Tag Archives: Healthcare

Senate delays healthcare vote as McCain recovers from surgery

Sen. John McCain (R-AZ) speaks with reporters about the Senate health care bill on Capitol Hill

By David Morgan

WASHINGTON (Reuters) – The U.S. Senate will delay its consideration of healthcare legislation while Arizona Republican Senator John McCain recuperates from surgery, Senate Republican leader Mitch McConnell said on Saturday.

McCain’s absence cast doubt on whether the Senate would be able to pass the legislation to dismantle and replace Obamacare. McConnell needs 50 “yes” votes for passage in a chamber the Republicans control by a 52-48 margin.

“While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act,” McConnell said in a statement.

The announcement came after McCain’s office said he would remain in Arizona next week following a procedure to remove a 2-inch (5-cm) blood clot from above his left eye.

Repealing and replacing President Barack Obama’s signature healthcare law was a top campaign promise for President Donald Trump and Republicans in Congress.

But two Republican senators have already declared their opposition to revised legislation unveiled on Thursday.

McCain has expressed concern about the healthcare bill but has not said how he would vote.

The 2008 Republican presidential nominee, McCain was resting comfortably at home in good condition after Friday’s operation, his office said.

“There are few people tougher than my friend John McCain, and I know he’ll be back with us soon,” McConnell said.

McCain’s surgeons removed the clot during a minimally invasive craniotomy through an incision in the 80-year-old lawmaker’s eyebrow. Tissue pathology reports would be available within the next several days.

“Thanks to @MayoClinic for its excellent care — I appreciate your support and look forward to getting back to work!” McCain, who chairs the Senate Armed Services Committee, said on social network Twitter late on Saturday.

 

(Reporting by David Morgan; Editing by Cynthia Osterman and Clarence Fernandez)

 

One more Republican defection would doom Senate healthcare bill

Senate Majority Leader Mitch McConnell speaks with reporters about the Senate health care bill on Capitol Hill in Washington, U.S., July 13, 2017. REUTERS/Aaron P. Bernstein

By Susan Cornwell and David Alexander

WASHINGTON (Reuters) – President Donald Trump turned up the heat on Friday on fellow Republicans in the U.S. Senate to pass a bill dismantling the Obamacare law, but with their retooled healthcare plan drawing fire within the party even one more defection would doom it.

Majority Leader Mitch McConnell has planned for a vote next week on revised legislation, unveiled on Thursday, and he has his work cut out for him in the coming days to get the 50 “yes” votes needed for passage. Republicans control the Senate by a 52-48 margin and cannot afford to lose more than two from within their ranks because of united Democratic opposition, but two Republican senators already have declared opposition.

“After all of these years of suffering thru Obamacare, Republican Senators must come through as they have promised,” Trump, who made gutting Obamacare one of his central campaign promises last year, wrote on Twitter from Paris, where he attended Bastille Day celebrations.

The top U.S. doctors’ group, the American Medical Association, on Friday called the new bill inadequate and said more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of healthcare. Hospital and medical advocacy groups also have criticized the bill.

“The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage,” AMA President Dr. David Barbe said, referring to the government insurance program for the poor and disabled.

A major test for McConnell’s legislation expected early next week is an analysis by the nonpartisan Congressional Budget Office, which last month forecast that the prior version of the bill would have resulted in 22 million Americans losing insurance over the next decade.

A day after that CBO analysis was issued, McConnell postponed a planned vote on the legislation because of a revolt within his own party, including moderates and hard-line conservatives.

While the bill’s prospects may look precarious, the same could have been said of healthcare legislation that ultimately was passed by the House of Representatives. Republican House Speaker Paul Ryan called off a vote in March in the face of a rebellion involving the disparate factions of the party but managed to coax enough lawmakers to back it and engineered narrow approval on May 4.

PENCE SEEKS SUPPORT

Vice President Mike Pence sought to shore up support among the nation’s governors at a meeting in Rhode Island, but a key Republican governor, Ohio’s John Kasich, came out strongly against the revised bill, saying its Medicaid cuts were too deep and it does too little to stabilize the insurance market.

Kasich’s opposition could put pressure on Rob Portman, a Republican senator from Ohio, who has not yet taken a position on the bill.

If the current Senate legislation collapses, some lawmakers have raised the possibility of seeking bipartisan legislation to fix parts of Obamacare but leaving intact the structure of the Affordable Care Act, Democratic former President Barack Obama’s signature legislative achievement, commonly known as Obamacare.

“There are changes that need to be made to the law,” Dick Durbin, the No. 2 Senate Democrat, told MSNBC, citing “a bipartisan appetite to tackle this issue.”

