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Mitch McConnell works to revise Senate health bill, aides say

Senate Majority Leader Mitch McConnell is aiming to send a revised version of his health care bill to the Congressional Budget Office as soon as Friday, according to Capitol Hill aides and lobbyists.

The effort reflects the tight timeline McConnell faces in his attempt to hold a vote before the August recess — and the pressure he is under to make changes that improve the nonpartisan CBO’s measure of the bill’s impact on coverage levels and federal spending.

McConnell is trying to move quickly to produce a new CBO score by the time lawmakers return to Washington in mid-July, giving the Senate about two weeks to fulfill the majority leader’s goal of voting before the August recess.

McConnell and his aides plan to continue negotiations through the end of the week and will be in frequent communication with the CBO, according to McConnell spokesman David Popp.

It remains unclear exactly what parts of the Better Care Reconciliation Act are being revised — or whether McConnell is trying to move the measure to the right, with greater savings or regulatory adjustments, or to the left, with more coverage protections. McConnell needs to bring on board about nine senators who have said they wouldn’t vote for the bill in its current form. Moving to the right would appease conservatives in the Senate — but also in the House, where any Senate bill would also have to pass.

Aides both at the White House and on Capitol Hill are aware of the effort, several GOP aides said Wednesday on condition of anonymity to discuss private talks. One aide described the situation as akin to the weeks leading up to the draft bill’s release, when McConnell presented chunks of the emerging legislation to the CBO to expedite the scoring process. The aide expected GOP leaders to present tweaks to the CBO for review as soon as this week.

Another aide said that after Tuesday’s meeting with President Donald Trump at the White House, Republicans have a better sense now of what everyone wants. A draft is not yet ready, but the reworking process has begun.

Republican leaders bowed to pressure from within their own ranks Tuesday and postponed a vote until after the Fourth of July recess. While they bought themselves more time to work out disagreements, the move also gave rise to new doubts about their ability to ever get to the point of a holding a final vote.

Trump is also trying to help, mainly by wooing skeptical conservatives, which he has struggled to do. He convened a meeting of all GOP senators at the White House on Tuesday after McConnell announced the vote would be delayed.

But the White House appears less involved in crafting specific policy tweaks. From the outset of the effort, McConnell and a small clutch of aides have controlled that process.

Conservatives are blasting the plan for leaving in place too much of the ACA, while a coalition of patient advocates, doctors and senior citizens’ groups has joined Democrats in decrying the plan’s proposed cuts to the Medicaid program and rollback of taxes on the wealthy.

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