Republicans are jumping on board a proposal by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana to replace the Affordable Care Act’s insurance subsidies with block grants to states, which would decide how to help people get health coverage.
The Congressional Budget Office said Monday it will offer a partial assessment of the measure early next week, but that it won’t have estimates of its effects on the deficit, health insurance coverage or premiums for at least several weeks. That could make it hard to win over several Republicans who opposed previous versions of repeal legislation.
On the conservative side, Sen. Rand Paul insisted Monday he is opposing the bill because it keeps too much of the Affordable Care Act.
“It’s another incarnation of replace. I won’t support it,” Paul of Kentucky told reporters, adding that it isn’t a “kidney stone” you pass to “just get rid of it.”
Asked about the likelihood that the bill would get enough GOP support to pass, Paul said, “Two weeks ago I would have said zero. But now I’m worried.”
Two months ago, Majority Leader Mitch McConnell’s effort to pass a replacement with only Republican support suffered a spectacular defeat in the Senate. When members of the Senate health committee then began working on a bipartisan plan to shore up Obamacare, Graham and Cassidy revved up a new bid to get their GOP-only bill to the Senate floor.
Democrats are warning that the proposal is a serious threat.
“This bill is worse than the last bill,” Senate Democratic leader Chuck Schumer of New York told reporters Monday. “It will slash Medicaid, get rid of pre-existing conditions. It’s very, very bad.”
Later at a news conference, Schumer said voting on the measure without a full CBO analysis would be “legislative malpractice.”
The measure would end Obamacare’s requirements that individuals obtain health insurance and most employers provide it to their workers, and give states broad flexibility to address the needs of people with pre-existing medical conditions. The proposal would end the Affordable Care Act’s tax on medical devices while keeping others intact, including taxes on the wealthy, to fund the block grants.
Shares of hospitals and health insurers that could see profits drop under the plan declined. Tenet Healthcare Corp. fell 6% to $15.72 at the close in New York while Community Health Systems Inc. slipped 4.6% to $7.26. The insurer Molina Healthcare Inc. lost 0.9% and Centene Corp. fell 1.5%.
No Democratic Support
Because the Graham-Cassidy plan has no Democratic support, Republicans have only until Sept. 30 to push it through the Senate before rules expire that allow it to be passed with 50 senators plus Vice President Mike Pence’s tiebreaking vote. Republicans control the Senate 52-48.
Graham said last week that McConnell said he was “all in” to help the two bill sponsors round up the 50 votes to pass the bill. Graham said they could have as many as 48 votes if the vote were held now. But a number of Republican senators have yet to get on board, including the three who defeated McConnell’s plan — Susan Collins of Maine, Lisa Murkowski of Alaska and McCain.
Collins “has a number of concerns” about the new proposal, including the cuts to Medicaid and the effect on people with pre-existing conditions, spokeswoman Annie Clark said Monday. She will examine the CBO analysis of the bill’s impact, Clark said.
Murkowski is getting a hard sell from Republican backers of the bill. Moments before she walked into McConnell’s office Monday, she said she’s working with Cassidy’s office to learn what the bill would mean for Alaska.
“What I’m trying to figure out is the impact to my state,” Murkowski told reporters. “There are some formulas at play with different pots of money with different allocations and different percentages so it is not clear.”
The conservative group Heritage Action, which opposed the GOP bill that failed in July, said last week the Graham-Cassidy proposal doesn’t appear to deliver on Republicans’ promise to repeal and replace Obamacare, though the group hasn’t taken a final position.