Two new polls on Thursday show a sizable bipartisan majority of Americans wanting Republicans and Democrats to work together on health-care legislation, rather than the GOP trying to repeal and replace ObamaCare on its own. In a CNN/SSRS poll, 77 percent of respondents said they would like to see Republicans work with Democrats to pass a health bill with bipartisan support, including 69 percent of Republicans, while only 12 percent of all respondents (and 25 percent of Republicans) wanted the GOP to continue going it alone.
When asked how they would like Congress to handle ObamaCare, 35 percent said they wanted President Trump and the GOP to just abandon trying to change the law and keep it as is, 34 percent said they wanted to see parts of ObamaCare repealed only when a replacement was ready, and 18 percent (and 30 percent of Republicans) said they wanted ObamaCare scrapped, replacement or no.
In an Associated Press/NORC poll also released Thursday, 8 in 10 respondents — including 66 percent of Republicans — said they wanted Republicans to approach Democrats to negotiate, and almost 90 percent wanted Democrats to take the GOP up on that prospective offer, including 81 percent of Democrats. In the AP poll, solid majorities of voters opposed all the major parts of the GOP replacement plan, though they also did not seem enthusiastic about ObamaCare's individual mandate. And a growing majority, 62 percent, said the federal government has a responsibility to make sure all Americans have health coverage, while 37 percent disagreed.
The CNN/SSRS poll was conducted July 14-18 among 1,019 adults, and has a margin of sampling error of plus or minus 3.7 percentage points. The AP/NORC poll was conducted July 13-17, also among 1,019 adults, and has a margin of sampling error of plus or minus 4.1 points. Peter Weber
Late-night Senate GOP meeting to resuscitate ObamaCare repeal ends with cautious optimism, little progress
A group of at least 20 Republican senators met for nearly three hours in Sen. John Barrasso's (R-Wyo.) office on Wednesday night, hoping to hash out their differences on health-care legislation and revive a push to repeal and maybe replace the Affordable Care Act that had been declared dead earlier this week. At various points, Senate aides and members of President Trump's Cabinet were part of the meeting, but the get-together ended with just the GOP senators talking among themselves. "We're at our best when we're among ourselves," Sen. John Kennedy (R-La.) said afterward.
Several senators said after the meeting that it was productive and made them more optimistic that they could pass some form of ObamaCare repeal next week, though none of them was sure what legislation Senate Majority Leader Mitch McConnell (R-Ky.) will have them vote on. The senators said there were no breakthroughs, however, and they still appear to be short the votes to pass either McConnell's repeal-and-replace bill or the repeal-and-delay backup plan, especially with Sen. John McCain (R-Ariz.) sidelined by brain cancer treatment. "We do have work to do to get to a vote of 50," Barrasso said.
Unidentified people familiar with the meeting told The Washington Post it had been set up by the White House to help persuade reluctant senators to support McConnell's repeal-and-replace bill, though at least two of the four GOP senators on record opposing that bill — Sens. Rand Paul (Ky.) and Susan Collins (Maine) — did not attend; Barrasso told Politico the meeting had been planned before Wednesday's lunch at the White House, where Trump had told GOP senators to give up their August recess to work on health-care legislation and needled senators wary of the bill. Between the lunch meeting and late-night conference, the Congressional Budget Office estimated that the repeal-and-delay bill would leave 17 million more people uninsured next year and 32 million more uninsured in a decade. Peter Weber
Senate Majority Leader Mitch McConnell (R-Ky.) insists he will hold (and probably lose) a vote on repealing without replacing the Affordable Care Act, the idea presumably being that after seven years of promising to scrap ObamaCare, Republican senators will be pressured to follow through.
President Trump has moved on to blaming Democrats and vowing to let ObamaCare fail, but "there is no way to spin to those who were promised that the Affordable Care Act would be repealed and replaced once Republicans held full power in Washington that what has happened is the fault of forces outside the party," says Dan Balz at The Washington Post. "It is as though Republicans unknowingly set a trap and then walked into it without having prepared escape routes." He argues that Republican voters will punish the party in 2018:
The failed promise to repeal and replace ObamaCare surely will affect the mood and enthusiasm of the Republican base heading toward 2018. When the Gallup organization asked Americans about the future of the Affordable Care Act recently, 30 percent overall said they favored "repeal and replace," but 70 percent of Republicans supported that option. GOP lawmakers will have left them empty-handed, perhaps disillusioned. [Washington Post]
That's certainly the "unexamined conventional wisdom," says the Kaiser Family Foundation's Drew Altman at Axios, but "when you look at the polling, the idea that the base will rise up and punish Republicans if they don't repeal the ACA appears to be exaggerated, and possibly even a political fiction." Altman points to KFF polls showing that only 7 percent of Trump voters and 5 percent of Republican voters listed health care as their top concern.
