Tag Archives: Obamacare

Anthem to pare back Obamacare offerings in Nevada and Georgia

FILE PHOTO: The office building of health insurer Anthem is seen in Los Angeles, California February 5, 2015. REUTERS/Gus Ruelas/File Photo

(Reuters) – U.S. health insurer Anthem Inc <ANTM.N> said on Monday it will no longer offer Obamacare plans in Nevada’s state exchange and will stop offering the plans in nearly half of Georgia’s counties next year.

The moves come after Republican senators last month failed to repeal and replace Obamacare, former President Barack Obama’s signature healthcare reform law, creating uncertainty over how the program providing health benefits to 20 million Americans will be funded and managed in 2018.

Hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as insurers consider pulling out of those markets in the coming months.

Nevada had said in June that residents in 14 counties out of 17 in the state would not have access to qualified health plans on the state exchanges. Anthem’s decision to leave the state entirely does not increase the number of “bare counties” in the state, Nevada Insurance Commissioner Barbara Richardson said in a statement.

The insurer will still offer “catastrophic plans,” which can be purchased outside the state’s exchange and are only available to consumers under 30 years old or with a low income.

Anthem also said it will only offer Obamacare plans in 85 of Georgia’s 159 counties. It said the counties it will continue to offer the plans in are mostly rural counties that would otherwise not have health insurance coverage for their residents.

It said these changes do not impact Anthem’s Medicare Advantage, Medicaid or employer-based plans in either state.

The company said last week that it will pull out of 16 of 19 pricing regions in California in 2018 where it offered Obamacare options this year.

Anthem blamed the moves in part on uncertainty over whether the Trump administration would maintain subsidies that keep costs down.

U.S. President Donald Trump last week threatened to cut off subsidy payments that make the plans affordable for lower-income Americans and help insurers to keep premiums down, after efforts to repeal the law signed by his predecessor, President Barack Obama, failed in Congress.

Trump has repeatedly urged Republican lawmakers to keep working to undo Obama’s Affordable Care Act.

(Reporting by Michael Erman and Bill Berkrot in New York; Editing by Chizu Nomiyama and Lisa Shumaker)

Trump tells Republicans to get back on healthcare bill

U.S. President Donald Trump calls on Republican Senators to move forward and vote on a healthcare bill to replace the Affordable Care Act in the Blue Room of the White House in Washington,

By Susan Cornwell

WASHINGTON (Reuters) – U.S. President Donald Trump and members of his administration on Sunday goaded Republican senators to stick with trying to pass a healthcare bill, after the lawmakers failed spectacularly last week to muster the votes to end Obamacare.

For the second day running, the Republican president tweeted his impatience with Congress’ inability to deliver on his party’s seven-year promise to replace the Affordable Care Act, President Barack Obama’s signature healthcare bill commonly known as Obamacare. Members of his administration took to the airwaves to try to compel lawmakers to take action.

But it was unclear whether the White House admonishments would have any impact on Capitol Hill, where Republicans who control both houses signaled last week that it was time to move on to other issues.

Republicans’ zeal to repeal and replace Obamacare was met with both intra-party divisions between moderates and conservatives and also the increasing approval of a law that raised the number of insured Americans by 20 million.

Polling indicates a majority of Americans are ready to move on from healthcare at this point. According to a Reuters/Ipsos poll released on Saturday, 64 percent of 1,136 people surveyed on Friday and Saturday said they wanted to keep Obamacare, either “entirely as is” or after fixing “problem areas.” That is up from 54 percent in January.

With the U.S. legislative branch spinning its wheels, the executive branch pledged to look at rewriting Obamacare regulations. Health and Human Services Secretary Tom Price told ABC’s “This Week” that he would change those regulations that drive up costs or “hurt” patients.

Price sidestepped questions about whether there were administration plans to waive Obamacare’s mandate that individuals have health insurance, saying “all things are on the table to try to help patients.”

But Price also told NBC he would implement Obamacare because it is the “law of the land.”

That Obamacare was still law clearly angered Trump, who has no major legislative accomplishments to show for his first half-year in office. “Don’t give up Republican Senators, the World is watching: Repeal Replace …” the president said in a tweet on Sunday morning.

 

NOT ‘TIME TO MOVE ON’

On Friday, Senate Republicans failed to collect enough votes to repeal even a few parts of Obamacare. That capped a week of failed Senate votes on whether to simply repeal, or repeal and replace, the 2010 law, while Trump repeatedly berated lawmakers in a late attempt to influence the legislation.

“The president will not accept those who said, quote, ‘it’s time to move on,'” Kellyanne Conway, a senior counselor to Trump, said on Fox News Sunday. Senate Majority Leader Mitch McConnell, a Republican, had made exactly that comment before dawn on Friday morning after the failed healthcare vote.

The White House budget director, Mick Mulvaney, said on Sunday lawmakers should stay in session to get something done on healthcare – even if this means postponing votes on other issues such as raising the debt ceiling.