Moderate Susan Collins and conservative Rand Paul already oppose the revised Senate bill. Other Republican senators have either expressed concern or remained noncommittal, including Portman, Mike Lee, Shelley Moore Capito, John McCain, Dean Heller, John Hoeven, Lisa Murkowski, Jeff Flake, Ben Sasse, Cory Gardner, Todd Young and Thom Tillis. Republican Senators Lindsey Graham and Bill Cassidy floated an alternative plan.

The new version was crafted to satisfy the Republican Party’s various elements, including moderates worried about Americans who would be left without medical coverage and hard-line conservatives who demand less government regulation of health insurance.

A provision championed by Republican Senator Ted Cruz and aimed at attracting conservatives would let insurers sell cheap, bare-bones insurance policies that would not have to cover broad benefits mandated under Obamacare.

But two major health insurance groups, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, called on McConnell to drop the Cruz proposal, saying it would undermine protections for pre-existing medical conditions, raise insurance premiums and destabilize the individual insurance market.

The bill retained certain Obamacare taxes on the wealthy that the earlier version would have eliminated, a step moderates could embrace. But it kept the core of the earlier bill, including ending the expansion of Medicaid that was instrumental in enabling Obamacare to expand coverage to 20 million people, and restructuring that social safety-net program.

John Thune, a member of the Senate Republican leadership, said in order to complete work on the bill by the end of next week, Senate leaders would have to try to formally begin debate on Tuesday or Wednesday, a move that requires a majority vote.

(Reporting by Susan Cornwell and David Alexander; Writing by Will Dunham; Editing by Bernadette Baum and Jonathan Oatis)

Feuding U.S. Senate Republicans to get revised healthcare bill

Sen. Rand Paul (R-KY) speaks with reporters about the Senate health care bill on Capitol Hill in Washington, U.S., July 12, 2017. REUTERS/Aaron P. Bernstein

By Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republican leaders are expected to unveil a new version of their legislation to repeal and replace Obamacare on Thursday, amid continued feuding among lawmakers over what should go in the bill and uncertainty over its prospects.

With his reputation as a skillful strategist hanging in the balance, Senate Majority Leader Mitch McConnell will present the revised bill in a bid to unite disparate Republican factions and deliver on his party’s signature issue in the 2016 elections. He is aiming for a vote next week.

A Wednesday closed-door meeting did not resolve several disputes among moderate and conservative Republicans over the bill’s contents, senators said.

But President Donald Trump, in an interview with the Christian Broadcasting Network, said he would be “very angry” if he does not get a bill on his desk to repeal and replace the 2010 Affordable Care Act, otherwise known as Obamacare.

John Cornyn, the Senate’s No. 2 Republican, told Reuters in a Capitol hallway many senators had come to realize they could talk about healthcare “endlessly” without deciding anything. “That’s why it’s important that we go ahead and schedule the vote,” he said.

The House of Representatives passed a healthcare overhaul bill last month. In the interview on Wednesday, the Republican president said McConnell “has to pull it off” in the Senate.

Several of the Senate’s 52 Republicans said they were waiting to see the revised legislation before deciding whether to back it. This made it difficult to predict whether it can gather the minimum of 50 votes it will need to pass the 100-vote chamber, with Vice President Mike Pence ready to cast a tie-breaking vote for the bill.

Democrats are united in opposition to the effort to scrap Obamacare.

Conservative Republican Senator Rand Paul made clear he was against the bill and would not even vote to advance it procedurally. He said it would be “worse” than a previous draft because it is expected to leave in place some of the Obamacare taxes on wealthy Americans.

Cornyn said one unresolved issue was whether to include a proposal by conservative Republican Ted Cruz that would let insurers offer basic low-cost healthcare plans that do not comply with Obamacare regulations. Some moderates dislike this, saying it could leave insurers charging more for comprehensive plans that do comply with Obamacare. Insurers weighed in strongly against the idea on Wednesday as well.

The previous draft of the bill unveiled last month would phase out the Obamacare expansion of Medicaid health insurance for the poor and disabled, sharply cut federal Medicaid spending beginning in 2025, repeal many of Obamacare’s taxes, end a penalty on individuals who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

Moderate Republican senators are uneasy about the millions of people forecast to lose their medical insurance under the legislation and hard-line conservatives say it leaves too much of Obamacare intact.

(Additional reporting by Yasmeen Abutaleb and Caroline Humer; Editing by Mary Milliken and Tom Brown)

Senate may vote on revised healthcare bill next week

Senate Majority Leader Senator Mitch McConnell (R-KY) attends a new conference following party policy lunch meeting at the U.S. Capitol in Washington, U.S. July 11, 2017. REUTERS/Carlos Barria

By Yasmeen Abutaleb and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans said Tuesday they will seek to bring their healthcare overhaul to the Senate floor next week after a lengthy intraparty struggle, but it remained unclear whether they had the votes to pass the measure or even what form it would finally take.