— Axios (@axios) July 19, 2017
Republicans don't like ObamaCare, but November 2018 is a long way away and they have bigger fish to fry, Altman says. "The one thing most likely to keep the ACA on the agenda now would be an effort by the administration to undermine it, and it's far from clear who benefits and loses politically from that." In fact, former Rep. Tom Davis (R-Va.) tells The Washington Post, "Republicans might have gotten a break by not seeing an unpopular law go into effect. Sometimes, having no law is better than having one that people perceive as bad law." Peter Weber
Republicans decided last fall that they would use their unexpected control of the White House and Congress to quickly repeal the Affordable Care Act and move on, but as their replacement legislation faces yet another delay and continued uncertainty in the Senate, it is clearer than ever that President Trump and "many in Congress dramatically underestimated the challenge of rolling back former President Barack Obama's signature achievement," Politico reports.
Congressional GOP aides now point to the lack of experience, vision, and expertise in the slow-starting Trump White House, while White House aides note that congressional Republicans have been promising to repeal and replace ObamaCare since 2010, long before Trump ran for office. But the fissures in the Republican caucus were clear as early as late January, at a closed-door GOP policy retreat in Philadelphia, Politico says:
House Speaker Paul Ryan laid out a three-pronged approach to scrapping ObamaCare. He wanted to repeal as much of the legislation as possible, eliminate more through deregulation, and then work with Democrats on a replacement, said one former Republican aide. Many Republican lawmakers doubted Democrats would work with them on redoing the health-care law.
The president and one of his former campaign rivals also unexpectedly helped undermine the GOP's repeal plans. Sen. Rand Paul (R-Ky.) said on television the GOP needed a replacement plan if it was going to repeal the law. Then Trump endorsed that requirement. Their comments caused GOP leaders to start from scratch. Now that the Senate's attempt to revamp the health-care law has run into roadblocks — with moderates insisting on protecting coverage for their constituents, while conservatives focus on undoing as much of ObamaCare as possible — both Paul and Trump have suggested going back to a repeal-only bill. [Politico]
One White House aide told Politico that if Trump signs a health-care law by August, all this drama will be forgotten. You can read more about the Republican health-care missteps and inflated expectations at Politico. Peter Weber
Sen. John McCain (R-Ariz.) announced Saturday that he is recovering at home from surgery to remove a blood clot above his left eye, prompting Senate Majority Leader Mitch McConnell (R-Ky.) on Sunday to postpone a vote on the newest version of his health-care overhaul. Two of the 52 Republican senators — Susan Collins (Maine) and Rand Paul (Ky.) — have said they will vote no on the bill as currently written, meaning McConnell can't lose another Republican and pass the bill. Collins said Sunday on ABC's This Week that eight to 10 other GOP senators have "deep concerns" about the bill.
A key question for the bill's future, then, is when McCain will return to the Senate. The statement from McCain's office suggested he would be out only this week, but its explanation for the procedure — removal of a blood clot from "above his left eye" during a "minimally invasive craniotomy with an eyebrow incision" — prompted some medical experts contacted by The New York Times to suggest he could be out of longer than expected, depending on the specifics. A craniotomy is when surgeons open the skull, and the recovery time from such an operation "is usually a few weeks," said Dr. Nrupen Baxi, a neurosurgeon at New York's Albert Einstein College of Medicine.
The GOP push to replace the Affordable Care Act is getting increasingly unpopular and attracting more opposition from medical and insurance groups, a few key Republican governors, and liberal groups. "The McCain absence gives Mr. McConnell and the White House a chance to continue working on holdout senators without having to back down from a vote this week," The Wall Street Journal explains. "But it also creates a window for the 2010 health law's supporters to continue a fight they believe is more likely to be successful the longer they wage it." The bill's GOP proponents and outside analysts say they think the bill will be harder to pass the longer it is delayed, too.
"The longer the bill languishes, the less likely it will pass," Greg Valliere, chief global strategist at Horizon Investments, tells The Wall Street Journal. "While McCain's absence complicates the health debate, it already was in deep trouble, even when he was healthy." The White House, which unsuccessfully lobbied skeptical GOP governors over the weekend, did not comment directly on the delay. "We wish Sen. McCain a speedy recovery," said spokeswoman Helen Aguirre Ferré. Peter Weber
Ted Cruz's health-care plan earns key endorsements from the White House, outside conservative leaders
The White House and a pair of influential conservative advocacy groups have endorsed a proposal by Sen. Ted Cruz (R-Texas) that would allow health insurers to offer cheaper, less-comprehensive plans as long as they also offered at least one plan that includes the essential consumer protections required by the Affordable Care Act. Senate Majority Leader Mitch McConnell (R-Ky.) has sent Cruz's proposal to the Congressional Budget Office for cost-benefit analysis.