“So yes. They need to stay. They need to work. They need to pass something,” Mulvaney said on CNN.

The House of Representatives has already gone home for its August break and the Senate is expected to do the same by mid-August.

Mulvaney also said Trump was seriously considering carrying out threats he tweeted about on Saturday, when the president said that “if a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!”

That tweet appeared to be referring to the approximately $8 billion in cost-sharing reduction subsidies the federal government pays to insurers to lower the price of health coverage for low-income Americans.

The Saturday tweet also appeared to be a threat to end the employer contribution for members of Congress and their staffs, who were moved from the normal federal employee healthcare benefits program onto the Obamacare insurance exchanges as part of the 2010 healthcare law.

“What he’s saying is, look, if Obamacare is hurting the American people – and it is – then why shouldn’t it hurt insurance companies and more importantly, perhaps for this discussion, members of Congress?” Mulvaney said on Sunday on CNN.

Some Republicans have said they are trying to find a way forward on healthcare. Senate Republican Susan Collins, one of three Republicans who voted against repealing parts of Obamacare on Friday, told NBC that Congress should produce a series of bills with bipartisan input on healthcare, including appropriating the cost-sharing subsidies.

The Senate has one vote scheduled when it reconvenes on Monday afternoon: whether to confirm a U.S. circuit court judge. Senate aides said they had no guidance for the agenda beyond that vote.

 

(Additional reporting by Sarah N. Lynch, Roberta Rampton, and Caren Bohan; Editing by Phil Berlowitz and Mary Milliken)

 

Hundreds of counties at risk for no Obamacare insurer in 2018

FILE PHOTO: Healthcare activists protest against the Republican healthcare bill on Capitol Hill in Washington, U.S., July 19, 2017. REUTERS/Aaron P. Bernstein

By Caroline Humer

NEW YORK (Reuters) – With Republican efforts to dismantle Obamacare in disarray, hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as insurers consider pulling out of those markets in the coming months.

Republican senators failed this week to repeal and replace Obamacare, former President Barack Obama’s signature healthcare reform law, creating new uncertainty over how the program providing health benefits to 20 million Americans will be funded and managed in 2018.

In response, Republican President Donald Trump on Friday again suggested that his administration would let the Obamacare program “implode.” He has weakened enforcement of the law’s requirement for individuals to buy insurance, threatened to cut off funding and sought to change plan benefits through regulations.

Anthem Inc, Cigna Corp, Health Care Service Corp and Molina Healthcare, four of the biggest health insurers selling Obamacare plans, said they are weighing whether to pull out of more markets for 2018 rather than face financial losses. They have until Sept. 27 to finalize their plans.

So far, 40 U.S. counties are expected to have no insurer offering individual coverage next year, but that number could rise by the hundreds, according to U.S. government data, Kaiser Family Foundation analysis and insurer disclosures. More than 1,300 counties, primarily in 15 states, currently have only one insurer participating in 2018. Anthem and HCSC are the last man standing in one-third of those counties and states – putting those areas in particular at risk.

“Right now the number of counties at immediate risk of having no insurers in 2018 is small, but it could easily grow significantly if a couple major insurers decide to exit,” Larry Levitt, health economist at the Kaiser Family Foundation, said.

Many insurers have been waiting for an answer from Trump or lawmakers on whether they will continue to fund $8 billion in annual government subsidies. Without assurances, many insurers plan to raise rates an additional 20 percent by an Aug. 16 deadline for premium prices. Others say that the many unknowns will make the business too risky.

The last-minute drama has left millions of Americans questioning whether they will have medical coverage next year.

Julie Grady, a 59-year-old small business owner in Carson City, Nevada, is currently covered by Blue Cross Blue Shield of Nevada, part of Anthem, which has already decided to leave the exchanges in her county and most of the state. Carson City will have no insurer on the exchanges next year.

Grady’s pays a reduced premium of $70 per month and a deductible under $1,000 for her plan, which is part of the Affordable Care Act, commonly called Obamacare. Grady is looking at being uninsured, as she was before the law.

“I would have to go without health insurance,” she said. “I would just stay healthy, hike, eat well. I’d be in trouble if something catastrophic happened. I would lose everything.”

ANTHEM CONSIDERING 2018 PLANS

Anthem, the second-largest U.S. health insurer, sells Blue Cross Blue Shield plans in 14 states. It has already decided to pull out of most individual markets in Nevada, Ohio, Indiana and Wisconsin in 2018. Earlier this week, Chief Executive Officer Joe Swedish said he was still weighing 2018 participation in its other states.

In states like Colorado, Georgia, Kentucky, Missouri, and Virginia, Anthem sells plans in more than 250 counties where it is the only insurer, and they could be left “bare” next year, according to government data.

Health Care Services Corp is a Blue Cross Blue Shield licensee in five states and is the only Obamacare individual insurer in more than 90 Texas counties, more than 75 Oklahoma counties, and half a dozen Illinois counties. It confirmed on Friday that it has submitted products for its five states but is still weighing next year.

“We’re working through the regulatory filing process and hope to fully participate…in 2018, however no final decisions have been made,” HCSC spokeswoman Kristen Cunningham said.

Molina, which has more than 1 million members in Obamacare plans, and Cigna, with more than 250,000 participants, have said they need more certainty from the government to decide on 2018 participation and would weigh their decisions up until the late September deadline.

State insurance regulators have worked hard in recent months to replace insurers who have left. In Nevada, for instance, Centene Corp and Aetna Inc entered in some counties that Anthem left after the insurance commissioner said he would favor these insurers for its Medicaid contract bids.

But they are unlikely to find replacements for new dropouts in these final weeks, particularly if the Trump administration signals it won’t fund $8 billion in subsidies for out-of-pocket medical costs.

“There is almost no chance they would step in to participate,” said Kurt Wrobel, a fellow at the Society of Actuaries and chief financial officer of the Geisinger Health Plan in Pennsylvania.

Some insurers say they will likely just raise rates and hope it works. Blue Cross Blue Shield of Michigan filed two sets of rates with the state department of insurance, one up to 32 percent higher if the fate of subsidies remains unclear.

“We don’t have any plans to pull out,” said Rick Notter, director of the individual business at BCBS Michigan. “But it would certainly help to have more certainty around what the market holds.”

(Additional reporting by Jilian Mincer; Editing by Michele Gershberg and Cynthia Osterman)

Republican effort to gut Obamacare crashes in U.S. Senate

The United States Capitol is seen prior to an all night round of health care votes on Capitol Hill in Washington, U.S., July 27, 2017. REUTERS/Aaron P. Bernstein

By Yasmeen Abutaleb, Amanda Becker and David Morgan

WASHINGTON (Reuters) – A U.S. Senate led by Donald Trump’s fellow Republicans failed by a single vote to pass a healthcare bill on Friday, delivering a stinging blow to the president as it undermined his campaign promise to dismantle Obamacare.

Three Republican senators – John McCain, Susan Collins and Lisa Murkowski – joined Senate Democrats in the dramatic early-morning 51-49 vote rejecting the bill. The outcome may spell doom for the party’s seven-year quest to gut a 2010 law that was Democratic former President Barack Obama’s signature domestic policy achievement.

For the moment the Affordable Care Act, which extended health insurance to 20 million people and drove the percentage of uninsured people to historic lows, remains in place and must be run by an administration that is hostile to it.

This leaves health insurers unsure how long the administration will continue to make billions of dollars in Obamacare payments that help cover out-of-pocket medical expenses for low-income Americans.

In Friday’s vote, Senate Majority Leader Mitch McConnell was unsuccessful in securing passage of even a stripped-down so-called skinny bill that would have repealed a few key parts of Obamacare. Broader legislation was defeated earlier in the week.

“It’s time to move on,” McConnell, whose reputation as a master strategist was in tatters, said on the Senate floor after the vote that unfolded at roughly 1:30 a.m.

“The American people are going to regret that we couldn’t find a better way forward,” McConnell added.

Republicans have long denounced Obamacare – which expanded the Medicaid health insurance for the poor and disabled and created online marketplaces for individuals to obtain coverage – as an intrusion by government on people’s healthcare decisions.

The Senate failure to move forward on dismantling it called into question the Republican Party’s basic ability to govern even as it controls the White House, Senate and House of Representatives.

Trump has not had a major legislative victory after more than six months in office. He had promised to get major healthcare legislation, tax cuts and a boost in infrastructure spending through Congress in short order.

“3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode, then deal. Watch!” Trump wrote on Twitter after the vote.

But McCain wrote on Twitter, “Skinny repeal fell short because it fell short of our promise to repeal & replace Obamacare w/ meaningful reform.”

Republicans released the skinny bill just three hours before voting began. It would have retroactively repealed Obamacare’s penalty on individuals who do not obtain health insurance, repealed for eight years a penalty on certain businesses that do not provide employees with insurance and repealed a tax on medical devices until 2020. The nonpartisan Congressional Budget Office estimated that if it became law, 15 million fewer Americans would be insured in 2018 than under existing law.

The Affordable Care Act was passed by a then-Democratic controlled Congress with no Republican support in 2010. But Republicans have failed to come up with a consensus plan to replace it at a time when they hold all the power in Washington.

UNCERTAINTY FOR HEALTHCARE INDUSTRY

Health insurers have until September to finalize their 2018 health plans in many Obamacare marketplaces.

Some insurers, including Humana and Aetna, have pulled out of such markets, citing the uncertainty over the payments. Others have raised rates by double digits and said that they will need to raise rates another 20 percent if the uncertainty does not ease. Anthem Inc, which has already left three of the 14 states where it sells Blue Cross Blue Shield plans, said this week it might pull out of more.