With his reputation as a master strategist on the line, Senate Majority Leader Mitch McConnell laid out a timetable for Senate consideration of legislation to fulfill President Donald Trump’s campaign promise to dismantle the 2010 Affordable Care Act, also known as Obamacare.

In a departure from Republican orthodoxy on tax-cutting, the legislation likely will retain some of the taxes that were imposed on the wealthy under Obamacare, Senate sources said.

But it was unknown whether a revised version of the bill to be announced on Thursday morning can satisfy both moderates and hard-line conservatives in the Republican majority who voiced opposition to a draft unveiled last month on very different grounds.

With Trump urging the Senate to act before taking the August break, McConnell pushed back the Senate’s planned August recess by two weeks to allow senators more time to tackle the measure that would repeal key parts of Obamacare, as well as pursue other legislative priorities.

McConnell’s announcement drove a turn-around in stock prices in afternoon trading on Wall Street after an earlier sell-off, on hopes that a shortened recess could mean progress on the stalled Republican legislative agenda.

A dark mood lingered among some Republicans over the healthcare subject, with party leaders appearing to act because of the need to dispense with healthcare and turn to other issues, among them increasing the U.S. debt ceiling.

“I think we’ve narrowed down now to where we know where the decision points are, and we just have to make those decisions,” Senator John Thune, a junior member of the Republican leadership, told reporters. Leaders were still trying to “figure out how we get to 50” votes, he said.

Republicans, who hold 52 seats in the 100-seat Senate, would need 50 votes to pass the bill, with Vice President Mike Pence providing the tie-breaking vote.

“I am very pessimistic” about the prospects for Republican healthcare legislation, Chuck Grassley, a senior senator, told Fox News on Tuesday. Another Republican senator, Lindsey Graham, was working on his own healthcare proposal and will unveil it this week, a Graham aide said.

KEEPING OBAMACARE TAXES

McConnell said the plan was to vote on the healthcare bill next week, and said he hoped to have a fresh analysis of the bill from the nonpartisan Congressional Budget Office at the start of the week. He did not reveal any of the planned changes to the draft, on which he postponed action last month after it failed to gather enough support.

But Senate sources said it is likely that two Obamacare taxes on the wealthy will be kept in place – a 3.8 percent net investment tax and a 0.9 percent payroll tax that helps finance Medicare – which would appeal to moderates who have balked at the prospect of cutting taxes for the wealthy while reducing benefits for the poor.

“Obviously that’s the direction I think that a lot of our members want to move, is to keep some of those (taxes) in place and be able to use those revenues to put it into other places in the bill,” Thune said, while stressing that no decisions were final.

Republicans could also retain Obamacare’s limit on corporate tax deductions for executive pay in the health insurance industry, one Senate source said.

It was unclear whether the bill would include a proposal by conservative Republican Ted Cruz that would allow insurers to offer basic low-cost healthcare plans that do not comply with Obamacare regulations.

Cruz argues it would help to lower premiums, but critics say it would allow insurers to offer skimpier plans that may not cover essential health benefits while also charging more for more comprehensive, Obamacare-compliant plans.

The Senate Republican healthcare bill unveiled last month would phase out the Obamacare expansion of Medicaid health insurance for the poor and disabled, sharply cut federal Medicaid spending beginning in 2025, repeal many of Obamacare’s taxes, end a penalty on individuals who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

Democrats are united in opposition to the bill and at least 10 Republicans have said they oppose the existing draft. The House of Representatives passed its own version in May.

Moderate Republicans are uneasy about the millions of people forecast to lose their medical insurance under the draft legislation, and hard-line conservatives say it leaves too much of Obamacare intact.

Democrats call the Republican legislation a giveaway to the rich that would hurt the most vulnerable Americans.

(Additional reporting by David Morgan and Amanda Becker; Writing by Susan Cornwell and Tom Brown; Editing by Mary Milliken and Leslie Adler)

Senate Republicans struggle to salvage healthcare effort

A demonstrator heads home after protesting the Republican healthcare bill outside Republican Congressman Darrell Issa's office in Vista, California, June 27, 2017. REUTERS/Mike Blake

By Susan Cornwell and Yasmeen Abutaleb

WASHINGTON (Reuters) – The top U.S. Senate Republican struggled on Wednesday to salvage major healthcare legislation sought by President Donald Trump, meeting privately with a parade of skeptical senators as critics within the party urged substantial changes.