Wednesday's endorsement of the Cruz amendment by the leaders of FreedomWorks and the Club for Growth "is significant: Without at least a neutral stance from conservative groups, it could be impossible for McConnell to find the 50 votes needed to pass a repeal this month," Politico reports. "But what the right is asking for may not be able to pass the Senate." The proposal may well violate budget rules that McConnell is using to push through his bill with 51 votes, and more centrist senators and outside insurance experts are concerned that it would essentially price people with pre-existing conditions and other high medical needs out of the insurance market.
"People who have higher health-care needs and need more comprehensive coverage would choose ACA-compliant plans," said Cori Uccello at the American Academy of Actuaries. "People who are healthy now would tend to choose noncompliant plans with really basic benefits. People who want or need more comprehensive coverage could find it out of their reach, because it might become unaffordable." Sen. Susan Collins (R-Maine), who was frequently thanked during July 4 festivities for helping at least slow down the bill, agreed that the Cruz language "would lead to adverse selection in the marketplace," adding: "It would also vitiate the important consumer protection of having a prohibition against annual and lifetime caps" on benefits.
Cruz and his allies argue that the amendment would lower premiums and allow individual consumers to essentially opt out of ObamaCare, but touching the pre-existing condition language may be a deal-breaker for other Republicans. "Sen. Lamar Alexander of Tennessee is speaking against it in caucus lunches and Sen. Deb Fischer of Nebraska, a staunch conservative, also vocally opposes Lee and Cruz's idea," Politico says. "Many senators believe that the House made a critical error by allowing states to opt out of pre-existing condition protections and are determined not to touch that part of ObamaCare." A Senate vote could come as early as next week. Peter Weber
Only a handful of Republican senators made public appearances on the Fourth of July, and almost all of those who did march in Independence Day parades or appear at public celebrations had opposed the Senate GOP health-care bill. Negotiations among Republicans are ongoing during the July 4 break, and the Senate could vote on a modified bill as early as next week, if the Congressional Budget Office releases a new cost/benefit analysis.
Senate Majority Leader Mitch McConnell (R-Ky.), who scrapped a planned vote last week after a handful of Republicans threatened to block the bill, had wanted a vote before the break in part so GOP senators would not be swayed by public sentiment against his widely unpopular bill. Only four of the 52 GOP senators announced participation in July 4 parades — Sens. Susan Collins (Maine), Lisa Murkowski (Alaska), Dean Heller (Nev.), and Ted Cruz (Texas) — and all but Cruz marched in remote locations; all four had voiced concern about McConnell's bill, and all but Murkowski were solid no votes before the break.
"Never before, in the 15 times that I've marched in this parade, have I had people so focused on a single issue," Collins told The New York Times while marching in the July 4 parade in Eastport, on a small island close to Canada. "I heard, over and over again, encouragement for my stand against the current version of the Senate and House health-care bills," she told The Washington Post. "People were thanking me, over and over again. 'Thank you, Susan!' 'Stay strong, Susan!'" Murkowski, parading in Wrangell, Alaska, said that most of the people who spoke to her at the festivities did not indicate "for or against" the bill. "They just say, 'Make sure you're taking care of our interests,'" she said. "In fairness for those that do the 'for or against,' everybody is pretty much [saying] they don't think this is good for us."
Heller rode on horseback through Ely, Nevada, a Republican stronghold, while Cruz faced off against protesters and mingled with supporters in heavily Democratic McAllen, Texas. The rest of the Senate GOP caucus laid low, like McConnell, or opted to join a delegation to Afghanistan. "The relative scarceness of the senators," The Washington Post notes, "challenged the busy liberal 'resistance' movement." McConnell's next big deadline for a health-care vote is the monthlong August recess. He can lose no more than two senators. Peter Weber
Senate Republicans left for their 10-day July 4 recess on Thursday night without a politically viable health-care plan, and it is unclear if Senate Majority Leader Mitch McConnell (R-Ky.) will be able to entice, persuade, or cajole at least 50 Republicans of his 52-member caucus to pass a health-care bill before his new deadline of mid-July, or perhaps early August. On Twitter Friday morning, President Trump jumped in with some advice: "If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!"
This was the original Republican plan, but they abandoned it earlier this year after deciding it was politically untenable. Trump was a significant player in the House GOP push to pass their health-care bill, but Senate Republicans have been mostly keeping him at arm's length, more or less openly saying they do not believe Trump understands even the basics of health-care policy. Peter Weber