The president said once again Thursday that the Senate has the votes to pass health care, and the only thing stopping senators from repealing Obamacare is the rule that allows the opposition party to filibuster.
“What I’m going to do, is we do have the votes for health care, but the filibuster, you know, if you look at what’s going on with respect to timing, we have only until Friday for reconciliation, so we’re going into next year,” Trump told Fox News Thursday morning.
“We have the votes on Graham-Cassidy,” Trump said Wednesday afternoon during his tax reform speech in Indiana.
The president appears more than confident health care can pass, but it remains to be seen if a repeal bill, any repeal bill, can make its way through the Senate. The Senate can always muster around 45 votes to overhaul Obamacare, but getting to the 50 votes needed under budget reconciliation has proved an insurmountable road block.
The Senate was unable to repeal, repeal and replace and even tweak Obamacare in late-July. The most votes Republicans were able to whip behind any bill was 49, and that was for the “Skinny Repeal,” which kept a number of the features of Obamacare intact.
Sens. John McCain of Arizona, Lisa Murkowski of Alaska and Susan Collins of Maine acted as the unwavering holdouts during the summer, and McCain and Collins remained opposed to the most recent push to reform the American health care system.
Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana put forth a bill in early September that would have repealed Obamacare’s main funding mechanisms and replaced them with a system of block grants. The bill was met with some support from their Republican colleagues, but, like all previous repeal attempts this year, fell short of the ever elusive 50 vote threshold.
Senate Majority Leader Mitch McConnell pulled the Graham-Cassidy bill Tuesday afternoon, after four Republican senators–Rand Paul of Kentucky, Ted Cruz of Texas, McCain and Collins–announced they would vote against the party’s 11th-hour push to upend the American health care system.
“We haven’t given up on changing the American health care system,” Senate Majority Leader Mitch McConnell told reporters Tuesday at the Capitol. “We aren’t going to be able to do it this week. But it still lies ahead of us, and we haven’t given up on that.”
The party is unwilling to give up on trying to make good on a seven-year campaign promise.
Graham told TheDCNF Tuesday that his bill will make a resurgence in the Spring of 2018, likely around Easter.
“What I would expect is that we take a clear shot at taxes. We’ll use the time to come up with a better process for health care,” Graham told TheDCNF. “We will have a debate worthy of a great country and when taxes are over early next year, which is what I envision, we’ll go back to repealing and replacing Obamacare.””
The president laid out a more ambitious timeline Wednesday, saying that the party will move on health care sometime in January or February.
Graham is meeting with the president Thursday at the White House to discuss a way to move forward on health care.
Trump wants McConnell to change the rules so that the Senate only requires 51 “yes” votes to pass legislation, down from the current 60 vote threshold, and he wants the majority leader to do away with the filibuster rule.
Again, budget reconciliation only requires leadership to get to 50, at which point Vice President Mike Pence can vote, as president of the Senate, to get Republicans to the 51 votes needed to pass a bill. Reconciliation also allows leadership to bypass filibusters from Democrats. With both of the features in place, the party was unable on three occasions to repeal Obamacare.
Even if leadership moved to abolish the filibuster and lowered the threshold for passing bills, McCain and Murkowski would likely give a thumbs down to any legislation that did not go through regular order and in a bipartisan fashion.
Murkowski said Wednesday that she would like to see Republicans and Democrats work together on the next major health care reform bill.
“You know what, I think it needs to be bipartisan,” Murkowski said of any future bill to repeal and replace Obamacare. The Alaskan senator told reporters that she is already working with Sens. Lamar Alexander of Tennessee and Patty Murray of Washington, who spent the better part of September in the Senate Health committee trying to come up with a bipartisan solution to fix Obamacare and strengthen the individual marketplace.
Even before McConnell pulled the bill, Murkowski was signalling she needed more time, more assurances that Alaskans with pre-existing conditions would be covered and more analysis of the legislation to see its overall effects on her home state.
“I am insisting that there are elements of the ACA that must be saved, that must be preserved. For example, we must continue to prohibit insurers from discriminating against pre-existing conditions … as long as this legislature wants to keep [Medicaid] expansion, Alaska should have the option — so I will not vote to repeal it,” Murkowski told reporters Monday.
McCain said he would likely be a “no” vote on Graham-Cassidy because the bill was not going through regular order.
“As I have repeatedly stressed, health care reform legislation ought to be the product of regular order in the Senate…I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” he said in a statement.
“Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions,” McCain said.
Paul told TheDCNF last week that he would not support Graham-Cassidy, and wants a bill that repeals and replaces Obamacare entirely. Paul notably called rougly every iteration of repeal thus far in 2017 “Obamacare-Lite.” The Kentucky senator has been working with the administration for the past six months on his own bill to reform health care.
“I think Rand will be there for us. He was there for me two times before. I like Rand Paul a lot and I think he’ll be there for me,” Trump told reporters Wednesday evening at the White House after returning from a tax reform speech in Indiana. “He’s a good guy and he wants what’s good also for the party. I think Rand will be there.”
Murkowski is going to be a difficult sell for Republicans, given that Alaska is one of the costliest states under Obamacare. With such a sprawling population, providing and implementing health care services is a difficult task that requires a great deal of money.
Under the original version of Graham-Cassidy, Alaska could see as much as a $1 billion cut to the state’s federal health care funding from 2020 to 2026, according to research from consulting firm Avalere. That would work out to roughly a $1,350 cut per resident.
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