Senate GOP sees way forward for ObamaCare repeal

Senate Republican leaders are moving ahead with an ObamaCare repeal package, cautiously optimistic they have the 51 votes needed to pass it.

Senate Majority Leader Mitch McConnell (R-Ky.) appeared to take a major stride toward winning over conservatives Monday evening by floating a proposal to strengthen a House-passed repeal bill by phasing out the expansion of Medicaid over two years.

{mosads}A Senate GOP leadership aide said the bill would be strengthened in other ways but declined to reveal specifics.

Senate conservatives have been told the bill will repeal as much of ObamaCare as possible under the special budgetary rules known as reconciliation, implying that leaders want to repeal all of the law’s tax increases as well as subsidies for people who buy insurance through government-run heath exchanges.

Members of the GOP leadership team expressed confidence Monday that they would send the package to President Obama’s desk.

“I think we’ve found a pretty good spot so I’m optimistic,” said Senate Republican Whip John Cornyn (Texas). “We are going to do more, repeal more of ObamaCare.

“It’s bigger and better,” he added.

“I think when push comes to shove we’ll be there,” Sen. John Thune (S.D.), chairman of the Senate Republican conference, said of the 51 votes McConnell needs to pass the package under an expedited process known as reconciliation.

Sen. Mike Lee (R-Utah), an influential conservative who vowed to oppose the House-passed ObamaCare repeal package, said he was “very encouraged.”

McConnell will bring the House package straight to the floor and offer a substitute or so-called curative amendment to address procedural problems created by the so-called Byrd Rule. The rule is a litmus test for what can pass the Senate under reconciliation with simple majorities instead of 60 votes, as is usually required of controversial legislation. 

Another wrap-around amendment will have to be considered to address Medicaid expansion, which the House bill left intact.

Sens. Ted Cruz (R-Texas) and Marco Rubio (R-Fla.), who are running for president, along with Lee, panned the House bill for not going far enough — raising the threat that McConnell might fall short of the 51 votes needed to pass a repeal package.

Cruz and Rubio were on the campaign trail and did not attend the meeting.

Mainstream and moderate Republicans have balked at undoing the Medicaid expansion, which 30 states have embraced. Some of those concerns have been eased by a compromise proposal to reverse the expansion after a two-year transition period.

Sen. Shelley Moore Capito (R-W.Va.), who initially opposed reversing Medicaid expansion — noting it has expanded coverage to 160,000 people in her home state — said Monday evening she felt reassured. 

“We feel pretty good,” she said. “It’s a two-year transitional period to move to a replacement vehicle so we can come up with a better plan.”

Another GOP senator representing a state thinking about adopting the Medicaid expansion, who requested anonymity, said he would first check with his local governor before making a decision on how to vote.

A senior Senate Republican aide emphasized the substitute amendment offered by McConnell to address the Byrd-Rule issues would start the beginning of the amendment process and the legislation could change significantly and unpredictably before a final vote.

“What will be unveiled is only the beginning of the process,” the aide said of the substitute amendment that will be made public on Tuesday.

McConnell convened a special meeting of the Republican conference in the Strom Thurmond Room Monday evening to discuss the ObamaCare package and the plan for passing it this week.

Under reconciliation, the bill can pass with a simple-majority vote but it must address issues that are primarily budgetary in nature — a test the House-passed package fails in several respects.

Republican senators say they expect to vote Wednesday on a motion to begin 20 hours of debate and then vote on a series of amendments and final passage on Thursday.

“I think we’ll do it this week. Wednesday will probably be that vote,” said Sen. Johnny Isakson (R-Ga.), referring to the vote on the motion to proceed.


McConnell can afford only three defections from his 54-person conference and has to walk a fine line between a handful of moderates and conservatives who have expressed concern with the House-passed legislation.

While Lee said he was encouraged, Cruz and Rubio did not attend Monday’s meeting because of their presidential campaigns. There’s no guarantee they will come on board although leaders are hopeful.

The three conservatives issued a statement in October panning the House bill.

“If this bill cannot be amended so that it fully repeals ObamaCare pursuant to Senate rules, we cannot support this bill,” they said.

The House measure repeals the individual and employer mandates, which require people and large-enough companies to buy and offer health insurance.



It also repeals the “Cadillac tax” on expensive health plans and the medical device tax but leaves in place billions of dollars in tax increases as well as expensive subsidies for people who buy insurance through government-run exchanges.



Votes on amendments to repeal the Medicaid expansion over a two-year phase in and to repeal the ObamaCare subsidies and more of its tax increases will come later in the vote-a-rama. If they don’t pass, Cruz and Rubio might vote against final passage — although GOP leaders don’t seem too worried right now. 

Republicans from battleground states facing tough re-elections said recently they wanted to leave the Medicaid expansion in place, fearing a repeal could leave their governors with big bills otherwise. 



Illinois, New Hampshire, Ohio and Pennsylvania are among those that have embraced the Medicaid expansion, which covers households earning up to 138 percent of the federal poverty level.



McConnell also has to keep his eye on three GOP centrists, Sens. Mark Kirk (Ill.), Susan Collins (Maine) and Lisa Murkowski (Alaska) oppose a provision in the House package defunding Planned Parenthood.



According to a source familiar with the internal deliberations, Senate GOP leaders had initially signaled to them that the parliamentarian, Elizabeth MacDonough, would likely rule it couldn’t be included but, unexpectedly, she said it was OK.


Collins on Monday declined to say how she would vote for the ObamaCare repeal package.

Senate GOP leaders could also face additional hurdles from the parliamentarian, Elizabeth MacDonough.

The House bill ran into trouble last month when MacDonough ruled the provisions repealing the individual and employer mandates do not pass the Byrd Rule.

Senate GOP leaders will try to get around one objection by proposing amendment language that would eliminate the penalties for failing to comply with the mandates, according to a senator who attended the meeting.



“We’ll do what the administration did and take away the penalty,” said the lawmaker, referring to executive actions taken by the president.



Cornyn told reporters that leaders are still in talks with the parliamentarian about what provisions need to be changed to comply with the Byrd Rule.



“We’re continuing that conversation,” he said.

This story was updated on Dec. 1 at 12:23 p.m.