Republican leaders hope to agree on changes to the legislation by Friday so lawmakers can take it up after next week’s Independence Day recess.. Senate Majority Leader Mitch McConnell on Tuesday abandoned plans to seek passage of it this week because Republicans did not have 50 votes to pass the bill.

For seven years, Republicans have led a quest to undo the 2010 law known as Obamacare, Democratic former President Barack Obama’s signature legislative achievement. Trump made dismantling it a top campaign promise during last year’s presidential campaign but policy differences within the party have raised doubts Republicans can achieve a repeal.

Democrats have unified against the bill and Republicans control the Senate by a slim 52-48 margin, which means McConnell can afford to lose only two Republicans. So far at least 10 – including moderates and hard-line conservatives – have expressed opposition to the current bill, although some indicated they would vote for it with certain changes.

McConnell, with his reputation as a strategist on the line, met with a procession of Republican senators in his office on Wednesday. John Cornyn, the No. 2 Senate Republican, said party leaders will talk to every Republican senator who has concerns about the bill or is undecided.

The House of Representatives passed its healthcare bill last month, only after striking a balance between the center of the party and the right wing. Now McConnell must find a similar sweet spot.

During a lunch meeting on Wednesday Republicans made presentations on potential fixes. Senator Rand Paul called for jettisoning more parts of Obamacare to get conservatives on board.

TAX ISSUE

Senator Mike Rounds suggested keeping a 3.8 percent Obamacare tax on high earners’ investment income, which the current bill would eliminate. Rounds said the tax could pay for more Americans to receive the tax credits that help pay for health insurance.

Senator Bob Corker, who also supports keeping the tax, said one of the issues he was focused on was helping lower-income Americans pay for health plans.

“My sense is there’s a good chance that issue and other issues people are trying to get addressed can be addressed,” Corker told reporters.

Trump said the bill was moving along well and predicted a “great, great surprise” but did not elaborate.

Maine Senator Susan Collins, a moderate, said it would be “very difficult” to reach agreement by Friday. Collins and other centrists were put off by the nonpartisan Congressional Budget Office’s projection on Monday that 22 million people would lose medical insurance under the existing bill.

Finishing the legislation’s revisions by Friday would be “optimal,” Cornyn said, so the CBO can analyze the new version..

Even then, Democrats could mount a forceful resistance. They have repeatedly said they will not discuss a repeal but have expressed openness to negotiating improvements.

The Senate’s top Democrat, Chuck Schumer, proposed Trump call all 100 senators to Blair House across the street from the White House to craft a bipartisan bill fixing Obamacare but Trump said did not think Schumer’s offer was serious.

McConnell said Democrats had refused “to work with us in a serious way to comprehensively address Obamacare’s failures in the seven years since they passed it.”

The legislation has triggered protests at the Capitol and police said they arrested 40 people, including cancer survivors, on Wednesday for blocking Senate offices.

Obama’s 2010 Affordable Care Act, which passed without Republican support, expanded health insurance coverage to some 20 million people but Republicans call it a costly government intrusion.

The Senate bill rolls back Obamacare’s expansion of the Medicaid government insurance for the poor and cuts planned Medicaid spending starting in 2025. It also repeals most of Obamacare’s taxes, ends a penalty for not obtaining insurance and overhauls subsidies that help people buy insurance with tax credits.

For graphic on who’s covered under Medicaid, click: http://tmsnrt.rs/2u06kvB

(This story fixes attribution of quote in 10th paragraph to Senator Corker from Senator Rounds.)

(Additional reporting by Susan Heavey, Richard Cowan, Susan Cornwell, Steve Holland, Jeff Mason, Mohammad Zargham, Tim Ahmann and Jeff Mason; Writing by Lisa Lambert, Will Dunham and Frances Kerry; Editing by Bill Trott)

Facing revolt on healthcare bill, U.S. Senate Republicans delay vote

Protesters demonstrate the Republican healthcare bill outside Republican Congressman Darrell Issa's office in Vista, California, June 27, 2017. REUTERS/Mike Blake

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republican leaders postponed a vote on a healthcare overhaul on Tuesday after resistance from members of their own party, and President Donald Trump summoned Republican senators to the White House to urge them to break the impasse.

The delay put the future of a longtime top Republican priority in doubt amid concerns about the Senate bill from both moderate and conservative Republicans. With Democrats united in their opposition, Republicans can afford to lose only two votes among their own ranks in the Senate.

Senate Majority Leader Mitch McConnell had been pushing for a vote ahead of the July 4 recess that starts at the end of the week. The legislation would repeal major elements of Obamacare and shrink the Medicaid government healthcare program for the poor.

“We’re going to press on,” McConnell said after announcing the delay, adding that leaders would keep working to make senators “comfortable” with the bill. “We’re optimistic we’re going to get to a result that is better than the status quo.”

