Longtime GOP pessimistic about health care bill prospects

A long-time Republican lawmaker said Tuesday he is "very pessimistic" that his party will push a health care bill through the Senate, even as a colleague warned leaders about retaliation by conservative voters should they react to a collapse of the measure by striking a deal with Democrats.

The downbeat assessments came with Republican leaders aiming toward a climactic Senate vote next week on their wounded legislation erasing much of President Barack Obama's health care law. The comments highlighted the divisions that top Republicans must heal to have a shot of pushing a bill through the chamber embodying one of the GOP's top priorities.

After abruptly canceling a vote last month on an initial bill for lack of support, Senate Majority Leader Mitch McConnell, R-Ky., has been crafting changes aimed at nailing down GOP votes.

"I'm very pessimistic," Sen. Charles Grassley, R-Iowa, said on the Fox News Channel of the chances a bill will pass.

Grassley, first elected in 1980, said that Republicans have been promising for years to repeal Obama's 2010 statute and said, "There are consequences if you don't deliver on election promises, and there ought to be."

Over the weekend, Grassley tweeted that if Republicans don't complete a bill, "WE WILL GO FROM MAJORITY TO MINORITY."

With Democrats solidly against the effort, Republicans will lose if just three of their 52 senators oppose it. McConnell has said if the wide-ranging bill fails, he'd pursue a narrower measure aimed at propping up insurance markets — an effort that would likely require talks with Democrats.

"I think that's the wrong strategy," Paul said on the Fox News Channel about the possibility of a bipartisan deal on a smaller scale bill. "And I think Republicans will be very unhappy across the land if the Republican leadership gives up and goes and works with the Democrats."

Paul, among several Republicans who've said they'll oppose the initial GOP bill unless it's changed, also suggested he wouldn't support the legislation even if an amendment embraced by other conservatives is included.

Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, are pushing a revision to let insurers sell low-price policies with bare-bones coverage, as long as the company also sells a policy that covers a list of services like maternity care that Obama's law mandates.

But the overall bill also contains more than $100 billion that states could give to insurers to help them contain premiums. He said if the Cruz language is included in the bill in exchange for retaining that money, "this is a tradeoff that I'm not necessarily willing to take."

He added, "That to me is not a pro-free market tradeoff."

On Monday, No. 2 Senate GOP leader John Cornyn of Texas told reporters, "We need to start voting" on the GOP bill." Some Republicans said a revised version of the bill could be introduced Thursday, and Cornyn said the "goal" was for a vote next week.

Cornyn cited seven years of unresolved Republican debate over how to replace the 2010 statute during which "we gain a vote, we lose a vote." That underscored a sense among top Republicans that they had little to gain by letting their disputes drag on much further.

Republicans were hearing divergent messages from the White House Monday. President Donald Trump pressured GOP senators to pass the measure quickly, while Vice President Mike Pence suggested they might have to revert to a straightforward "Obamacare" repeal if they can't agree on an alternative.

With at least a dozen Republicans opposing or challenging parts of McConnell's bill, the leader has been working on revisions aimed at bringing more GOP senators on board. Final decisions remain to be made on how tightly to curb the growth of Medicaid, the health insurance program for the poor; whether to let insurers sell low-cost policies with very limited coverage; and how much money to devote to making health care tax credits more generous, said No. 3 Senate Republican John Thune of South Dakota.

Congress is beginning a three-week sprint toward its traditional five-week August recess, and GOP leaders want to finish work on the measure by then. Some lawmakers have suggested the break should be shortened or canceled if they can't get health care done first, though that's unlikely to happen.

Too many Republicans oppose repealing Obama's law without also enacting an alternative to give that tactic much chance of succeeding.

The House managed to pass health care legislation in May after plentiful struggles of its own to reach agreement. Both the House and Senate bills eliminate Obamacare's mandates for people to buy insurance and individuals to provide it, gradually undo an expansion of Medicaid and reduce the size of the federal-state health care program for the poor and disabled. The measures would cut taxes for the wealthy.


This story was corrected to attribute quotation in 11th paragraph to Vice President Pence, not President Trump.