Senate Republican leaders hit the brakes on their proposal to overhaul the health care system Tuesday, throwing into doubt the fate of the party’s central campaign promise and injecting a major dose of uncertainty into an industry that encompasses one-sixth of the nation’s economy.
The move, which came in the face of mounting dissent from centrists and conservatives alike, sent both ends of Pennsylvania Avenue into a tizzy as President Donald Trump and GOP leaders sought to swiftly reunite their fractious caucus behind closed doors.
The body blow came from a Congressional Budget Office report showing that the plan could leave 22 million more Americans without health insurance after 10 years.
U.S. Senate Majority Leader Mitch McConnell vowed that the pullback was just a pause, as Democratic leaders declared the delay a signal of the proposal’s public unpopularity.
The proposal was meant to lift the requirements of the federal health care law known as Obamacare, both opening up the insurance markets to smaller, less expensive policies and fundamentally restructuring how the nation pays for health care for the poor.
McConnell said the Senate would take up the measure after the Independence Day recess, though he did not say exactly how long after July 4.
“We’re going to press on,” McConnell told reporters during a press conference following the luncheon meeting where party leaders came to grips with the setback.
“Look, legislation of this complexity almost always takes longer than anybody else would hope,” he added. “It’s a big, complicated subject. We’ve got a lot of discussions going on and we’re still optimistic we’re going to get there.”
Hours after the news of the delay broke, Trump convened a meeting with most Senate Republicans at the White House.
The commander in chief said the GOP had “really no choice but to solve this situation.” But then Trump appeared to pivot and begin tamping down on expectations.
“This will be great if we get it done,” he said. “And if we don’t get it done, it’s just going to be something that we’re not going to like, and that’s OK and I understand that very well.”
How soon it would happen remained unclear. U.S. Sen. Marco Rubio of Florida said “maybe” a completed bill from both the House and the Senate could be on the president’s desk by the lawmakers’ August recess.
In contrast, U.S. Sen. David Perdue of Georgia told reporters that “another couple of days, I think we can iron out the differences.” He added, “We’re so close.”
Rescuing health care
Perdue has been one of the most consistent voices supporting the GOP repeal effort and decrying the failures of the Affordable Care Act.
Indeed, in 96 of Georgia’s 159 counties the Obamacare exchange market now depends on just one insurance company, Blue Cross Blue Shield of Georgia. If it pulls out, Obamacare will partly cease to exist in those counties. Yet another issue is the price of staying in, as premiums continue to rise.
During McConnell’s press conference with other members of the Republican leadership, to defend their proposal they pounded on the faults of Obamacare.
U.S. Sen. John Barrasso of Wyoming called Obamacare a bus going off a cliff, but Republicans were trying “to rescue the American people” while “Democrats are saying, ‘Stay on board.’ ” U.S. Sen. John Thune of South Dakota called it “a failed system that needs to be replaced.”
Concern over high health prices is nearly universal among Georgians surveyed by The Atlanta Journal-Constitution.
But many advocates for patients and health care providers had come out in force, saying this bill was not the solution.
“Today’s events are a good thing — for now,” said Dr. Ben Spitalnick, a Savannah pediatrician and president of the American Academy of Pediatrics’ Georgia chapter. “Obviously, we don’t know what’s going to come back after the July Fourth holiday. But at least for now it’s a sigh of relief for pediatricians to know the situation is stable.”
The proposal was, as McConnell said more than three times Tuesday, complicated.
It has several key initiatives. First and foremost it would fundamentally restructure Medicaid, America’s health care program for the poor, for the first time in a half-century. That includes big cuts in federal assistance over time.
Additionally, it would end the requirement that most Americans carry health insurance. And it would undo some of the mandates for all health insurance plans that the Obamacare law set in place, giving states flexibility to let insurance companies have more control in what they sell to customers.
In the process, it would give a big tax break to the rich insurance companies, restoring to them a funding stream that has helped support the program. And it would shave down the budget deficit.
For both of Georgia’s senators, Republicans Johnny Isakson and Perdue, there was more good than bad in the proposal. Their votes are not widely seen as in doubt.
“Doing nothing is not acceptable,” Isakson told the AJC after the lunch Tuesday. “And I think doing something makes a lot of difference. I’d rather do something.”
But each of those provisions in the plan has been a hot political potato for the Republican senators who helped tank this week’s proposed vote: some from rural areas that depend more on Medicaid, some from states dealing with opioid crises that fear losing the money that helps that fight. Or others from states that elected them to cut taxes and don’t think the plan goes far enough. Satisfying all those concerns is a challenge.
Agenda at risk
GOP leaders were initially pushing hard for the Senate to vote on the health care bill this week, before the chamber leaves for its recess.
The gambit was meant to pressure wavering Republicans to hurry up and back the bill, offering the additional incentive of moving on quickly to a tax overhaul, viewed by many lawmakers to be the political holy grail of a unified GOP government.
“Things change,” John Cornyn of Texas, the Senate’s No. 2 Republican, told reporters Tuesday.
Leaders hope they can strike an agreement with fellow Republicans by the end of the week, rewrite the bill and provide enough time for the CBO to score the rewritten proposal over the holiday. That would allow senators to come back to Washington the week of July 10 and quickly vote on a final proposal.
But it’s still very much unclear whether leaders can do anything to unite their fractious caucus by then, given that McConnell can only afford to lose two votes and at least a half-dozen Republicans have expressed serious reservations about the current bill.
Orrin Hatch, the chairman of the Senate Finance Committee, acknowledged that the longer the health care debate goes on, “the more difficult it’s going to be to move through tax reform.”
“But we’re still early,” the Utah Republican continued.
There’s been some fear among Republicans that sending senators home for the July Fourth holiday without a health care vote under their belt could make it harder for the party to ultimately come to agreement. Senators may go home and hear more outcry from the plan’s opponents. But Perdue disagreed, saying the delay “was a good decision.”
The clock is ticking. After senators return from the recess, they will have only three legislative weeks to move on some of their biggest priorities — including health care, taxes, the budget and preventing a default on the national debt — before the August recess.
Could this delay lead to bipartisan efforts to pass something both sides can tolerate?
Some Republicans, including centrist holdout U.S. Sen. Susan Collins of Maine and former Georgia U.S. Sen. Saxby Chambliss, have suggested that Democrats should be folded into the negotiations. Senate Minority Leader Chuck Schumer, D-N.Y., said during a press conference — where he and other Democrats insisted they were not crowing, but “relieved” — that they wanted to work on a bipartisan bill, but they had requirements of their own: “Abandon tax breaks for the wealthy. Abandon cuts to Medicaid. Abandon repeal.”
“We’re the first to say it needs further improvement,” Schumer said. “We want to sit down and talk to you about it.”
But McConnell flatly put that strategy to bed Tuesday.
“They’re not interested in participating in this,” the Kentucky Republican said of Democrats.
They are certainly interested in seizing the moment. Democratic U.S. Sen. Dick Durbin of Illinois, Schumer’s second in command, indicated that Republicans had given them a gift.
“What Republicans have done is allow us to remind people that the Affordable Care Act needs work, but it’s fundamentally sound and now a majority of Americans agree with it,” Durbin said. “We were never able to sell that idea until the Republicans attacked it.”
And the message Democrats will be pounding home in public meetings over the recess?
“Health care, health care, health care.”
Staff writer Kyle Wingfield and Cox Media Group reporter Jamie Dupree contributed to this article.