At the White House meeting with most of the 52 Republican senators, Trump said it was vital to reach agreement on the Senate healthcare measure because Obamacare was “melting down.”

“So we’re going to talk and we’re going to see what we can do. We’re getting very close,” Trump told the senators. But he added, “If we don’t get it done, it’s just going to be something that we’re not going to like, and that’s okay.”

McConnell, whose party has a razor-thin majority in the 100-member Senate, told reporters that Republican leaders would work through the week to win over the 50 senators needed to pass the bill, with a vote planned after the recess. Vice President Mike Pence could provide the crucial vote needed to break a tie.

“I think we can get 50 votes to yes by the end of the week,” Republican Senator Roger Wicker said after the White House meeting.

REPUBLICAN OPPOSITION GROWS

The House of Representatives last month passed its own version of a healthcare bill, but the Senate bill has been criticized from both the left and the right. Moderate Republicans worried millions of people would lose their insurance. Conservatives said the bill does not do enough to erase Obamacare.

The bill’s prospects were not helped by a Congressional Budget Office analysis on Monday saying it would cause 22 million Americans to lose insurance over the next decade, although it would reduce the federal deficit by $321 billion over that period.

The report prompted Senator Susan Collins, a Republican moderate, to say she could not support the bill as it stands. At least four conservative Republican senators said they were still opposed after the CBO analysis.

Three more Republicans, Rob Portman of Ohio, Jerry Moran of Kansas and Shelley Moore Capito of West Virginia, said after the delay was announced that they oppose the current draft.

Portman and Capito cited the bill’s Medicaid cutbacks and how that would hurt efforts to combat the opioid epidemic that has taken a heavy toll in their states. The Medicaid program was expanded under former President Barack Obama’s signature healthcare law.

“I think giving time to digest is a good thing,” Republican Senator Bob Corker said after the delay was announced.

“UNCERTAINTY” ON WALL STREET

U.S. stock prices fell, as the decision to postpone the vote added to investor worries about Trump’s ability to deliver on his promises of tax reform and deregulation, as well as changes to the health sector. Those expected changes have driven a rally in U.S. stocks this year.

The benchmark S&P 500 index closed down 0.8 percent, and the Dow Jones industrial average finished down 0.46 percent.

“The market likes certainty and now there’s uncertainty. What is this going to look like when this gets out of the next iteration?” said Peter Costa, president of trading firm Empire Executions Inc.

Passing the measure would be a win for Trump as he seeks to shift attention after weeks of questions over Russia’s role in last year’s U.S. presidential election.

McConnell has promised since 2010 that Republicans, who view Obamacare as a costly government intrusion, would destroy the law “root and branch” if they controlled Congress and the White House. Republicans worry a failure to deliver will cost them votes in next year’s congressional elections.

If the Senate passes a healthcare bill, it will either have to be approved by the House or the two chambers would reconcile the differences in a conference committee. Otherwise, the House could pass a new version and send it back to the Senate.

Lawmakers are expected to leave town by Friday for their July 4 holiday break, which runs all next week. The Senate returns to work on July 10, the House on July 11. Lawmakers then have three weeks in session before their month-long August recess.

(This story corrects Dow Jones industrial average’s percent loss in 16th paragraph.)

(Additional reporting by Yasmeen Abulateb, Amanda Becker, Eric Walsh, Susan Heavey and Tim Ahmann; Writing by John Whitesides and Frances Kerry; Editing by Leslie Adler)

Republican leaders work to buoy Senate healthcare bill

FILE PHOTO: U.S. Vice President Mike Pence attends a healthcare listening session at the White House in Washington, DC, U.S. June 5, 2017. REUTERS/Joshua Roberts

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – Republican leaders are in a frenzied push to shore up support for a healthcare bill in the U.S. Senate after a non-partisan congressional office said on Monday it would cause 22 million Americans to lose insurance over the next decade.

Vice President Mike Pence is expected to travel to Capitol Hill on Tuesday to join Senate Republicans for a policy lunch before hosting a key conservative senator for dinner.

Senate Majority Leader Mitch McConnell will continue meeting on-the-fence senators facing questions from their governors and state Medicaid offices about the bill’s cuts to the government insurance program for the poor and disabled, lawmakers said.

The Congressional Budget Office (CBO) analysis on Monday prompted Senator Susan Collins, a key moderate vote, to say she could not support moving forward on the bill as it was written.

At least four conservative Republicans – Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee – said their opposition remained unchanged after the CBO analysis.

