WASHINGTON (Reuters) - Republican U.S. Senate leaders, struggling to keep
a seven-year promise to end Obamacare, turned their focus on Wednesday to
passing a
slimmed-down "skinny" repeal measure that would throw the
issue into negotiations with the House of Representatives.
The last-ditch effort came after senators voted 55-45 against a straight
repeal of Obamacare, which would have provided for a two-year delay in
implementation to give Congress time to work out a replacement. Seven
Republicans opposed the measure.
It was the Senate's second failure in 24 hours to repeal the 2010
Affordable Care Act, popularly known as Obamacare, which expanded health
insurance to about 20 million people, many of them low-income. On Tuesday,
senators rejected the repeal-and-replace plan Republicans had worked on since
May.
The failures underscored the party's deep divisions on the role of
government in helping provide access to healthcare as the Senate conducted its
second day of a freewheeling debate that could stretch through the week.
Republicans said they were still working out what would be in a skinny
repeal, which could simply eliminate mandates requiring individuals and
employers to obtain or provide health insurance, and abolish a tax on medical
device manufacturers.
Senator John Thune, the No. 3 Senate Republican, said the party was
trying to "figure out what the traffic will bear, in terms of getting 50
of our members to vote for things that will repeal as much of Obamacare as
possible."
Republicans hold a 52-48 majority in the Senate.
Any Senate legislation would be enough to kick the issue to a special
negotiating committee with the House, which passed its own version in May. If
that panel can agree on a new bill, the full House and Senate, both controlled
by Republicans, would again have to approve the legislation - a process that
could last months.
"I think people would look at it not necessarily based on its
content, but as a forcing mechanism to cause the two sides of the building to
try to solve it together," Republican Senator Bob Corker said.
"That’s going to be the last chance."
Senator John Cornyn, the No. 2 Senate Republican, told reporters there
was growing support for a slimmed-down approach that would kick the can to
negotiators.
"I think there is plenty of agreement," he said.
Seeking 'More Organized Process'
President Donald Trump has come down hard on his fellow Republicans for
failing to act on Obamacare, something he promised repeatedly to repeal and
replace in his election campaign last year. Some Senate Republicans were
growing uncomfortable with the chaotic debate.
"We've got to have a more organized process," Republican
Senator Ron Johnson said, noting the skinny repeal would simply delay acting on
the core issue. "We just don't have the courage and really the intestinal
fortitude to suck it up and ... do this right."
Late on Wednesday, only 10 senators voted for a largely symbolic
amendment stating lawmakers' commitment to preserve a part of Obamacare that
helped states expand the government's Medicaid insurance program for the poor
to cover a wider net of people.
Democrats refused to approve any amendment to a bill they dislike and the
vote primarily highlighted deep divisions among Republicans. The amendment was
introduced by Senator Dean Heller, who faces a tough re-election fight in
Nevada next year, and supported by Senators Susan Collins, John McCain and
other party moderates who have expressed skepticism about the
repeal-and-replace process.
Trump attacked one of those senators, Lisa Murkowski of Alaska, by name
in an early morning tweet on Wednesday. Murkowski, one of two party members who
voted on Tuesday against opening debate on a bill to end Obamacare, told MSNBC
she was not worried about the political fallout.
"Every day shouldn't be about winning elections. How about just
doing a little bit of governing around here?" she said.
Healthcare industry organizations are similarly troubled and have urged a
more bipartisan effort.
The Blue Cross Blue Shield Association, which represents health insurers
across the country, said that if the individual mandate is repealed, it must be
replaced with incentives for people to buy health insurance and keep it
year-round.
The mandate is considered critical to helping hold down the cost of
premiums, because it means that healthy people as well as the sick, who incur
high medical costs, buy insurance.
The group also said the government needed to fund subsidies for medical
expenses and provide funds to cover high-cost patients.
Anthem Inc (ANTM.N), a health insurer with more than 1 million customers
in Obamacare individual insurance plans, threatened to further shrink its 2018
market participation because of uncertainty about the government paying for the
subsidies that make the plans affordable for millions of Americans.
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