The Republican effort to repeal Obamacare appeared to be on the brink of collapse on Monday night, but the GOP leadership may still be able to revive it. On Monday afternoon, the Congressional Budget Office said the Senate health-care bill, which Majority Leader Mitch McConnell wants to pass by the end of the week, will cost 22 million Americans their health insurance over the next decade. Within hours, four Republicans said they won’t even let the current bill be brought to the floor for debate.
With every Democrat opposed to the health bill, McConnell can only afford to lose two Republican votes. The plan was to hold a procedural vote to start debate on the bill in the next day or two, clearing the way for a final Senate vote as early as Thursday.
Republican senator Dean Heller had already said he would oppose the motion to proceed when he announced his opposition to the bill on Friday. On Monday night, senators Susan Collins, Rand Paul, and Ron Johnson said they’ll vote “no” on the initial motion to proceed as well.
Collins, a moderate who has said her goal is to see even more people insured than under Obamacare, tweeted that she’ll vote against proceeding with the current GOP bill because it’s too harsh. She also said she wants to bring Democrats into the health-care process, suggesting she’s unlikely to be swayed by compromises offered by the GOP leadership.
Rand Paul, one of four senators who said they oppose the bill because it’s insufficiently conservative, told reporters he’ll vote against the motion to proceed as well. “On the current bill I’m not voting to get on it unless it changes before we get to it,” he said.
Finally Senator Ron Johnson, another conservative “no” vote, told CNN that it would be a “mistake” to begin debate on the bill as it’s currently written.
“If Leader McConnell says failure is not an option, don’t set yourself up for failure would be my advice for the leader,” Johnson told reporters.
A number of other GOP moderates from states that accepted Obamacare’s Medicaid expansion have expressed concerns about coverage losses, but haven’t officially come out against the bill. One such senator, Bill Cassidy, suggested the CBO score makes him less likely to support the bill:
The CBO report wasn’t all bad news for McConnell. It found that compared to the House version of the bill, his Better Care Reconciliation Act nearly triples the deficit-reduction estimates. That gives McConnell a considerable slush fund, which he can use to win over wavering Republicans.
What happens next is up to McConnell. He could try to convince Heller, Collins, Paul, and Johnson to allow the bill to proceed this week, but as with the final vote, concessions to the moderates could alienate the conservatives, and vice versa. Plus, Johnson seems particularly riled about McConnell’s attempts to “jam this thing through” in a matter of days, as he told radio host Hugh Hewitt. “I have a hard time believing I’ll have enough information for me to support a motion to proceed this week,” Johnson said.
McConnell could pull the current bill and try to negotiate a new version over the coming weeks. But after suggesting over the weekend that the real deadline for a vote was August 1, on Monday Senate Majority Whip John Cornyn said the bill needs to pass this week:
McConnell’s third option is to let the bill fail, blame Democrats for preventing health-care reform, and move on to other issues like taxes. Cutting taxes is a bigger priority for McConnell than sorting out the Republicans’ disparate positions on health care, and many have speculated that McConnell might have purposely crafted an unpopular bill that he knew would fail quickly, just to get it out of the way.
President Trump was already previewing that message on Monday: