WASHINGTON — Senate Majority Leader Mitch McConnell plans to unveil his revised draft bill to replace Obamacare Thursday with the hope that changes he has made since he pulled it from a vote two weeks ago will win over enough Republicans to pass it next week.
As he attempts to overcome divisions in his own party, McConnell also has come under heavy pressure to succeed from President Donald Trump, who said in an interview Wednesday that he would be “very angry” if the bill fails to pass, adding, “Mitch has to pull it off.”
But McConnell faces hurdles in his quest, including recalcitrant members of his caucus pulling in opposite directions, a unified Democratic opposition, and to need to meet the strictures of a Senate rule that would allow him to pass the bill with a simple majority.
The draft he will propose is expected to retain deep long-term cuts to Medicaid, but also will add funds to help low-income households buy insurance and to combat opioid addiction, drop the repeal of taxes on the wealthy, and allow use of Health Savings Accounts to pay for premiums.
McConnell has called a Thursday morning meeting of his 52-member Republican caucus to introduce the bill and try to nail down the 50 votes he needs to pass it with a tie-breaking vote of Vice President Mike Pence.
Yet on Wednesday, before he released his bill, his fellow Republican senator from Kentucky, Rand Paul, attacked it for failing to fully repeal and replace Obamacare, which has been the Republican campaign promise since the passage of the health care law in 2010.
“The new bill is the same as the old bill, except it leaves in place more taxes,” Paul said of McConnell’s revised draft version. “At this point, I cannot support the bill.”
McConnell also is seeking to accommodate Sen. Ted Cruz (R-Tex.) and Sen. Mike Lee (R-Utah), who have proposed an amendment to allow insurance companies to sell cheap health insurance that doesn’t meet Obamacare’s minimum benefits if they also offer a plan that does.
Republicans told reporters that McConnell could actually release two versions of the bill, one with the Cruz and Lee amendment and the other without, and he would ask for the Congressional Budget Office score on each of them.
But the trade group America’s Health Insurance Plans opposed the amendment in a letter circulating in Congress that said it would further de-stabilize the individual market and increase costs for those with pre-existing conditions.
Sen. Susan Collins (R-Maine) and other moderates have raised concerns about the effects on health coverage for the poor, the disabled and children by the bill’s cap and low inflation rate for federal Medicaid money, which would reduce funding by $772 billion and result in a 16 percent drop in the program’s enrollment over the next decade.
McConnell was expected to appeal to those senators by adding $70 billion to a stabilization fund to help lower-income people pay for medical costs, a $45 billion fund to combat opioid addiction and the extension of the current 3.8 percent tax on the wealthy.
Meanwhile, Democrats said they’ll challenge the draft’s bans on abortion and other provisions for failing to meet the rules of budget reconciliation, which McConnell needs to block a 60-vote filibuster. Those rules do not allow measures that aren’t about spending or revenues.
In a White House interview Wednesday with the Christian Broadcasting Network’s “The 700 Club,” Trump was asked what would happen if the Senate doesn’t pass the health bill.
“Well, I don’t even want to talk about it because I think it would be very bad,” Trump said. “I will be very angry about it and a lot of people will be very upset.”