Voting Again for Health Care Next Week
Vote Delayed as G.O.P. Struggles to Align Support for Health Intendance Nib
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WASHINGTON — Facing intransigent Republican opposition, the Senate majority leader, Mitch McConnell, on Tuesday delayed a vote on legislation to repeal the Affordable Care Act, dealing another setback to Republicans' seven-year effort to dismantle the health law and setting upward a long, heated summer of health care battles.
Mr. McConnell faced resistance from beyond his briefing, non merely from the most moderate and conservative senators but from others also. Had he pressed forward this week, he almost surely would take lacked the votes fifty-fifty to begin debate on the neb.
"We will non be on the nib this calendar week, simply we're nonetheless working toward getting at least 50 people in a comfy place," said Mr. McConnell, who is known as a canny strategist but was forced to acknowledge on Tuesday that he had more piece of work to do.
The filibuster pushes Senate consideration of the bill until afterward a planned recess for the Fourth of July, but information technology does not guarantee that Republican senators will come up together. Opponents of the bill, including patient advocacy groups and medical organizations, plan to anteroom senators in their abode states side by side week. Senators are likely to exist dogged by demonstrators. Democrats vowed to go along up the pressure, and some Republican senators have suggested that their votes will be difficult to win.
After coming together with President Trump at the White Business firm, Mr. McConnell told reporters that if Republicans could non come to an agreement, they would be forced to negotiate a deal with Senator Chuck Schumer of New York, the Autonomous leader.
"The status quo is simply unsustainable," Mr. McConnell said. "It'll be dealt with in 1 of two ways: Either Republicans will agree and change the condition quo, or the markets will go along to collapse, and we'll have to sit down with Senator Schumer. And my suspicion is that whatsoever negotiation with the Democrats would include none of the reforms that we would like to make."
Republicans have promised for 7 years to repeal the health law, President Barack Obama'south signature domestic achievement. Merely Mr. McConnell's announcement on Tuesday was yet another major stumble in the unsteady quest by Republican congressional leaders to evangelize a repeal bill to the desk of Mr. Trump, who has nevertheless to sign his get-go piece of marquee legislation.
Mr. McConnell, the chief author of the Senate repeal neb, tin can afford to lose merely two of the 52 Republican senators, but more than than a half-dozen have, for widely divergent reasons, expressed deep reservations about the pecker.
Mr. Trump, meeting with Republican senators at the White House, alleged, "We're getting very close."
"This will be great if we get information technology done," he said. "And if we don't get it done, it'southward just going to exist something that nosotros're not going to similar, and that's O.Chiliad., and I understand that very well."
Mr. McConnell wrote his nib behind airtight doors, betting he could style a product that would show significant comeback over the bill that was narrowly canonical by the House last month. And he laid out an aggressive timeline for its passage, hoping to secure Senate approving roughly a calendar week subsequently unveiling the legislation.
Yet on Tuesday, just five days after releasing the nib, Mr. McConnell had to bow to reality: Republican senators were not ready to move alee with the bill.
At least a small number might never exist — raising questions nigh whether Mr. McConnell will be able to win over the votes for passage.
"It's difficult for me to see how whatever tinkering is going to satisfy my fundamental and deep concerns about the impact of the bill," said Senator Susan Collins, Republican of Maine, who was among the lawmakers prepared to vote against taking upward the bill this week.
Mr. McConnell and his leadership team are hoping to replicate the feat of Speaker Paul D. Ryan, who revived the House's repeal bill and pushed it to passage six weeks after it appeared to be expressionless.
Epitome 
"I would hope, by the end of the week, that we accept reached basically a decision with regard to the substance and the policy of this," said Senator John Thune of South Dakota, a fellow member of the Senate Republican leadership.
And so, he said, it is just a question of timing.
Democrats are unified against the repeal pecker, but they were not celebrating on Tuesday.
"The mantra on our side is never to underestimate Mitch McConnell," said Senator Richard Blumenthal, Democrat of Connecticut.
Mr. Schumer said: "Nosotros know the fight is non over. That is for sure." Over the next few weeks, he said, Mr. McConnell "will try to use a slush fund to buy off Republicans, cut dorsum-room deals, to try and go this affair done."
At least four Republican senators — Ms. Collins, Dean Heller of Nevada, Ron Johnson of Wisconsin and Rand Paul of Kentucky — had said they would vote against the motion to begin fence, enough to ensure information technology would fail. Other Republicans besides appeared reluctant most moving forrard with the nib.
"I'm just grateful leadership decided, allow's take our time, requite this more than thought and endeavor and get this correct," said Mr. Johnson, who had been critical of the desire by Republican leaders to hold a vote this week.
After Mr. McConnell'south annunciation, iii other Republicans announced their opposition to the bill in its current course: Jerry Moran of Kansas, Shelley Moore Capito of West Virginia and Rob Portman of Ohio.
Ms. Capito and Mr. Portman, who announced their opposition together, expressed concern about how the bill would affect Medicaid and the opioid crunch, which has had devastating effects in their states.
The release of a Congressional Budget Function evaluation on Monday fabricated information technology much more than hard for political party leaders to win over hesitant Republican members. The budget office said the Senate bill would leave 22 million more than people uninsured by 2026, and many people buying insurance on the individual market would have skimpier coverage and higher out-of-pocket costs.
The Senate Autonomous whip, Richard J. Durbin of Illinois, said the report past the Congressional Budget Office "did more to strike a dagger to the heart of this Republican repeal than annihilation else."
In 2026, the budget part said, 15 one thousand thousand fewer people would have Medicaid coverage nether the Senate beak than nether the Affordable Intendance Human activity, and seven meg fewer people would have coverage they purchased on their ain. Faced with deep cuts in Medicaid, the report said, land officials would confront unpalatable choices: restrict eligibility, eliminate services, reduce payments to health care providers and wellness plans, or spend more than of their own money.
Appearing in Washington, Gov. John R. Kasich of Ohio cited the 22 million projection and expressed bewilderment that boyfriend Republicans would be on board with the bill.
"And they remember that's bully?" he asked. "That's good public policy? What, are you kidding me?"
Doctors, hospitals and other wellness intendance provider groups accept come up out strongly against the Senate bill, as accept patient advocacy groups like the American Centre Clan. Merely business groups were ramping upward their support. In a letter on Tuesday, the U.Southward. Sleeping accommodation of Commerce urged senators to vote for the bill.
The Senate nib "will repeal the about egregious taxes and mandates" of the Affordable Intendance Act, assuasive employers to create more than jobs, said Jack Howard, a senior vice president of the grouping. The nib, he noted, would repeal a revenue enhancement on medical devices and eliminate penalties on big employers that do non offering coverage to employees.
A separate letter expressing general support for the Senate'south efforts was sent past a coalition of business and employer groups including the National Clan of Dwelling Builders, the National Restaurant Association and the National Retail Federation.
Only Senate conservatives plant themselves squeezed between business sentiment and their conservative base. The Club for Growth, a bourgeois group, came out against the Senate measure on Tuesday. The organisation's president, David McIntosh, noted that congressional Republicans had "promised to repeal every discussion" of the Affordable Care Deed.
"Just in Washington does repeal interpret to restore," he said. "Because that's exactly what the Senate G.O.P. wellness care nib does: It restores Obamacare."
Source: https://www.nytimes.com/2017/06/27/us/politics/republicans-struggle-to-marshal-votes-for-health-care-bill.html
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