Wall Street traded lower on Friday with less focus on the news from the Senate overnight and more on key earnings from Amazon and Exxon. Shares of hospitals were mixed: Tenet Healthcare fell 2 percent, Community Health Systems was nearly flat and HCA Healthcare gained 1.2 percent. Shares of health insurers were also mixed. Aetna was off 0.2 percent, Anthem gained 0.4 percent and Humana was off 0.3 percent.

Democrats, and some Republicans, said the bill’s failure could present an opportunity for the two parties to work together to fix problematic areas of the Obamacare law without repealing it.

Top House Democrat Nancy Pelosi called on Republican House Speaker Paul Ryan to establish a process for moving forward on improving Obamacare, rather than repealing it.

After the House passed a bill to repeal and replace Obamacare in May, McConnell grappled to get Senate Republicans to agree on their version of the bill. Hard-line conservatives wanted a bill that would substantially gut Obamacare, while moderates were concerned over legislation that could deprive millions of people of their healthcare coverage.

Republicans hold a 52-48 majority in the 100-seat Senate and could afford to lose support from only two Republican senators, with Vice President Mike Pence ready to cast a tie-breaking vote on the Senate floor.

DRAMA OVER MCCAIN

As the vote on the skinny bill approached, all eyes in the Senate chamber were on McCain. The 2008 Republican presidential nominee flew back from Arizona earlier in the week after being diagnosed this month with brain cancer. McCain, an 80-year-old former prisoner of war in Vietnam who tangled with Trump during the 2016 election campaign and was disparaged by him, won praise for this from the president.

McCain, a veteran senator who has long been known for his independent streak, delivered a rousing speech on Tuesday calling for cooperation between the parties and then cast a decisive vote in allowing the Senate to take up the healthcare bill.

Early on Friday, he sat on the Senate floor talking to Collins, Murkowski, and Republican Senator Jeff Flake, also from Arizona. Collins and Murkowski both voted this week against broader Republican healthcare proposals, and both had concerns about the pared-down proposal.

McCain was approached before voting began by Pence and a close friend, Republican Senator Lindsey Graham. After speaking to them, McCain walked across the Senate floor to tell top Senate Democrat Chuck Schumer and other Democrats he would vote with them.

When McCain walked to the front of the Senate chamber to cast his deciding “no” vote, giving a thumbs down, Democrats cheered, knowing the bill would fail.

Trump had often expressed exasperation over the failure of congressional Republicans to overcome internal divisions to repeal Obamacare, but offered no policy specifics himself.

He has demanded at various times that Obamacare should be allowed to collapse on its own, that it should be repealed without replacement, and that it should be repealed and replaced.

(Additional reporting by Susan Cornwell, Richard Cowan and Eric Walsh in Washington, Saikat Chatterjee and Abhinav Ramnarayan in London; Writing by Will Dunham; Editing by Louise Ireland and Frances Kerry)

Senate poised for healthcare showdown

Senate Majority Leader Mitch McConnell, accompanied by Senator John Cornyn (R-TX) and Senator John Barrasso (R-WY), speaks with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington, U.S., July 25, 2017. REUTERS/Aaron P. Bernstein

By Amanda Becker and Yasmeen Abutaleb

WASHINGTON (Reuters) – U.S. Senate Republicans begin their final push on Thursday to unravel Obamacare, seeking to wrap up their seven-year offensive against former Democratic President Barack Obama’s signature healthcare law that extended insurance coverage to millions.

Republicans leaders hope a pared-down “skinny” bill that repeals several key Obamacare provisions can gain enough support to pass after several attempts at broader legislation failed to win approval earlier this week.

The skinny bill’s details will be released at some point on Thursday, before the Senate embarks on a marathon voting session that could extend into Friday morning. The legislation is expected to eliminate mandates requiring individuals and employers to obtain or provide health insurance, and abolish a tax on medical device manufacturers.

The effort comes after a chaotic two-month push by Senate Republicans to pass their version of legislation that made it out of the Republican-controlled House of Representatives in May.

Members of the party, including President Donald Trump, campaigned on a pledge to repeal and replace what they say is a failing law that allows the government to intrude in people’s healthcare decisions.

Republicans were optimistic about the skinny bill’s chances of receiving at least 50 votes in the Senate where they hold a 52-48 majority.

Senator John Cornyn, the chamber’s No. 2 Republican, said the bill, once approved, would go to a special negotiating committee of lawmakers from both chambers that would reconcile the House and Senate versions into a single piece of legislation.

Republican leaders had tapped a group to craft legislation largely behind closed doors, exposing rifts within the party. While conservatives said the group’s proposals did not go far enough, moderates said they could not support measures estimated to deprive tens of millions of health insurance.

The Senate voted 55-45 on Wednesday against a simple repeal of Obamacare, which would have provided a two-year delay so Congress could work out a replacement. Seven Republicans opposed the bill. On Tuesday, senators rejected the repeal-and-replace plan Republicans had been working on since May.

