Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
May 30, 2017 01:00 AM

GOP senators gloomy about repeal prospects, but watch out for House repeat

Harris Meyer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Majority Leader Mitch McConnell

    The seeming impasse among Senate Republicans to reach an agreement on how to repeal and replace the Affordable Care Act feels like déjà vu all over again.

    The question is which senator will take on Republican congressman Fred Upton's role and broker a last-minute compromise. Upton's amendment in early May brought just enough moderates and conservatives together to pass the American Health Care Act in the House.

    Late last week, after the nonpartisan Congressional Budget Office walloped the House GOP replacement bill by estimating it would spike the number of uninsured Americans by 23 million, Senate Republicans wrung their hands, acknowledging it would make their repeal-and-replace efforts more difficult. Some dreaded the hostile reception they might get back home during the Memorial Day recess.

    "If I had to bet my house, I'd bet we don't get it done," an unnamed GOP senator told Politico.

    Even normally unflappable Majority Leader Mitch McConnell said he didn't know how his party would get the needed 50 of the 52 Senate Republicans to pass a healthcare bill under special budget reconciliation rules requiring only a simple majority (Vice President Mike Pence would provide the 51st vote to pass the bill).

    McConnell's drafting group of 13 senators began writing the Senate's bill at the end of the week, even though the GOP caucus remains far from agreement on many key issues, including phasing out the ACA's Medicaid expansion, structuring premium tax subsidies, capping Medicaid spending, letting states opt out of the ACA's insurance market rules, and whether to repeal all of the ACA's taxes that finance expanded coverage.

    There is also discord over whether to end funding for Planned Parenthood, which at least three Republican senators oppose.

    Prominent political reporters at the New York Times, the Wall Street Journal, and Politico wrote quasi-obituaries for the Senate's struggling healthcare effort, with headlines like "GOP turns gloomy over Obamacare repeal."

    But don't forget that nearly everyone had written off the chances of House Republicans passing their repeal-and-replace bill after Speaker Paul Ryan and President Donald Trump withdrew their bill without a vote in late March. Ryan declared that "Obamacare is the law of the land" for the foreseeable future. Even three days before the AHCA passed on May 4, it was dubbed "zombie Trumpcare" —a dead bill that didn't know it was dead.

    Opponents of the GOP repeal-and-replace effort, including many healthcare industry groups, were lulled into complacency thinking the bill was going nowhere.

    Then Rep. Upton—who a day earlier said he couldn't vote for the AHCA because it weakened protections for people with pre-existing medical conditions—proposed an amendment offering $8 billion for high-risk pools to cover otherwise uninsurable people. Critics called that a fig leaf giving more centrist GOP lawmakers cover to reverse themselves and vote for the bill; but it worked, enabling Ryan to squeak the bill through on a 217-214 vote.

    The same could well happen again, ACA supporters and opponents say.

    "McConnell is probably the most effective leader on the GOP side in corralling votes, and anyone underestimating his ability to bring his caucus together does so at their peril," warned Ron Pollack, chair emeritus of Families USA, who helped build support for passage of Obamacare.

    "I'm betting today that you get two-thirds of the House bill through the Senate," said Tom Scully, who headed the CMS under President George W. Bush. "The odds are better than 50-50."

    While there's lots of talk about relative moderates from Medicaid-expansion states, such as Ohio Sen. Rob Portman, serving as a firewall against the House bill's repeal of the Medicaid expansion, those senators have indicated they are amenable to compromises. Portman said he wants a "soft landing" for states that expanded coverage to low-income adults. He's reportedly seeking a delay of several years in the phase-out of enhanced federal funding for the expansion population.

    "A delayed cut is still a cut with long-term repercussions," Pollack said. "I worry whether the moderates will provide the kind of resistance to things that will harm their constituents that they appeared to be signaling early on."

    That's why pro-ACA observers fear another Upton-type surprise in the Senate, with some GOP senator proposing modest changes to give cover to moderates to vote yes on the bill, despite big coverage losses and erosions in consumer protections that they previously opposed.

    "Senate moderates are going to be under the same enormous pressure moderates faced in the House," said former Democratic Senate Majority Leader Tom Daschle. "Only time will tell if they cave in a similar fashion."

    Many healthcare industry leaders, particularly in insurance, are keeping a low profile while they wait to see the shape of the legislation Senate Republicans produce.

    But that strategy could be risky, because the Senate bill could make a rapid recovery from intensive care. Senate GOP leaders are determined to make that happen because they must pass their healthcare overhaul first to enact permanent large tax cuts later this year.

    "Doing nothing is not an option," Senate Majority Whip John Cornyn of Texas said Thursday.

    Billy Wynne, a former Democratic Senate staffer and healthcare lobbyist who represents hospitals and other industry groups, advised healthcare groups to press their positions on senators as strongly as possible now.

    "Don't take anything for granted," Wynne said. "You can think something is dead, but then all of a sudden it's not."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Biden COVID_i.jpg
    Biden to end COVID emergency declarations on May 11
    WHO_i.jpg
    COVID-19 still an emergency but approaching 'inflexion point,' WHO says
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing