Senate Republican Leaders Delay Vote On Health Care Bill

Jun 27, 2017
Originally published on June 27, 2017 5:47 pm
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ARI SHAPIRO, HOST:

The fate of the Senate bill to overhaul the Affordable Care Act is up in the air. Senate Republican Leader Mitch McConnell is putting off a vote on the measure because right now there isn't enough support to pass it. Against that backdrop, President Trump invited Republican senators to the White House this afternoon.

NPR national political correspondent Mara Liasson joins us from the White House. And Mara, talk us through what led McConnell to delay this vote.

MARA LIASSON, BYLINE: He doesn't have the votes, pure and simple. He could only afford to lose to Republicans since no Democrats are going to vote for this. And he lost more than two. And he was trying to satisfy concerns from different factions - conservatives like Rand Paul or Mike Lee who were unhappy that the bill actually didn't repeal Obamacare altogether. It merely made it less generous.

Then there were moderates who were concerned that 22 million fewer people would have health insurance over 10 years in this bill and premiums and deductibles for lower-income, older, working-class people would go up. That was particularly a concern for senators like Susan Collins of Maine or Dean Heller from Nevada or Shelley Moore Capito from West Virginia. These are states that have a lot of poor, rural voters that expanded Medicaid. And here is how Mitch McConnell explained the delay.

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MITCH MCCONNELL: Legislation of this complexity almost always takes longer than anybody else would hope. But we're going to press on. We think the status quo is unsustainable for all the obvious reasons we've discussed over and over and over again. And we're optimistic we're going to get the result that's better than the status quo.

LIASSON: What's so interesting here is Mitch McConnell is a guy who people think almost has magical powers. He's such a skillful legislative technician. He left himself some wiggle room to make deals with these senators, but it turns out it wasn't enough wiggle room to get this bill over the finish line this week.

SHAPIRO: This week.

LIASSON: Doesn't mean he won't get it in the end.

SHAPIRO: Right.

LIASSON: Remember; the House bill took two tries.

SHAPIRO: So what is the president's role in trying to get it over the finish line if not this week, then sometime later in the summer?

LIASSON: The president is getting a lot more involved. He made calls to senators over the weekend. He had lunch with Rand Paul today. He's invited all 52 Republican senators to White House this afternoon, and he told them Obamacare was melting down, needed to be replaced. But as for the prospects for passing the Senate bill, here's what he said.

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PRESIDENT DONALD TRUMP: This will be great if we get it done. 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.

LIASSON: Doesn't sound super optimistic. He also didn't say how he wants the bill changed. You know, he had said the House bill was too mean, and he wanted the final product to be more generous. He's also promised no cuts to Medicaid. But that being said, the president has not been involved in the policy details. He's really subcontracted out the policymaking process to Republicans on Capitol Hill.

And this bill is a very traditional conservative Republican product. It's not a Trumpian bill. It has big tax cuts for the wealthy, much less assistance for low-income and working-class people to buy health care. It also includes what has been the Holy Grail for Republicans for a generation, which is entitlement reform. It transforms Medicaid from an open-ended commitment to anybody who meets certain criteria into a much less generous block grant.

SHAPIRO: And Mara, one reason McConnell wanted a vote this week was because he was afraid people would get an earful if lawmakers went back home over the July Fourth recess, which they are now about to do. What's the risk there?

LIASSON: The risk is really big. This bill is unpopular, and it's getting more so by the day. There are going to be town meetings. There'll be interactions with the angry constituents. There'll be another chance for Democrats to push back. And you know, Republicans have yet to lay out a positive case for this bill. They've mostly focused on how horrible Obamacare is, at least for the 8 percent of Americans who get their insurance on the individual marketplace. Now they're going to have to explain why it's a good idea to transform Medicaid, why the wealthy should get tax cuts. This is a hard sell. That's why Mitch McConnell wanted it pushed through before they went home.

SHAPIRO: NPR's Mara Liasson. Thank you very much.

LIASSON: Thank you. Transcript provided by NPR, Copyright NPR.