Senate Majority Leader Mitch McConnell can lose only two Republican votes to pass healthcare legislation. Even then, he would have to call on Vice President Mike Pence to cast a tie-breaking vote as head of the Senate. Democrats are united in opposition.

GOVERNORS SEEK INVOLVEMENT

A bipartisan group of 10 governors urged senators in a letter on Wednesday to start over and use a drafting process that includes governors from both parties. Governors of Nevada, Ohio, Louisiana, Pennsylvania and Colorado were among those who signed the letter, all of whose states have Republican senators.

The Congressional Budget Office, a nonpartisan research agency, estimated on Wednesday that a combination of provisions that might go into the skinny bill would lead to 16 million people losing their health coverage by 2026.

It had earlier estimated that the two other bills rejected by the Senate this week would have led to 22 million to 32 million people losing their health insurance by 2026.

Senate Democratic leader Chuck Schumer criticized Republican leaders for crafting a “yet-to-be-disclosed final bill” in secret.

“We don’t know if skinny repeal is going to be their final bill, but if it is, the CBO says it would cause costs to go up, and millions to lose insurance,” Schumer said on the Senate floor.

(Additional reporting by Susan Cornwell, Richard Cowan and David Morgan; Writing by Lisa Lambert; Editing by Peter Cooney)

Brawl over Obamacare repeal returns to Senate floor

Senate Majority Leader Mitch McConnell, accompanied by Senator John Cornyn (R-TX) and Senator John Barrasso (R-WY), speaks with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington, U.S., July 25, 2017. REUTERS/Aaron P. Bernstein

By Richard Cowan

WASHINGTON (Reuters) – After a months-long struggle, Republicans have succeeded in bringing Obamacare repeal legislation, a centerpiece of their 2016 election campaigns, to a debate on the U.S. Senate floor. Now the hard part begins.

Republicans, deeply divided over the proper role of the government in helping low-income people receive healthcare, eked out a procedural win on Tuesday when the Senate voted 51-50, with Vice President Mike Pence breaking a tie, to allow debate to start on legislation.

The outcome came as a huge relief to President Donald Trump, who has called Obamacare a “disaster” and pushed fellow Republicans in recent days to follow through on the party’s seven-year quest to roll back the law.

But hours later, Senate Republican leadership suffered a setback when the repeal and replace plan that they had been working on since May failed to get enough votes for approval, with nine out of 52 Republicans voting against it.

Usually, bills reach the floor with a predictable outcome: Senators have received summaries of the legislation to be debated that were written in an open committee process, leaders have counted the number of supporters and opponents, amendments are debated and everybody knows the likely outcome: passage.

All that is out the window now, as the Senate on Wednesday continues a freewheeling debate that could stretch through the week on undoing major portions of former Democratic President Barack Obama’s signature Affordable Care Act, which expanded health insurance to about 20 million people, many of them low-income.

Republican leaders have insisted they can devise a cheaper approach this week and with less government intrusion into consumers’ healthcare decisions than Obamacare.

Democrats and other critics of the Republican effort said it would deprive millions of health coverage.

“We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition,” Republican Senator John McCain said on Tuesday.

“I don’t think that is going to work in the end. And it probably shouldn’t,” he added.

The veteran Arizona lawmaker made his remarks after receiving a standing ovation from his colleagues, as he returned to the Senate just days after surgery and being diagnosed with brain cancer.

McCain appealed to Senate Majority Leader Mitch McConnell to start over by having a Senate committee, in a bipartisan way, craft new healthcare legislation.

His proposal was promptly ignored.

‘SKINNY’ BILL GETS TRACTION

As senators grind through potentially scores of amendments in coming days – in a process called a “vote-a-rama” – they will have more than McCain’s scorn to worry about.

Healthcare industry organizations are similarly troubled.

“We strongly oppose all plans so far to replace the Affordable Care Act and have no confidence lawmakers can overcome the flaws in these proposals,” said America’s Essential Hospitals, a group representing hospitals that treat poor people.

Like McCain, the group urged the Senate, narrowly controlled by Republicans, to halt its work on Obamacare repeal legislation and begin a bipartisan effort on healthcare.

The Republican drive to “repeal and replace” Obamacare has taken many unexpected turns since the House of Representatives began working on its version of legislation last March.

For now, many Republican senators are wondering whether they may end up going to a Plan B – a “skinny” healthcare bill that would simply end Obamacare’s penalties for individuals and employers that do not obtain or provide health insurance, as well as abolish a medical device tax.

It would then be up to a special Senate-House committee to come up with a final bill that could take many turns during the negotiation.

After Tuesday’s nail-biter Senate vote setting up the floor debate, McConnell may have best summed up the landscape facing the chamber’s 100 senators.

“This is just the beginning,” he told reporters.

