President Trump's badgering and other pressure tactics arguably backfired in July, when three Senate Republicans sank the previous last effort to repeal much of ObamaCare, but when you have a very large megaphone, you apparently use it.
Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as "the Republican who saved ObamaCare."
— Donald J. Trump (@realDonaldTrump) September 22, 2017
Senate Republicans are holding a vote next week on the Graham-Cassidy health-care bill, and Sen. Rand Paul (R-Ky.) — who voted for the last GOP health-care bill, says he is a solid no on this one. The other Republicans up in the air are believed to be Sens. Susan Collins (Maine), John McCain (Ariz.), and Lisa Murkowski (Alaska) — though if Republicans let Alaska keep ObamaCare, who knows? Peter Weber
National Review asks why Jimmy Kimmel won't 'leave policy talk to health-care experts,' gets an earful
Weirdly, late-night comedian Jimmy Kimmel is now a big part of America's health-care debate. His critiques of the Graham-Cassidy health-care bill — after one of its sponsors, Sen. Bill Cassidy (R-La.), promised to oppose any bill that failed his "Jimmy Kimmel Test," which Graham-Cassidy appears to do — have hit a nerve perhaps because Kimmel is a goof and probably the least political of the late-night TV hosts. So on Wednesday, Theodore Kupfer at National Review published an article critical of Kimmel's audacity to weigh in on health care, as if he had "deep and hidden reservoirs of knowledge on risk-adjustment programs, the Medicaid expansion, or per capita caps." The article is titled, "Jimmy Kimmel, Policy-Wonk Wannabe," but the NRO social media editor posed it as a question:
— National Review (@NRO) September 21, 2017
It so happens that Politico had examined that question, and found that "in the war of words between Jimmy Kimmel and Sen. Bill Cassidy, the late-night host has the better grasp of health policy, health-care analysts say." So a lot of the responses to National Review's tweet were along those lines. But that was just the tip of the iceberg. If Kimmel isn't an expert, some asked, why are these guys being invited on cable news to talk health care?
Uh huh... pic.twitter.com/LZtvBeiIAJ
— Jade (@jade3457) September 21, 2017
— Silver Shamrock Mask (@dogdadbod) September 21, 2017
Several people noted that the occupant of the Oval Office doesn't exactly have a long health-care résumé, either:
Wow good point, National Review. pic.twitter.com/ZCH5IfWFFd
— Cody Johnston (@drmistercody) September 22, 2017
Others, like Nancy Sinatra, asked why National Review thinks Kimmel doesn't have the right to weigh in:
Because he is a patriotic American, that's why. It is a patriot's responsibilty to stand up and speak out. Thanks, @jimmykimmel
— Nancy Sinatra (@NancySinatra) September 21, 2017
Am I allowed discuss about policy publicly? If not, may I apply for a permit at your offices?
— Mike Cukan (@mcukan) September 22, 2017
And then Jason Helgerson, who runs New York State's Medicaid program, stepped in and dropped the mic:
— Jason Helgerson (@policywonk1) September 21, 2017
Twitter: Ask, and ye shall receive. Peter Weber
On Thursday, the National Association of Medicaid Directors (NAMD), a group representing the Medicaid directors from all 50 states, joined other medical and patient advocacy groups in opposing the latest Senate Republican bill to repeal the Affordable Care Act, named after sponsors Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.). The bill would scrap ObamaCare's subsidies for consumers and Medicaid expansion and redistribute that money as state grants, in what the NAMD board of directors calls "the largest intergovernmental transfer of financial risk from the federal government to the states in our country's history."
The Medicaid directors said they don't want that risk, especially without being consulted first, and they called a Congressional Budget Office score — which Graham-Cassidy won't have before voting — "the bare minimum required for beginning consideration." Setting up entire new health-care programs in 50 states requires an enormous amount of work and resources, NAMD said, and "the vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities."
Andy Slavitt, administrator of the Centers for Medicare and Medicaid Services from 2015 until January and an opponent of repealing ObamaCare, said all 50 Medicaid directors coming out against Graham-Cassidy was "very unusual," and Sen. Chris Murphy (D-Ct.), was similarly impressed:
Seriously. This is BANANAS.