Further, Collins, Paul and Johnson, along with Senator Dean Heller, have all said they will oppose a procedural motion that would allow McConnell to move forward and bring the bill up for a vote. Heller, a moderate Republican up for re-election next year in Nevada, is already facing political fallout after a group started by former campaign aides to President Donald Trump and Pence promised to run ads against him.

The overlapping concerns and competing interests of the lawmakers highlights the balancing act facing McConnell as he tries to unify his party and deliver a legislative win to the president.

Trump – and most Republicans in Congress – were elected on campaign pledges to repeal and replace Obamacare, Democratic President Barack Obama’s signature 2010 law that extended insurance coverage to some 20 million Americans. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate.

McConnell’s goal was to vote on the bill before the July 4 recess that starts at the end of this week. He can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate to pass healthcare, with Pence casting the tie-breaking vote.

Moderate senators are concerned about millions of people losing insurance. Conservative senators have said the Senate bill does not do enough to repeal Obamacare.

The CBO is only able to assess the impact of legislation within a 10-year window, but it said insurance losses were expected to grow beyond 22 million due to deep cuts to Medicaid that are not scheduled to go into effect until 2025. The CBO estimated it would decrease the budget deficit by $321 billion between 2017 and 2026.

If the Senate passes a bill, it will either have to be approved by the House, which passed its own version last month, or the two chambers would have to reconcile their differences in a conference committee. Otherwise, the House could pass a new version and bounce it back to the Senate.

(Writing by Amanda Becker; Additional reporting by Yasmeen Abulateb, Amanda Becker and Eric Walsh; Editing by Paul Tait)

U.S. Senate Republicans to issue revised health bill to win support

Speaker of the House Paul Ryan (R-WI) speaks after Senate Republicans unveiled their version of legislation that would replace Obamacare on Capitol Hill in Washington, U.S.

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to issue a revised version of their healthcare bill on Monday, according to a Republican Senate aide, as the chamber’s leaders scrambled to get legislation passed ahead of a July 4 holiday recess starting on Friday.

The aide, who is familiar with the plan, did not provide details of changes in the works. Politico reported that a likely change to the bill would be to add a provision to encourage people, mainly those who are young and healthy, to enroll in insurance plans.

President Donald Trump and his fellow Republicans in Congress have been pushing to repeal and replace Obamacare, Democratic former President Barack Obama’s signature domestic legislation. The House of Representatives passed its version of a healthcare bill last month.

The Senate bill unveiled last week was immediately criticized by both conservatives and moderates in the party. With Republicans holding only a 52-seat majority in the 100-seat Senate, the bill was unlikely to win passage in its initial form.

At least four conservative Republicans have expressed opposition to the draft legislation, saying it does not go far enough in repealing Obamacare.

A spokesman for Senate Majority Leader Mitch McConnell would not comment on whether a vote on a bill would be held in the full Senate on Thursday, as originally anticipated.

The nonpartisan Congressional Budget Office later Monday might release its assessment of the bill’s cost and impact on future budget deficits. It was not clear whether the report will also estimate how many people might lose healthcare coverage under the legislation or whether that estimate would come later.

Meanwhile, some moderate Republicans have either withheld judgment or expressed doubts about replacing Obamacare with legislation that is similar to the House version.

They are concerned that the party’s approach to healthcare would cause too many people, and especially those with low incomes, to lose insurance. Trump touted passage of the House bill as a victory but later called it “mean.”

Republicans have targeted Obamacare since it was passed in 2010, viewing it as costly government intrusion and saying individual insurance markets are collapsing. The legislation expanded health coverage to some 20 million Americans, through provisions such as mandating that individuals obtain health insurance and expanding Medicaid, the government program for the poor.

TRUMP’S INVOLVEMENT

As he did during the House negotiations, Trump has personally pushed for a Senate bill, calling fellow Republicans to mobilize support.

In the efforts by Senate Republicans to push through a bill, the party has split over a provision in the draft bill ending federal funding of Planned Parenthood, the women’s healthcare provider, for one year.

Moderates are wary of this, while conservatives have called for an end to federal funding of Planned Parenthood because it provides abortions, even though they are not performed with taxpayer dollars.

Health insurance companies are concerned about the bill’s plan to cut Medicaid and any impact on state governments as well as the prospect of losing Obamacare’s mandate on individuals to buy insurance without creating alternative incentives for people to stay in their plans.

If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate.

The House is also controlled by Republicans but faced a similar balancing act between moderates and conservatives to pass its version.

A Republican leadership aide in the House said if the Senate manages to pass a healthcare bill this week, no decision has been made on when the House might schedule a vote on it or whether House Republicans might seek any changes to the Senate measure.