(Reporting by Richard Cowan; additional reporting by Susan Cornwell; Editing by Mary Milliken, Peter Cooney and Michael Perry)

McCain to return for pivotal Senate vote on healthcare

FILE PHOTO: Senator John McCain (R-AZ) speaks to reporters after the Senate voted to remove the filibuster rule for Supreme Court nominees, on Capitol Hill in Washington, U.S., April 6, 2017. REUTERS/Joshua Roberts/File Photo

By James Oliphant

WASHINGTON (Reuters) – Senator John McCain will make a return to the U.S. capitol on Tuesday to play what could be a crucial role in keeping Republican efforts to repeal Obamacare afloat.

McCain, who is battling brain cancer at his Arizona home, is set to help decide whether the repeal push will move forward or perhaps be abandoned entirely.

Senators will be asked whether to begin debate on the Senate floor on a healthcare overhaul that would supplant the 2010 Affordable Care Act, better known as Obamacare.

A loss would force Senate leaders, who have struggled to amass support for their version of an overhaul, to find another strategy or move on to other legislative matters.

President Donald Trump has been increasingly critical of Republican senators and their failure to pass a bill. Trump held an event at the White House on Monday in which he chastised them, saying they “have not done their job in ending the Obamacare nightmare.”

The vote in the divided chamber was expected to be extremely tight, making McCain’s return critical to the repeal effort.

McCain has said that he typically votes to open legislative debates such as these, but has also voiced concerns about the Senate bill and said he would try to address them on the floor.

He was diagnosed with an aggressive form of brain cancer earlier this month after surgery to remove a blood clot and had not been expected to attend Tuesday’s vote. His office, however, released a statement late Monday announcing his return.

Should enough Republicans vote to move forward, senators would begin debating the bill that passed the U.S. House of Representatives in April. But that bill likely would be heavily modified through the amendment process.

Some senators said it was time to either tackle the issue on the Senate floor or move on to other matters.

“Now it’s time to fish or cut bait,” said Republican Senator Mike Rounds. “Let’s get on with it. We have a lot of other things to do.”

No Democrat is expected to vote in favor of opening debate, meaning that Republicans, who hold 52 seats in the 100-seat chamber, cannot afford to lose more than two of their own.

Senator Susan Collins has been the only Republican who has publicly said she will vote against opening debate, but it remained possible that she could be joined by other Republicans concerned about the form the legislation might ultimately take.

Vice President Mike Pence, a Republican who is expected to be on Capitol Hill on Tuesday, would step in the case of tie and vote to move forward.

(Reporting by Amanda Becker, Susan Cornwell, Richard Cowan and James Oliphant; Writing by James Oliphant; Editing by Mary Milliken and Michael Perry)

Republicans’ push to roll back Obamacare faces crucial test

President Donald Trump (C) gathers with Vice President Mike Pence (R) and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, May 4, 2017.

By Amanda Becker

WASHINGTON (Reuters) – A seven-year Republican effort to repeal and replace Obamacare faces a major test this week in the U.S. Senate, where lawmakers will decide whether to move forward and vote on a bill whose details and prospects are uncertain.

The Senate will decide as early as Tuesday whether to begin debating a healthcare bill. But it remained unclear over the weekend which version of the bill the senators would ultimately vote on.

President Donald Trump, after initially suggesting last week that he was fine with letting Obamacare collapse, has urged Republican senators to hash out a deal.

“Republicans have a last chance to do the right thing on Repeal &amp; Replace after years of talking &amp; campaigning on it,” Trump tweeted on Monday.

Republicans view former President Barack Obama’s signature 2010 health law, known as Obamacare, as a government intrusion in the healthcare market. They face pressure to make good on campaign promises to dismantle it.

But the party is divided between moderates, concerned that the Senate bill would eliminate insurance for millions of low-income Americans, and conservatives who want to see even deeper cuts to Obama’s Affordable Care Act.

The House in May passed its healthcare bill. Senate Republicans have considered two versions but have been unable to reach consensus after estimates showed they could lead to as many as 22 million fewer Americans being insured. A plan to repeal Obamacare without replacing it also ran aground.

If the Senate approves a motion to begin debating a healthcare bill, Majority Leader Mitch McConnell will determine which proposal has the most Republican support and move forward to a vote, Republicans said.

Republicans hold 52 of 100 Senate seats. McConnell can only afford to lose two Republican votes as Democrats are united in opposition.

Senator John Barrasso, a member of the Republican leadership, acknowledged on Sunday that there remained a lack of consensus among Republicans.

“Lots of members have different ideas on how it should be best amended to replace what is really a failing Obama healthcare plan,” Barrasso said on CBS’s “Face the Nation.”

The Republican effort has also been complicated by the absence of Senator John McCain, who has been diagnosed with brain cancer and is in his home state of Arizona weighing treatment options.

