Senate leadership is expected to push a vote on health care reform as early as Tuesday, but senators remain unsure if they will be voting to repeal and replace, or simply repeal, Obamacare.
The confusion stems from mixed messaging coming from Senate Majority Leader Mitch McConnell and President Donald Trump.
After four Republican senators came out against the Senate bill to largely repeal and replace Obamacare–the Better Care Reconciliation Act (BCRA)–late in the evening on July 17, McConnell and Trump called for a full, clean repeal of the current system before instituting a replacement.
The president tweeted that Republicans should repeal Obamacare before coming up with a replacement legislation, a prospect that the CBO projected would leave 27 million Americans without health coverage in 2020. (RELATED: Third Time’s A Charm: CBO Releases Report On GOP’s Third Health Care Attempt)
Responding to the president’s call the same night, McConnell announced he would put forth a repeal-only piece of legislation before the Senate.
The Senate majority leader changed course on July 18, pledging that he would first move forward on the motion to proceed on the BCRA, which poses its own set of political risks for Republicans.
If Congress passes the legislation, some 15 million more Americans would be without insurance coverage in 2018 than those that would lose insurance under Obamacare. That figure increases to 22 million in 2026. Eighty-two percent of Americans under the age of 65 would have health insurance in 2026, compared to 90 percent under Obamacare. (RELATED: CBO Scores Senate Obamacare Bill: Saves $420 Billion, Leaves 22 Million Uninsured)
Moderate Republicans in the Senate are unwilling to support a bill that institutes steep cuts to Obamacare’s Medicaid expansion program, as millions of their constituents have obtained insurance coverage through the program. Some 20 Republican senators serve in states that chose to expand Medicaid under Obamacare. If either bill makes its way through the Senate, these senators will have a large constituent base left without health insurance–a situation that does not bode well for them in the 2018 election cycle.
McConnell is expected to put up a motion to begin debating some version of health care reform Tuesday. If the Senate approves it, McConnell will be the one to decide which version has more consensus and a greater likelihood of passing.
With only a slim 52-seat majority in the Senate, the Senate majority leader needs to obtain at least 50 Republican votes, with Vice President Mike Pence acting as the tiebreaker.
Adding to the Republican difficulties is the fact that GOP Sen. John McCain of Arizona is absent during the ongoing health care reform debates, after he was diagnosed with brain cancer Wednesday.
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