By Sean Sullivan, Juliet Eilperin and Kelsey Snell,
Senate Republicans are in the final stages of producing a sweeping rewrite of the nation’s health-care laws after weeks of highly secretive deliberations and lingering frustration among the rank and file over how to fulfill the party’s signature campaign promise of the last seven years.
Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday that the GOP leadership will produce a “discussion draft” of the health-care bill on Thursday. Several Republicans said a vote could come as soon as next week — even as key senators expressed concern about the emerging legislation, the secrecy surrounding it and the level of disagreement that remains.
“We’re going to lay out a discussion draft Thursday morning, you’ll be able to take a look at it,” McConnell told reporters. He declined to discuss the specifics of what he planned to present. McConnell said the Senate would proceed to the bill once it receives a score from the nonpartisan Congressional Budget Office.
Sen. Ted Cruz (R-Tex.), a key architect of a health-care working group that has been huddling regularly for weeks, said that while the senators “continue to make good progress” on crafting a compromise, “a great deal of work remains to be done.”
The critical test, Cruz said, is whether the bill would drive down premium costs. “Right now, the current draft doesn’t do nearly enough in that regard,” he said.
As he exited a working-group meeting Tuesday, Sen. Orrin G. Hatch (R-Utah) was asked whether Republicans had moved any closer to completing their work.
“Didn’t seem like it to me,” he responded, with a chuckle. Hatch added: “There’s still a lot of different points of view. And there are no simple answers to these problems.”
McConnell and a small group of aides have been crafting the bill behind the scenes, with the majority leader collecting input from GOP senators in various meetings. His goal is to bring the bill to the Senate floor next week for debate, amendments and a final vote.
Republicans have vowed to repeal and replace key parts of the Affordable Care Act, also known as Obamacare, the sweeping 2010 law that has provided insurance to roughly 20 million additional Americans through a combination of expanded Medicaid coverage and private insurance, much of which is federally-subsidized.
But the sharp disagreements over the details — including how to reduce the cost of Medicaid and change the rules for health plans on the independent market to lower costs — have produced a complicated and messy drafting process.
The secretive effort has alarmed Senate Democrats and even some Republicans. Democrats registered their displeasure with both the process and policy Republicans are spearheading in a series of Senate floor speeches that stretched late into Monday night. On Tuesday, they continued their protests, using a parliamentary tactic to slow other Senate business.
Republican senators continued huddling Tuesday — in large and small groups — to discuss the direction of the bill.
“I think the plan, as I said earlier, is to reach the bill on Thursday.” Corker said. “It appears the vote would be a week or eight days later. Let’s see what the text says and let’s take it a step at a time.”
One of the biggest and most divisive matters under discussion is how to structure Medicaid. Some GOP senators from states that expanded the Medicaid under the Affordable Care Act are trying to phase out these benefits at a slower rate than a bill that passed the GOP-controlled House in May. Some conservatives, meanwhile, are seeking to slow the growth of Medicaid’s costs.
Sen. Patrick J. Toomey (R-Pa.) called talks on the bill “a work in progress” on Tuesday. Toomey is leading the conservative Republicans who want to slow Medicaid’s costs.
On the opposite end of the spectrum is Sen. Rob Portman (R-Ohio), who has been pushing for a seven-year phaseout of Medicaid expansion that he called a “glide path.” McConnell has been pushing for a three-year phaseout. Both would be more gradual than the House bill.
Asked whether negotiations were far enough along to allow for a vote next week, Cruz said he is more concerned with paring back regulations in Obamacare than he is in the Medicaid debate. “I think our decision not to set artificial deadlines was the right decision,” he said.
Cruz, who has frequently clashed with McConnell in the past, has been cooperating with him in this effort. But it was unclear how detailed a picture of the emerging bill Cruz has reviewed.
The Senate is scheduled to go into recess at the end of next week. If Republicans do not finish their work on health care before they, they may risk losing steam, as senators return to their home states and potentially face fresh resistance to their efforts.
Still, some Republicans said they were confused about the bill taking shape, voicing frustration about the lack of transparency or warning against rushing.
“I’m hearing lots of conflicting information,” said Sen. Susan Collins (R-Maine), a key centrist.
Sen. Marco Rubio (R-Fla.) said he has “no problem with a group of people leading the first draft.” But he added: “Ultimately, I would suspect, every member should have an opportunity to understand it, weigh in, propose and have an opportunity to make changes that they think are important.”