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 The U.S. Senate is up against a Saturday deadline for deciding the
fate of the 2010 Affordable Care Act, popularly known as Obamacare,
because of an expiring rule that lets the Republican healthcare
legislation pass with just a simple 51-vote majority, instead of the
60-vote threshold needed for most measures.
Republicans, who control the Senate 52-48, were finding it difficult
even to clear that lower hurdle.
The Senate Finance Committee is scheduled to hold a hearing on
Monday in an attempt to build support for the bill and to tamp down
Democratic criticisms the measure has not been thoroughly vetted.
Republican senators leading the effort plan to release a revised
version of their bill that would send more money to Alaska and
Maine, the states of two holdout senators, the Washington Post
reported late on Sunday.
For seven years, Republicans have hammered Obamacare as an
unwarranted and overly expensive government intrusion into American
healthcare. Republican President Donald Trump made repealing
Obamacare one of his top campaign promises in 2016. Democrats have
fiercely defended it, saying it has extended health insurance to
millions.
The most previous attempt to repeal Obamacare fell one vote short in
July, in a humiliating setback for Trump and Senate Majority Leader
Mitch McConnell.
Opposition grew on Sunday to the plan by Senators Lindsey Graham and
Bill Cassidy that could be up for a vote on the Senate floor this
week.
It would take federal money spent on the Medicaid program for the
poor and disabled, as well as subsidies to help Americans buy
private insurance, and divvy it up to the states in block grants.
Advocates say that would give states more discretion to manage their
own healthcare schemes.
Opponents fear that millions would lose healthcare, including some
with pre-existing medical conditions.
Conservative Republican Senator Ted Cruz, speaking at an event in
his home state of Texas, warned on Sunday that Trump and McConnell
could not count on his vote. Cruz has pushed for greater government
cost savings in healthcare.
Moderate Republican Senator Susan Collins of Maine, interviewed on
CNN's "State of the Union" on Sunday, said it was difficult for her
to "envision a scenario where I would end up voting for this bill."
She worried about cuts to Medicaid benefits to the poor and
disabled.
U.S. Senate Democratic leader Chuck Schumer dismissed the late
effort to revise the bill and add money for a few states, calling it
"just as bad for those states and the rest of the states because it
still contains a massive cut to Medicaid."
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GRAHAM VOWS TO KEEP UP EFFORT
A total of three Republican defections would kill off the latest
effort to repeal Obamacare. Republican Senators John McCain and Rand
Paul have already registered their opposition.
As early as Monday, the non-partisan Congressional Budget Office is
expected to produce a preliminary analysis of Graham-Cassidy that
would assess the bill's impact on budget deficits.
More time is likely needed for the CBO to gauge how the bill could
affect Americans' access to health insurance.
Despite the deepening skepticism, Graham pledged on Sunday to keep
pushing for passage. During an interview on ABC, Graham said that if
his bill was defeated, he would aim to use his seat on the Senate
Budget Committee to keep the effort alive.
An aide to Graham said in an email that the senator was suggesting
an extension of the Sept. 30 deadline. That could create
complications for tax overhaul legislation that Trump also is
pushing.
Independent analyses indicate Graham-Cassidy would fundamentally
redistribute federal healthcare money, generally with
Republican-leaning states benefiting and Democratic-leaning states
losing.
State-by-state impacts from Graham-Cassidy would vary, but some of
the states whose senators are undecided would stand to lose funding,
the Axios news website reported on Friday, citing a study by the
Centers for Medicare and Medicaid Services, a unit of the Department
of Health and Human Services that oversees Medicaid and the
Obamacare program.
The CMS study found that by 2026, Alaska would lose 38 percent of
its federal funding for insurance subsidies and Medicaid. Both of
Alaska's Republican senators, Lisa Murkowski and Dan Sullivan, are
still on the fence over Graham-Cassidy.
The insurance industry, hospitals, medical advocacy groups such as
the American Medical Association, American Heart Association and
American Cancer Society, the AARP advocacy group for the elderly and
consumer activists oppose the bill.
(Reporting by Susan Cornwell and Richard Cowan; Editing by Peter
Cooney and Mary Milliken)
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