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Republicans are set on repealing health care law, despite some senators' qualms

Lesley Clark, McClatchy Washington Bureau on

Published in Health & Fitness

WASHINGTON -- Senate Republicans vow to take a major step toward dismantling President Barack Obama's health care plan by the end of the week, despite worries from some members that there's not yet a plan to replace it.

Echoing House Republican leaders who have vowed a hasty repeal if not a speedy replacement plan, Senate Majority Leader Mitch McConnell said Tuesday the Senate planned to vote on the repeal resolution this week, even as the Senate continues to work "on what comes next."

Speaking to reporters after a Senate Republican lunch, McConnell pledged the Senate would work with the incoming Trump administration and the House "in crafting a package that we can all agree on and provide a smooth transition from the disaster we have now."

His remarks came despite some fears among senators who have urged lawmakers not to uproot the 2010 Affordable Care Act without offering an alternative. Five moderate Senate Republicans offered an amendment to give lawmakers more time and others said Tuesday said they would prefer a slower approach.

"Lay out the game plan, lay out the strategy," said Sen. Ron Johnson, R-Wis. "Let's understand exactly what we're doing here before we just take step one, not understanding what steps two, three and four are."

McConnell's decision comes amid pressure from a variety of factions -- from a conservative band of House lawmakers to the president-elect himself -- about how the Republican Party should best move forward to fulfill their campaign promises and get rid of Obamacare. Democrats, meanwhile, were laying their own strategies to shape, if not block, an overhaul of President Barack Obama's most significant achievement in his two terms.

And President-elect Donald Trump called Tuesday for something the legislative bodies may find all but impossible to deliver: a rapid replacement.

The budget resolution the Senate is expected to vote on as early as Thursday calls for a replacement plan to be delivered to the White House by Jan. 27. The amendment would extend the deadline until March 3.

"There are a number of senators who would like to see what the future is going to be and try to do it simultaneously if possible," said Sen. Bob Corker, R-Tenn., one of the sponsors of the amendment that would slow down the process. "I'm all for repeal, I just want it done in an appropriate manner."

Repealing the law without replacing it could create disruption in the insurance markets and risks cutting off health care for the 20 million people who, because of the Affordable Care Act, get coverage through the Medicaid program or receive federal help to pay costs. And Republicans have said they'd like to keep popular parts of the law -- such as requiring insurance companies to cover pre-existing conditions.

Democrats warn that it will be impossible to keep the popular parts without the unpopular, chiefly the requirement that most Americans have insurance or pay a penalty.

Republicans have been unable to forge agreement on a health care plan alternative since Obama pushed through the legislation in 2010 with only a single Republican vote. But Senate Republicans said Tuesday talks are underway with the incoming Trump administration and the House to find an alternative. Sen. John Thune, R-S.D., suggested the repeal vote could be followed by several proposals as Republicans look to overturn parts of the legislation that they don't like while keeping provisions they support.

"You might see this thing in a very step-by-step way, as opposed to having one huge, 2,700-page bill," Thune said, a reference to the size and complexity of the 2010 legislation.

Trump insisted Tuesday that his fellow Republicans act promptly to carry out his campaign promise. He told The New York Times that he wants a repeal vote "sometime next week" to be followed by a vote on a replacement "very quickly or simultaneously."

He told the Times he would "not accept a delay of more than a few weeks," which aligns with some of McConnell's schedule.

But the House Freedom Caucus has expressed worries that the budget measure fails to offer specifics about how Republicans plan to replace Obamacare.

The caucus wants the replacement to go into effect during the 115th Congress, meaning it should take no longer than two years.

Other Republicans have suggested transition periods that could take as long as three years.

And senators suggested the Jan. 27 deadline in the House resolution for two Senate committees to put the proposals into legislative language may be malleable.

"If it's the 28th, it's not the end of the world. If it's March 1, it's not the end of the world," said Sen. John Cornyn, R-Texas. "But we ought to be moving with all deliberate speed."

Lawmakers' hands may be tied because of the method they are using to pass the legislation: A budget resolution allows the repeal bill to pass with 50 votes and bypass a Democratic filibuster, but it can cover only budget issues.

"We're going to do as much as we can," Cornyn said. "The fact of the matter is, it's going to take a while for us to make the transition from Obamacare to the alternative."

He acknowledged worries from senators in his party "about the meltdown on Obamacare happening while we're trying to make the longer term replacement," but said the two chambers would find an agreement.

"I'm convinced, like so many things around here that seem a little confused at the beginning, that if put our minds to it we'll come up with a reasonable solution," Cornyn said.

Other senators downplayed the conflict, saying lawmakers had time to hammer out the details.

"I worry more about what we told the American people in the last election: 'Repeal and replace,'" said Sen. John McCain, R-Ariz.

Democrats, who ahead of the Thursday vote hope to force Republicans to vote on a series of health care-related amendments that could later be used against them in campaign ads, have pledged a public relations assault, urging supporters to call their member of Congress or McConnell's office to protest the move to repeal.

"We have to have a national movement here," Senate Minority Leader Chuck Schumer, D-N.Y. told members of progressive groups on a call late Monday. "This should not be just something a bunch of senators are talking about on the floor. We ain't resting until the move to repeal ACA is dead -- it has a dagger through its heart and will never be revitalized."

(c)2017 McClatchy Washington Bureau

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