As the Senate prepares to vote on some version of a health care reform bill, House Republicans remain optimistic that their GOP colleagues in the upper chamber will be able to reach a compromise that fulfills their promise to voters to repeal the Affordable Care Act.
Majority Leader Mitch McConnell announced Tuesday that the start of the Senate’s August recess will be delayed by two weeks so that lawmakers can complete work on their proposed replacement for the ACA, also known as Obamacare, and deal with other legislative matters.
“It’s in everybody’s interest I think to get a bill,” said Rep. Bradley Byrne, R-Ala.
The House version of a repeal-and-replace bill only passed earlier this year after extensive negotiation between leadership and various factions within the party. He expects the same will be necessary in the Senate.
“Not everybody can insist on their own way,” Byrne said. “They’re going to have to give a lot more in their compromise.”
Attempts to reach an agreement before the July 4 recess fell apart but conservative Senators Ted Cruz and Mike Lee have since put forth an amendment that might garner a few more votes.
The amendment would allow insurers to offer plans on the individual market that do not include all of the benefits required by the ACA as long as they sell one plan that does. Experts say this could allow younger, healthier patients to purchase less expensive plans, but some warn that it also puts older and sicker patients at risk of facing much higher costs.
Rep. Jim Jordan, R-Ohio, a member of the conservative House Freedom Caucus, said it adds an element of consumer choice that the legislation passed by his chamber lacked, though.
“That would make the bill that we sent from the House a better piece of legislation,” Jordan said.
House Democrats are skeptical that anything can be done in two extra weeks to rectify a bill that the Congressional Budget Office currently estimates will leave more than 20 million fewer people insured by 2026 and lead to massive reductions in Medicaid funding compared to current law.
“My experience in Congress is when you extend deadlines, people make up work to fill that void,” Rep. Gerry Connolly, D-Va., said.
He pointed to polls putting approval of the proposed Republican bill under 20 percent.
“What the underlying bill is all about is frankly something that you just can’t sell,” he said.
Because Republicans decided from the start to rely on the reconciliation process to pass the bill in the Senate, they only need 50 votes. If they fail to cobble that together, Democrats hope they will consider attempting to craft a bipartisan bill instead of continuing to leave the minority party out of the discussion.
“It was clear six months ago that there was no intent to have Democrats involved in this process,” Rep. Jim Costa, D-Calif., said.
Democrats cited the president’s own words in criticizing the current Republican proposal. Costa recalled that Trump often promised the ACA replacement would cover everyone in a better way for less money.
“If the legislation were to cover all and it would be less costly and it would be better, I would be happy to support it, but the Senate version doesn’t do either of the three,” he said.
Rep. Lloyd Doggett, D-Texas, noted that Trump called the House version of the bill “mean.”
“The Senate thus far has not come up with an approach that is less mean,” he said.
The revised Senate bill is expected to be released Thursday, with a CBO score coming early next week and a vote possibly happening before next Friday.
With recent headlines reflecting dwindling options for consumers on the individual markets in many counties, Republicans insist that doing nothing is not an option.
“Democrats and Republicans alike say that the health care system is broken,” Rep. Evan Jenkins, R-W.V., said. “The real question is how are we going to fix this. Nobody wants to go back to the status quo, the way it was years ago, but we all know the current system doesn’t work.”
Rep. Devin Nunes, R-Calif., said he prefers the version of the legislation that the House passed, but he feels the Senate bill is still an improvement over the current situation.
“The main thing is that we have to get something done,” he said. “Obamacare is failing people; insurance companies are dropping the plans. Medicaid is a broken system.”
After promising for years that they could improve the system by repealing the ACA, Republicans could face a political backlash if they fail.
“It’s important to deliver on the promises that we made to the American people,” Rep. Marsha Blackburn, R-Tenn., said.
Republicans often told voters they would completely repeal Obamacare, but many have balked now that they have the power to do that. Jordan hopes the Senate can accomplish something closer to full repeal than the House settled on.
“Sometimes we make this job too complicated,” Jordan said. “Our job should be real basic: do what you told the American people you’re going to do.”
Democrats do not deny that something needs to be done to fix the health insurance system and reduce costs, but they oppose rolling back the benefits and protections provided by the ACA.
“Their plan is just a veiled attempt to reduce entitlement programs and give tax breaks,” said Rep. Kurt Schrader, D-Ore., who co-chaired a Democratic task force that unveiled its own plan to fix Obamacare earlier Wednesday.
Among other things, the Democratic plan aims to eliminate the uncertainty that the Trump administration has sown in the individual markets.
“Our approach stabilizes and improves the individual marketplace,” he said.
Schrader claimed that the health insurance industry could collapse if the Republican bill passes.
“Their death spiral will be of their own making,” he said.