(Writing by Richard Cowan and Frances Kerry; Editing by Jeffrey Benkoe)

Trump reaches out to lawmakers on healthcare as another says ‘no’

U.S. President Donald Trump delivers remarks as he hosts a Congressional picnic event, accompanied by First Lady Melania Trump, at the White House in Washington, U.S., June 22, 2017. REUTERS/Carlos Barria

By Jeff Mason and Yasmeen Abutaleb

WASHINGTON (Reuters) – President Donald Trump made calls to fellow Republicans in the U.S. Senate on Friday to mobilize support for their party’s healthcare overhaul while acknowledging the legislation is on a “very, very narrow path” to passage.

Five Republican senators have announced they will not support the bill, which is designed to repeal and replace Obamacare, in its current form.

White House officials said on Friday that Trump has been in touch with Senate Majority Leader Mitch McConnell and made calls on Thursday and Friday to other lawmakers.

Trump’s role is expected to become more pronounced in coming days as the vote nears. Senate Republican leaders may rely on the deal-making former businessman to lean on conservative senators who are balking at the bill.

“We’re pleasantly surprised with a lot of the support that’s already come out and I think we’ll continue to work through (it,) in particular the four individuals who have expressed some ideas and concerns,” White House spokesman Sean Spicer told reporters at a White House briefing.

With all Democrats expected to oppose the measure, the Republicans can afford to lose the support of only two of their 52 members if they want to pass the legislation.

After Spicer spoke, Republican Senator Dean Heller became the fifth Republican opponent on Friday, saying he would not support the bill in its current form.

“This bill that’s currently in front of the United States Senate is not the answer,” Heller, a moderate who is up for re-election in 2018, said at a news conference in Las Vegas.

That could add Heller’s name to Trump’s call list. A White House official said the Trump has pushed his team to stay involved and plans to flex his negotiating muscle, the official said.

An outside political group aligned with the White House, America First Policies, said it is planning an advertising campaign targeting Heller for his opposition to the bill.

Healthcare stocks closed down 0.1 percent on Friday, clawing back some losses after the sector dropped sharply late in the session on Heller’s announcement.

The Senate’s 142-page proposal, worked out in secret by a group led by McConnell, aims to deliver on a central Trump campaign promise to undo former President Barack Obama’s signature healthcare law, which has provided coverage to 20 million Americans since it was passed in 2010.

Republicans view the law, formally known as the Affordable Care Act, as a costly government intrusion and say individual insurance markets created by it are collapsing.

FOUR CONSERVATIVES OPPOSE BILL

On Thursday, four of the Senate’s most conservative members said the new plan failed to rein in the federal government’s role.

Rand Paul, who has rejected the plan along with fellow Republican Senators Ted Cruz, Mike Lee and Ron Johnson, said fundamental problems remained that would leave taxpayers subsidizing health insurance companies.

Trump, in an interview with Fox News that aired on Friday morning, called the group of conservative lawmakers “four very good people.”

“It’s not that they’re opposed,” he said. “They’d like to get certain changes. And we’ll see if we can take care of that.”

Trump said getting approval would require traveling a “very, very narrow path” but that “I think we’re going to get there.”

“It’s going to be a good bill,” Trump said in a separate Fox News interview to air on Sunday.

For the House of Representatives’ version of healthcare, Trump held regular meetings with representatives at the White House. He celebrated the bill’s narrow passage last month in a Rose Garden event with House Republican leaders.

Trump later criticized the House bill privately as “mean” and this week called for a health plan “with heart.” He indicated the Senate plan met that request.

McConnell said in an interview with Reuters last month that he told Trump early on in the process that he did not need his help but that there may be a role for him later.

The Senate bill maintains much of the structure of the House’s but differs in key ways. It would phase out Obamacare’s expansion of the Medicaid program for the poor more gradually, waiting until after the 2020 presidential election, but would enact deeper cuts starting in 2025. It also would provide more generous tax subsidies than the House bill to help low-income people buy private insurance.

(Reporting by Jeff Mason, Richard Cowan, Susan Cornwell, Yasmeen Abutaleb, Caroline Humer, Lewis Krauskopf, Ginger Gibson and Susan Heavey; Editing by Kevin Drawbaugh and Bill Trott)

Senate Republicans unveil Obamacare replacement bill, but fate uncertain

U.S. Capitol is seen after the House approved a bill to repeal major parts of Obamacare and replace it with a Republican healthcare plan in Washington, U.S., May 4, 2017. REUTERS/Yuri Gripas

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans on Thursday unveiled legislation that would replace Obamacare with a plan that scales back aid to the poor and kills a tax on the wealthy, but the bill’s fate was quickly thrown into question as several senators voiced skepticism.

