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GOP Health Care Bill Collapses

Failure to pass an Obamacare repeal could upend the entire Republican agenda. The party has spent nearly seven months on a health care overhaul, with hopes it would ease the path to tax reform. Now Trump and the GOP-led Congress are staring at an impending August recess with no major legislative achievements in hand.

“We should not put our stamp of approval on bad policy,” Jerry Moran said., Chip Somodevilla/Getty

President Donald Trump's top legislative priority was dealt a potentially fatal blow Monday night as two more Republican senators announced their opposition to the party's health care overhaul.

Trump quickly called on Republicans to simply repeal Obamacare and begin work on a new health care plan, and Senate Majority Leader Mitch McConnell announced he would try to do so.

“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful," McConnell said.

The Kentucky Republican said he planned to hold a vote in the coming days to take up the House-passed bill to replace the 2010 health care law and then call up an amendment to eliminate major parts of Obamacare, such as the Medicaid expansion, insurance subsidies and fines for the employer and individual mandates.

Republicans passed a similar bill to effectively repeal Obamacare in 2015 under reconciliation — the fast-track budget procedure the GOP is using to thwart a Democratic filibuster — but it was vetoed by President Barack Obama.

McConnell added that the repeal-only bill is "what a majority of the Senate has already supported in 2015," but GOP lawmakers have voiced severe doubts that such a plan can win the 50 votes necessary this year given the uncertainty it would throw into insurance markets. The 2015 vote was viewed as mostly symbolic at the time, given Obama’s certain veto.

But after his own caucus tanked McConnell's attempts to repeal and replace Obamacare simultaneously and at the prodding of the president, the GOP leader is going to force his caucus to go on the record on health care. If the Senate does vote to open debate on the House bill, which is not guaranteed, the repeal-only bill would be the first amendment. But senators would still be able to offer unlimited amendments to the bill, leading the GOP down an uncertain road once the process began.

"Republicans should just 'REPEAL' failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!" Trump tweeted shortly before McConnell's statement came out.

McConnell's announcement followed the news that GOP Sens. Mike Lee of Utah and Jerry Moran of Kansas said they could not support the current bill. They joined Maine Sen. Susan Collins and Kentucky Sen. Rand Paul in opposition, denying GOP leaders the support to even bring the bill to the floor and upending Republicans' seven-year goal of repealing Obamacare. Sen. John McCain (R-Ariz.), who is recovering from surgery, issued a statement advising the party to start over with a bipartisan approach.

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Failure to pass an Obamacare repeal could upend the entire Republican agenda. The party has spent nearly seven months on a health care overhaul, with hopes it would ease the path to tax reform. Now Trump and the GOP-led Congress are staring at an impending August recess with no major legislative achievements in hand.

At a dinner with GOP senators on Monday evening, Trump said the party would look like “dopes” if they couldn’t pass the bill after passing a repeal bill in 2015.

“If the Republicans have the House, Senate and the presidency and they can't pass this health care bill, they are going to look weak,” Trump said, according to a source familiar with the meeting. “How can we not do this after promising it for years?”

Trump had no idea defections were coming Monday night, according to another White House official with knowledge of the meeting. "Why would we have a dinner like that if we knew people were going to drop out?" the official said.

Even before Lee and Moran's announcement, there were increasingly urgent signs that the GOP's 52-seat majority was too fragile to pass the bill, which would scale back Medicaid spending and Obamacare's insurance subsidies. The vote was already delayed because of McCain's surgery, and Sen. Ron Johnson (R-Wis.) had fumed that McConnell had committed a "breach of trust" in selling the bill to moderates.

Still, just minutes before Moran’s and Lee's statements, aides were toiling to revise the bill so it could win the support of 50 Republican senators.

But with Collins and Paul already in opposition, the conservative Lee and typically pragmatic Moran held hands and became the deciding votes in opposition to McConnell's latest plan.

Moran criticized the closed-door process for developing the bill and criticized the legislation for not repealing the entire 2010 health care law, concluding that "We should not put our stamp of approval on bad policy." Lee said the latest bill "doesn’t go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly Obamacare regulations."

Democrats, meanwhile, celebrated. Senate Minority Leader Chuck Schumer of New York said that the "second failure of Trumpcare is proof positive that the core of this bill is unworkable."

The announcement from Lee and Moran is just the latest in a long series of obstacles for the Obamacare repeal effort. McConnell pulled a vote on a previous version of the bill last month after skeptical Republicans came out against the plan.

Johnson was stunned to read in The Washington Post that McConnell was privately arguing that major reforms to Medicaid were so far in the distance that they would never take effect. Johnson said Monday that he’d confirmed through conversations with other senators that McConnell had made the remarks.

“The reported comments from Leader McConnell before last Thursday about ‘don’t worry about these Medicaid changes, they won’t take effect,’ that’s troubling to me. I have talked to senators that basically confirmed that. I’ll see what Leader McConnell says tomorrow,” Johnson said on Monday evening. “From my standpoint, it’s a pretty serious breach of trust, those comments. I’m just troubled by those comments.”

In response to Johnson's complaints, McConnell said, “I prefer to speak for myself, and my view is that the Medicaid per capita cap with a responsible growth rate that is sustainable for taxpayers is the most important long-term reform in the bill. That is why it has been in each draft we have released.”

Before Lee and Moran announced their opposition, more than a half-dozen key senators were undecided, many wavering over those cuts to Medicaid spending.

“I’m reserving judgment. I want a CBO score, analysis and we’re still doing more work on it,” said Sen. John Hoeven (R-N.D.). “They need more time … we’re still working on it.”

The effort stalled over the weekend as McCain's office announced the Arizona Republican, and his vote, would be away from Washington for at least a week.

GOP leaders had hoped he would return in a week and they could start work on the bill.

“We’re not going to come up short,” Senate Majority Whip John Cornyn (R-Texas) had said earlier in the day. "We need a full contingent of the Republican senators. We don’t have any to spare.”

Trump had also ramped up his outreach to the Hill — hosting a handful of GOP senators at the White House dinner Monday night, including Cornyn, John Thune of South Dakota, Lamar Alexander of Tennessee, Roy Blunt of Missouri, Steve Daines of Montana and James Lankford of Oklahoma, according to Republican aides.

Key swing-vote senators such as Rob Portman of Ohio, Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia, Jeff Flake of Arizona, Cory Gardner of Colorado and Johnson were not attending. Neither did Lee nor Moran.

And a charm offensive from the Trump administration aimed at skeptical GOP governors seemed to have little impact over the weekend.

“Governors have a large say. The reason why we’re not at 50 right now is a lot of governors don’t like what we’re doing,” said Sen. Lindsey Graham (R-S.C.), who is pitching them on his own plan to block grant federal health care money to the states and keep all of Obamacare’s taxes.

Several senators had also raised questions about an amendment from Sen. Ted Cruz (R-Texas), which would allow cheap plans to be sold alongside Obamacare-compliant plans that cover pre-existing conditions. Those plans’ premiums would have some subsidies, but senators were confused about whether that money would be drawn from a nearly $200 billion stabilization fund meant to woo moderates. They had hoped to use the time to further modify the bill.

But extra time cut both ways.

“The delay is what we have,” Alexander said earlier Monday. “So I don’t think we’ll know until we vote whether it’s been good or bad.”

Tara Palmeri, Josh Dawsey and Seung Min Kim contributed to this report.