 

(Reporting By Amanda Becker; Additional reporting by Susan Heavey; Editing by Caren Bohan and Nick Zieminski)

 

Republicans meet late into night as Trump demands new healthcare plan

Senate Majority Leader Mitch McConnnell, R, and Senator Richard Shelby, L, (R-AL) listen as U.S. President Donald Trump speaks during a meeting with Senate Republicans to discuss healthcare at the White House in Washington, U.S., July 19, 2017. REUTERS/Kevin Lamarque

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – Republicans struggling to agree on healthcare legislation to overhaul Obamacare obeyed U.S. President Donald Trump’s orders to try to swiftly reach a deal but were unable to resolve their differences in a long, late-night meeting.

Earlier on Wednesday, Trump took Senate Republicans to task for failing to agree on how to dismantle Obamacare, as a new report showed 32 million Americans would lose health insurance if senators opt to repeal the law without a replacement.

Trump gathered 49 Republican senators for a White House lunch after a bill to repeal and replace the 2010 Affordable Care Act collapsed on Monday amid dissent from a handful of the party’s conservatives and moderates.

After Trump’s exhortation to keep trying, party members met with Health and Human Services Secretary Tom Price behind closed doors on Wednesday night to try to finally come together on a major Republican promise of the past seven years – undoing former Democratic President Barack Obama’s signature legislation, popularly known as Obamacare.

There was no immediate breakthrough.

“We still have some issues that divide us,” said Senator Ted Cruz, a conservative who has proposed letting insurers offer cheaper bare-bones plans that do not comply with Obamacare regulations.

Republicans attending the late meeting sent their staff away in order to talk frankly and Senator John Kennedy said everyone was negotiating in good faith but he added he did not know if they would reach agreement.

Almost all the other senators rushed off after the meeting without comment.

As it was getting underway, the nearly two dozen Republican senators were shaken by news that their colleague, veteran Senator John McCain, had been diagnosed with brain cancer.

McCain’s absence from the Senate makes the job of passing a healthcare bill more difficult because leaders need every Republican vote they can get.

“Obviously, I think more people are worried about his health than thinking about the math. You understand the math. Obviously it makes things difficult,” Senator Bob Corker said as he left the meeting.

Trump had taken a hands-off approach to the healthcare debate last week and suggested on Tuesday that he was fine with letting Obamacare fail. Then on Wednesday he switched course and demanded senators stay in Washington through their planned August recess until they find common ground on healthcare.

“We can repeal, but we should repeal and replace, and we shouldn’t leave town until this is complete,” Trump said at the meeting.

Trump made the repeal and replacement of Obamacare, which he has called a “disaster,” a central promise of his 2016 campaign.

Even with Trump’s new push, Republican leaders in the Senate face a difficult task getting moderates and conservatives to agree on an overhaul that can pass.

Senate Majority Leader Mitch McConnell had planned to hold a straight repeal vote next week, but several Republican senators have already said they oppose that approach.

Thirty-two million Americans would lose their health insurance by 2026 if Obamacare is scrapped without an alternative in place, the nonpartisan Congressional Budget Office reported on Wednesday, while 17 million would become uninsured next year alone.

At the same time, premiums on individual insurance plans would rise 25 percent next year and double by 2026.

The CBO’s estimates were unchanged from a previous report that assessed the impact of a 2015 bill to repeal Obamacare that passed the House of Representatives and Senate and was vetoed by Obama.

‘TRUE DEATH SPIRAL’

Democrats were swift to highlight the CBO’s assessment, while Republicans remained silent.

“President Trump and Republicans have repeatedly promised to lower premiums and increase coverage, yet each proposal they offer would do the opposite,” Senate Democratic leader Charles Schumer said in a statement.

Insurers and hospitals have lobbied against straight repeal, saying the limbo would increase uncertainty and their costs.

“CBO projects half the country would have no insurers in the individual market by 2020 under the new repeal bill. That’s a true death spiral,” tweeted Larry Levitt, vice president at the Kaiser Family Foundation, a healthcare research group.

Republicans say Obamacare is a costly intrusion into the healthcare system.

But the party is divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to Obamacare, which boosted the number of Americans with health insurance by 20 million through mandates on individuals and employers, and income-based subsidies.

Moderate Republican Senators Susan Collins, Lisa Murkowski and Shelley Moore Capito said they opposed McConnell’s plan for a repeal that would take effect in two years. All three attended the lunch with Trump.

With Democrats united in opposition to repeal, McConnell can only lose two votes from the Republicans’ 52-48 majority in the 100-seat Senate to pass healthcare legislation.

Opponents of repeal protested throughout Senate buildings on Wednesday afternoon, leading to 155 arrests, police said. Demonstrators returned in the evening to yell as senators arrived for the meeting.

Party fractures also emerged in the House of Representatives. The chamber passed a plan to repeal and replace Obamacare in May. But on Wednesday, the House Freedom Caucus, the Republican Party’s conservative wing, filed a petition to vote on a straight repeal.

House Speaker Paul Ryan’s spokeswoman, AshLee Strong, said: “The House passed an Obamacare repeal-and-replace bill we are proud of and we hope the Senate will take similar action.”

