By Juliet Eilperin, Sean Sullivan and Ed O’Keefe,
Senate Democrats have identified new potential allies in their effort to scuttle the current health-care proposal: Republican governors, particularly those who helped expand Medicaid in their states under the Affordable Care Act.
Sen. Thomas R. Carper (D-Del.),who is leading the effort with the support of fellow Democrats, called “a couple dozen” senators and governors from both parties over the recess, he said in an interview, to say “this is a good time for us to hit the pause button in the Senate, and step back and have some good heart-to-heart conversations” about how to revise the 2010 law.
Carper said the fact that the National Governors Association is holding its summer meeting in Providence, R.I., later this week could give governors a chance to weigh in on the current debate.
The development shows Democrats moving beyond rhetorical calls for bipartisanship to insert themselves into a legislative process that Republicans have dominated. It also reflects continuing divisions within the GOP, with Republican governors emerging as a potential ally for Democrats and others who oppose the current GOP proposal.
Those divisions remained clear Monday, when Senate leaders said they hope to release yet another draft of their health-care legislation this week even as senators and White House officials continued to disagree publicly about what approach to take.
“The governors can play a critical role in helping us get to where we need to be,” Carper said.
Several GOP governors, especially those who took advantage of the law’s generous federal funding to expand Medicaid coverage to able-bodied adults, have raised concerns about the current Senate plan to not only cut $772 billion from Medicaid by over the next decade but make even deeper reductions after that through a revised spending formula. Those governors include Doug Ducey (Ariz.), John Kasich (Ohio) and Brian Sandoval (Nev.).
Three top administration officials — Vice President Pence, Health and Human Services Secretary Tom Price and White House budget director Mick Mulvaney — are scheduled to attend the NGA meeting. So is Sandoval, the first Republican governor to embrace Medicaid expansion under the ACA.
Meanwhile, a small group of centrist Republicans and Democrats have met occasionally in Washington to see if they can find common ground — though that goal has proven elusive given the ideological divide on health care.
Still, the ongoing conversations among a handful of senators suggest that some lawmakers are seeking a new path forward should the current bill collapse. A few rank-and-file Republicans have suggested that their party should negotiate with the minority, though White House officials rejected that idea outright on Monday.
There are a handful of short-term measures that the two parties could agree on, which would be primarily aimed at shoring up existing private insurance markets. That could include continuing to provide $7 billion in federal subsidies that help lower-income people to afford their out-of-pocket costs.
“Congress, in my view, could pass that immediately and it would make a big difference,” said Sen. Ron Wyden of Oregon, the top Democrat on the Finance Committee, in an interview Monday. “Because the number-one thing private insurance plans and everyone on [the exchanges] want is certainty.”
The administration regularly touts problems with the current federal health exchange, rather than proposing new ways to support it. On Monday, the Centers for Medicare and Medicaid Services announced the number of insurers submitting applications to offer plans on the ACA market next year dropped by 38 percent, to 141.
“This is further proof that the Affordable Care Act is failing,” said CMS Administrator Seema Verma.
Republicans continued to show discord over how to fix it, however.
Both Pence and a White House legislative affairs director Marc Short said Monday that senators should repeal the health-care law outright if they cannot reach a consensus on how to change it. Senate Republican Whip John Cornyn (R-Tex.), meanwhile, said his party would release a new draft of its proposal this week, “and then we’ll vote on it next week.”
That announcement came as lawmakers returned from their week-long recess, with many still raising questions about the leadership’s plan to abolish federal penalties for not having insurance while making deep cuts to the Medicaid program and providing billions in tax cuts to insurers and wealthier Americans. In a sign of how activists have mobilized on the issue, police made 80 arrests of health care protesters at 13 locations across Capitol Hill Monday.
Republican senators also faced new heat in their home states Monday, when Save My Care launched a new round of TV ads pressuring Sens. Dean Heller (R-Nev.), Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and Shelley Moore Capito (R-W.Va.) to vote against the bill. The Heller ad included footage of him forcefully coming out against the bill at a news conference last month. The group said it is spending more than $1 million on the new campaign.