Four conservative lawmakers said they could not support it in its current form, leaving Republicans short of the votes they need for passage. Democrats are united in opposition.

The 142-page proposal, worked out in secret by a group led Senate Majority Leader Mitch McConnell, aims to deliver on a central campaign promise of President Donald Trump by rolling back former President Barack Obama’s signature healthcare law, which has provided coverage to millions of Americans since it was passed in 2010.

Republicans view the law, formally known as the Affordable Care Act, as a costly government intrusion into the private marketplace.

Trump welcomed the bill but indicated that changes may be in store.

“I am very supportive of the Senate #Healthcarebill. Look forward to making it really special!” he wrote on Twitter.

Trump urged the House of Representatives to pass a similar bill in May, only to criticize it in private as “mean” once it passed. He said on Wednesday he wanted a health plan “with heart.”

Democrats immediately attacked the legislation as a callous giveaway to the rich that would leave millions without coverage.

“The president said the House bill was mean,” said Senate Democratic leader Chuck Schumer. “The Senate bill may be even meaner.”

Obama weighed in on Facebook. “If there’s a chance you might get sick, get old, or start a family – this bill will do you harm,” he wrote.

The Senate’s most conservative members said the plan did not do enough to scale back the U.S. government’s role.

“This current bill does not repeal Obamacare. It does not keep our promises to the American people,” said Senator Rand Paul, who along with fellow Republican Senators Ted Cruz, Mike Lee and Ron Johnson said they could not support it in its current form.

Shares of hospital companies and health insurers rose on the bill’s release, with the overall S&P 500 healthcare sector closing up 1.1 percent at an all-time high.

“The initial proposal I think is more generous and more positive to the industry than expected,” said Jeff Jonas, a portfolio manager with Gabelli Funds.

SHARPER CUTS TO MEDICAID

Over months of often bitter debate, Republicans have struggled to craft legislation that lowers costs and reduces government involvement, while minimizing the inevitable disruptions that would come with a revamp of a sector that accounts for one-sixth of the world’s largest economy.

The nonpartisan Congressional Budget Office found that the House bill would kick 23 million Americans off their health plans, and the legislation is unpopular with the public. Fewer than one in 3 Americans supports it, according to Reuters/Ipsos polling.

The Senate measure maintains much of the structure of the House bill, but differs in several key ways.

The Senate bill would phase out Obamacare’s expansion of the Medicaid program for the poor more gradually than the House version, waiting until after the next presidential election in 2020, but would enact deeper cuts starting in 2025. It would also allow states to add work requirements for some of the 70 million Americans who depend on the program.

The legislation also provides more generous tax subsidies than the House bill to help low-income people buy private insurance.

Those subsidies would be based on income, rather than the age-based subsidies contained in the House bill – a “major improvement,” according to Republican Senator Susan Collins, a key moderate who has expressed concern over the bill’s impact on the poor.

The Senate legislation provides less money, however, for the opioid epidemic, allocating $2 billion in 2018, compared with $45 billion over 10 years in the House version.

Both versions would repeal the 3.8 percent net investment income tax on high earners, a key target for Republicans.

They also would repeal a penalty imposed on large employers that do not provide insurance to their workers, and remove the fine that Obamacare imposes on those who choose to go uninsured.

Policy experts said that would keep more young, healthy people out of the market and likely create a sicker patient pool.

The Senate bill would provide money to stabilize the individual insurance market, allotting $15 billion a year in 2018 and 2019 and $10 billion a year in 2020 and 2021.

It proposes defunding Planned Parenthood for a year, but abortion-related restrictions are less stringent than the House version because of uncertainty over whether they would comply with Senate rules. They could be included in another Senate bill.

McConnell said Democrats chose not to help frame the bill, which Republicans say would fix a collapsing health marketplace.

“Republicans believe we have a responsibility to act, and we are,” he said.

Democrats say they offered to help fix Obamacare but were rebuffed.

The bill’s real-world impact is not yet known, but the CBO is expected to provide an estimate early next week.

As lawmakers spoke about the legislation on the Senate floor, a protest erupted outside McConnell’s personal office, with many people in wheelchairs blocking a hallway, holding signs and chanting: “No cuts to Medicaid.” U.S. Capitol Police said 43 protesters were arrested and charged with obstruction.

Aside from the quartet of conservatives, none of the other 48 Republican senators appeared to reject the bill out of hand. But several said they would check with home-state constituents before taking a position.

“I expect there’s going to be a number of changes between now and the final vote,” said Senator John Barrasso of Wyoming.

(Additional reporting by Yasmeen Abutaleb, Caroline Humer and Lewis Krauskopf; Writing by Andy Sullivan and Steve Holland; Editing by Jonathan Oatis and Peter Cooney)