(Writing by John Whitesides and Lisa Lambert; Additional reporting by Susan Cornwell, Richard Cowan, Yasmeen Abutaleb and Susan Heavey; Editing by Leslie Adler, Peter Cooney and Richard Pullin)

Trump chides Senate Republicans on healthcare, says it is time for action

Seated between Senators Dean Heller (R-NV), L, Tim Scott (R-SC), U.S. President Donald Trump meets with Senate Republicans to discuss healthcare at the White House in Washington, U.S., July 19, 2017. REUTERS/Kevin Lamarque

By Steve Holland and Amanda Becker

WASHINGTON (Reuters) – U.S. President Donald Trump scolded Senate Republicans on Wednesday for failing to reach agreement on repealing or overhauling Obamacare, demanding they keep their campaign promises and find a new healthcare approach.

Trump told 49 senators who came to a White House lunch that they should not leave Washington for a planned August recess until they can find common ground on healthcare.

“We’re close. We’re very close,” Trump said at the start of the lunch meeting, a day after the seven-year Republican quest to repeal and replace Democratic former President Barack Obama’s signature healthcare law seemed to collapse in the Senate.

“For seven years you promised the American people you would repeal Obamacare. People are hurting and, frankly, inaction is not an option,” Trump told the Republican lawmakers. “Any senator who votes against starting debate is really telling America that you’re fine with Obamacare.”

Senate Majority Leader Mitch McConnell has vowed to go ahead with a vote early next week on a repeal of the Affordable Care Act, popularly known as Obamacare, despite indications it will fail after the defections on Tuesday of at least three Republican senators.

Moderate Republican senators Susan Collins of Maine, Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia said they oppose McConnell’s plan for a repeal that would take effect in two years, giving Congress time to develop a replacement. All three attended the lunch.

With Democrats united in opposition to repeal, McConnell can only lose two votes from his 52-48 majority in the 100-seat Senate to pass healthcare legislation.

Trump, who had not been heavily involved in lobbying the Senate on the issue until this week, said he wanted more than a straight repeal vote and wanted the Senate to pass a replacement measure as well.

“We can repeal, but we should repeal and replace and we shouldn’t leave town until this is complete,” he said.

Capito, speaking to reporters ahead of the meeting on Wednesday, expressed some doubts the Senate vote on a repeal-only healthcare bill would actually occur next week. “It’s changing so quickly,” she said.

“I think we’re probably going to air what our differences are again. The president has taken a lot of time to try to call us all individually,” said Capito. “I don’t think anyone’s mind is going to get changed sitting right there, but it gives us a chance to frame it where we have our differences.”

‘HONOR OUR PROMISE’

Repealing and replacing Obamacare was a top campaign promise for Trump and Republicans in Congress, who say it is a costly intrusion into the healthcare system.

But the reality has been difficult for a party divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to Obamacare, which boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies.

“We have to honor our promise,” Republican Senator Ted Cruz told reporters. “For seven years Republicans have told the voters, if you elect us, we’ll repeal Obamacare. I think we will look like fools if we can’t deliver on that promise.”

Republican Senator Orrin Hatch said it was a tough issue for Trump, but “I suspect he could be a little bit more forceful and I hope he will be. I think he needs to.”

Democrats, clearly delighted with the turn of events, have welcomed the Republicans’ failure to replace Obamacare as an opportunity to work together. Republicans conceded their other options may be exhausted.

The No. 2 Senate Republican, John Cornyn, told reporters it was “unfortunate” that he expected bipartisan talks to begin.

“Democrats are strongly committed to Obamacare and are unwilling to admit structural problems, which create the problems we are having in the individual market today,” Cornyn said. “But we’ll do the best we can with the hand we’ve been dealt.”

If senators try to shore up Obamacare, an initial hurdle in coming weeks will be boosting faltering state insurance markets by ensuring that insurers keep receiving subsidies that help lower the cost of insurance for low-income individuals.

The Trump administration will continue making the subsidy payments through August while a related Republican lawsuit is pending. The uncertainty beyond that has rattled insurers.

Republican senators have acknowledged the need to address the unstable markets but resisted Democratic calls to fund the subsidies without accompanying reforms, calling it a “bailout” for insurance companies.

Funding for the Children’s Health Insurance Program, a part of the Medicaid government health insurance program for the poor and disabled, known as CHIP, expires on Sept. 30 and will require reauthorization.

Bills to address the subsidy payments and CHIP would likely require 60 votes for passage, acting as a barometer of how inclined Republicans and Democrats are to work together, industry lobbyists and experts said.

Trump suggested on Tuesday that Republicans should allow the insurance markets to fail before working with Democrats. But Republican Senator Lamar Alexander, the head of the Senate Committee on Health, Labor and Pensions, said he would begin holding hearings on the issue in the next few weeks.

(Writing by John Whitesides; Additional reporting by Susan Cornwell, Richard Cowan, Yasmeen Abutaleb and Susan Heavey; Editing by Jonathan Oatis and Nick Zieminski)