Capito, who met Monday with McConnell and a half dozen of his top deputies, said leaders are looking at how to treat Medicaid funding and they’re working on “finding that sweet spot” that gets them at least 50 yes votes.
Short acknowledged that the GOP plan remains unpopular with Americans, arguing that liberal groups have been “more organized in their messaging” on health care than Republicans. He said President Trump will continue to be “very active in this debate,” possibly traveling to the home states of key senators to apply political pressure on them to vote yes.
Short said the White House remains “confident” that the Senate will pass a bill before its August recess, “and we’re not going to be in a position of failure.” But if Republicans fall short of the 50 votes needed to pass a replacement, with Pence casting the tiebreaking vote, Short said lawmakers should just repeal the existing law.
Sen. Roy Blunt (R-Mo.), was one of several GOP leaders to say Monday that they do not think it is possible to get 50 GOP senators to vote for a repeal-only bill.
Pence made a similar point in an interview Monday with radio host Rush Limbaugh, questioning those in his party who have suggested that “we ought to reach out and do a bipartisan bill.” That description could include McConnell himself, who has said he would have to reach out to Democrats to shore up the insurance markets if Republicans fail to pass their own bill.
Pence continued: “The president has made it very clear: We believe that if they can’t pass this carefully crafted repeal and replace bill [where] we do those two things simultaneously, we ought to just repeal only and have enough time built into that legislation to craft replacement legislation in a way that’s orderly and allows states to adjust to different changes to Medicaid in a maybe three-year or four-year window.”
Pence’s endorsement of an outright repeal of the ACA, along with an amendment Sen. Ted Cruz (R-Tex.) has crafted that would allow insurers to sell minimalist health plans on the ACA insurance market, could further fracture an already divided GOP. At least three GOP senators — Cruz, Rand Paul (Ky.) and Ben Sasse (Neb.) — have endorsed this approach, but they remain the minority in their caucus.
“I think it picks up conservative votes and loses other votes,” Sen. Charles E. Grassley (R-Iowa) said.
“I don’t think it could work at all,” Sen. Roy Blunt (R-Mo.) said of a repeal-only bill. Blunt, who joined Pence on a horseback ride in Rock Creek Park Saturday, said the two talked about “how difficult it is to get people together on anything that impacts every family as much as health care does.”
Senate leaders also have serious concerns that the Cruz amendment might violate a set of Senate budget rules that the health care measure must meet to pass with 51 votes rather than the 60 votes needed for most other legislation.
Congressional Democrats have repeatedly asked Trump to work with them to fix — not repeal — the ACA. Before the recess, moderate Democrats led by Sen. Heidi Heitkamp (N.D.) tried to introduce a few proposed fixes before the recess, but Republicans rejected them. Senate Minority Leader Charles E. Schumer (D-N.Y.) also called for an all-senators meeting to discuss the subject and later for Trump to hold a meeting at the Blair House with members of both parties to craft a bipartisan plan. Both requests were ignored.
“It’s time to move on from the failing, Republican-only approach and start over,” Schumer said in a Senate floor speech on Monday.
Some liberal Democrats are now pushing for a single-payer, government-run system that would widen, rather than narrow, the divide between the parties.
Sen. Bernie Sanders (I-Vt.) is expected to introduce a single-payer bill soon that will be similar to the one he ran on in 2016, and Republicans have already challenged vulnerable Democrats to say whether they’ll stand with Sanders. Sen. Tammy Baldwin (D-Wis.), who is up for reelection next year, told reporters in Wisconsin that she’d likely back single-payer.
Sen. Marco Rubio (R-Fla.) said Monday that Sanders’ supporters are “putting a lot of pressure” on Democrats, making it more difficult to negotiate.
“I don’t believe we’re going to be able to repeal Obamacare with Democrats,” Rubio said. “They may be willing to replace it after it’s gone.”
Kelsey Snell, Philip Rucker and David Weigel contributed to this report.