You couldn't get ALL 50 state Medicaid directors to agree any anything else in health care policy. https://t.co/mKKwbSO1dw
— Chris Murphy (@ChrisMurphyCT) September 22, 2017
Sen. Jeff Flake tells Stephen Colbert why he's voting for Graham-Cassidy despite his bipartisan reputation
Senate Republicans are planning to vote next week on the Graham-Cassidy health-care bill, and they can only lose two Republican senators to squeak it through with the vice president's tie-breaking vote. One of the Republicans who says he's a yes on Graham-Cassidy, Sen. Jeff Flake (Ariz.), came on Stephen Colbert's Late Show Wednesday night and explained his thinking. "Why not wait to know what you're voting on before you affect one-sixth of the American economy?" Colbert asked. "Let me say, I want a bipartisan solution," Flake replied. "Part of the problem with ObamaCare is that it was pushed through by one party, and we're going to have the same kind of problem if we just do this long-term," but right now, 200,000 Arizonans don't have viable insurance options.
Flake said he thinks health care is better managed at the state level, and that governors will do a better job than federal officials at enabling health care for less money. (The last GOP health-care bill in July was supported by just 6 percent of Arizona voters, according to one poll.) Colbert asked Flake if he thinks Republicans have the votes to pass it, and he said yes. "It's going to come down to the final few senators," he said. "I hope we can. Like I said, people in Arizona are hurting, and that's who I'm responding to. We've got to fix it in a bipartisan way going forward — obviously it is never good for one party to push something through on its own. In the meantime, we've got to make sure that everybody has insurance." Flake did not connect those two thoughts, exactly, but you can watch his full argument below. Peter Weber
Does Graham-Cassidy have 50 Senate GOP votes? CNN tries to figure it out with body-language analysis.
Senate Republicans plan to vote next week on the Graham-Cassidy health-care bill, despite opposition from every major medical and patient health association, the insurance trade group AHIP, Blue Cross Blue Shield, every Democrat, Jimmy Kimmel, President Trump's ally Gov. Chris Christie (R-N.J.), and a handful of other Republican governors, and no Congressional Budget Office analysis of its effects on consumers and coverage. The legislation is believed to have the support of at least 48 Republican senators, with Sens. Susan Collins (Maine) and Rand Paul (Ky.) voicing opposition — though Paul also opposed earlier versions of similar bills and voted for them anyway — and Sens. John McCain (Ariz.) and Lisa Murkowski (Alaska) noncommittal. It needs 50 votes to pass. With so much at stake, CNN dabbled in a little bit of body-language analysis from video of the Senate floor on Wednesday evening. You can watch below. Peter Weber
On Tuesday evening, Sen. Lamar Alexander (R-Tenn.), the chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, said that he was ending bipartisan negotiations for a bill to stabilize health insurance markets and make a few changes to the Affordable Care Act, because after four hearings and involved negotiations, his group had "not found the necessary consensus among Republicans and Democrats." The unexpected decision appears aimed at shoring up support for the Senate GOP's last-ditch plan to repeal ObamaCare, sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), by removing any alternative legislation.
Sen. Patty Murray (D-Wash.), the top Democrat on the HELP Committee and Alexander's main negotiating partner, said she is "disappointed that Republican leaders have decided to freeze this bipartisan approach and are trying to jam through a partisan TrumpCare bill," adding that she is still committed to reaching a bipartisan deal. Alexander said that especially since Graham-Cassidy gained steam, appetite within his party for his bill was very low. "I know how to get bipartisan results, but I'm not a magician," he said.
Republicans expect to start voting on Graham-Cassidy next Wednesday, Axios reports, before a Sept. 30 deadline for passing a health-care bill with only 50 votes, with no Democrats. The Congressional Budget Office won't have its analysis on how much the bill would affect coverage or its costs for consumers until October. On Tuesday, a group of 11 governors, including five Republicans and independent Gov. Bill Walker (Alaska), urged the Senate to drop Graham-Cassidy, joining AARP, the American Medical Association, the American Hospital Association, and other patient advocacy groups, plus Jimmy Kimmel.
Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.) are believed to be opposed to the bill, and Sens. Lisa Murkowski (R-Alaska) and John McCain (R-Ariz.) are seen as the key votes on the measure — three GOP no votes, and it doesn't pass. Haley Bird at the Independent Journal Review notes:
McCain just told us he wants regular order bipartisan health bill and 10 minutes later Republicans killed the regular order bipartisan bill
— Haley Byrd (@byrdinator) September 19, 2017
Graham-Cassidy would convert ObamaCare's subsidies and Medicaid payments to block grants to states, allowing each state ample leeway to decide coverage rules and patient protections, plus cut Medicaid sharply and change its structure. Graham argues that it's the last barrier to "socialism." Peter Weber
On Tuesday, the Senate very narrowly voted to open debate on a bill to at least repeal much of the Affordable Care Act, and Tuesday night, nine Republicans and 48 Democrats and independents shot down Senate Majority Leader Mitch McConnell's plan to repeal and replace ObamaCare. (McConnell's modified Better Care Reconciliation Act "is not necessarily dead," Axios notes. "Another, simpler version — like the most recent one scored by the Congressional Budget Office — could still come up later in the process.")
Late Wednesday morning or early afternoon, the Senate is expected to vote on a measure to repeal ObamaCare without a replacement plan, similar to a bill Republicans passed in 2015, thwarted by former President Barack Obama's veto. It is widely expected to fail, too. If so, the last plausible option for Senate Republicans is to pass what's being called "skinny repeal," scrapping ObamaCare's personal and employee mandates and a medical device tax, but leaving Medicaid, ObamaCare subsidies, benefit regulations, and everything else in place. "Basically no senators will like it," Politico explains, "but they may vote for it just to keep the repeal drive going."
Assuming the House wouldn't hold an up-or-down vote on the "skinny repeal" bill, it would go to a House-Senate conference committee, where Republicans would try to come up with a bill that could pass in both chambers. "The endgame is to be able to move something at the end of this process across the Senate floor that can get 50 votes and then to get into conference with the House," said Sen. John Thune (R-S.D.).
Before a final vote, the Senate will consider dozens of amendments, in what's being called "vote-a-rama" sessions, likely starting Thursday night. The Senate parliamentarian will also likely be asked to approve or throw out measures that don't meet the restrictions of the budget reconciliation process Republicans are using. Nobody knows where this unusual legislative effort to modify a huge chunk of the economy and a health-care system used by tens of millions of Americans will end, but it is expected to conclude early Friday. "All we have to do today is to have the courage to begin the debate with an open amendment process," McConnell told his caucus on Tuesday. "And let the voting take us where it will." Peter Weber
Senate Majority Leader Mitch McConnell (R-Ky.) will ask the Senate as early as Tuesday to begin debate on a bill to gut the Affordable Care Act, but not even Senate Republicans know what bill they will be asked to vote on. It isn't entirely clear they will know before voting to open debate, either. Some senators said that McConnell has assured them they would be told before voting on the "motion to proceed" whether they would be proceeding to a vote on one of the versions of a bill to repeal and replace ObamaCare or just to repeal much of the law. The No. 2 Senate Republican, Sen. John Cornyn (R-Texas), said late last week that letting senators know what bill they would be voting on is "a luxury we don't have."
McConnell's current strategy "is to lean heavily on lawmakers to at least vote to allow debate on the bill, in the hopes that amendments and other tweaks could yield an agreement," The Wall Street Journal reported Sunday. That strategy carries some risk, as do all the others. McConnell put together his version of the bill with no public hearings or deliberation in committee. On Friday, the Senate parliamentarian issued a preliminary ruling that some two dozen provisions in the GOP bill would require 60, not 50, votes, throwing a new wrinkle in McConnell's plans to pass the bill using the budget reconciliation process.
On Saturday, President Trump urged Senate Republicans to "step up to the plate" and "vote to repeal and replace" ObamaCare.
When CBS News political director John Dickerson asked Sen. Susan Collins (R-Maine) what's going on with the legislation on Sunday's Face the Nation, she said that was a good question. "It appears that we will have a vote on Tuesday," she said. "But we don't know whether we're going to be voting on the House bill, the first version of the Senate bill, the second version of the Senate bill, a new version of the Senate bill, or a 2015 bill that would have repealed the Affordable Care Act now and then said that somehow we'll figure out a replacement over the next two years. I don't think that's a good approach to facing legislation that affects millions of people and one sixth of our economy." The part on health care begins at the 4-minute mark. Peter Weber