Senate Republican leaders had hoped to start the voting process for the Better Care Reconciliation Act on Wednesday. But Senate Majority Leader Mitch McConnell, R-Ky., pulled the 142-page bill — which would make sweeping changes to Medicaid and the Affordable Care Act — from consideration on Tuesday after it was clear he did not have enough support in the Senate GOP caucus.
The move was a reminder of the impossible legislative tangle McConnell and Republicans face as they struggle to fulfill a years-long promise to roll back former President Barack Obama’s health care reform.
So instead of holding a vote, Republicans are now regrouping and rewriting the bill. What exactly happened? Here’s what Capitol Hill Producer Julie Percha and I found after talking with dozens of senators and staffers across three different buildings today:
- CBO: The Congressional Budget Office report, which came out Monday and found that the bill would cause 22 million people to lose their insurance, was clearly a massive factor. Sen. Bob Corker, R-Tenn., told me he read the report at 4 a.m. Tuesday morning, and then called to suggest that CBO staffers join all Republican senators at their lunch later on in the day to answer questions. (They did, and that was the bulk of the 90-minute meeting.) Other senators echoed concerns over CBO’s conclusions that millions of people, especially those making under $30,000, would no longer have health insurance — and that deductibles and out-of-pocket costs for many people would skyrocket. The bill was already sliding down hill when CBO released its report. The nonpartisan finding only accelerated the process.
- The opposition: On nearly every level, Republican senators were met with a tidal wave of opposition this week. Constituents and organized groups made sure senators’ phones were ringing off the hooks. Email drives hit their inboxes. Most of the medical community – including doctors, nurses and patient groups — whipped itself into a near frenzy of opposition. And groups lobbying for serious medical business concerns also put on a full court press opposing the bill. Why? Out of a fear that fewer people could pay for their services under the bill.
- Other developments: Senators were also not ready to vote for multiple reasons. The votes were just not there, as the NewsHour and others reported. But neither was a basic understanding of the bill, the details of which were not released until late last week. Several senators were clearly still grappling with the content of the bill. An example: When I spoke to Sen. Chuck Grassley, R-Iowa, around 12:45 p.m. Tuesday, he told me he had not decided how he would vote yet because he hadn’t yet read the bill. He then pointed down to the bill in his hand, opened up to one of the first pages. Grassley was reading it while walking to the lunch with his fellow Republicans.
- What’s next? The July Fourth congressional recess is coming, or is at least scheduled for next week. Senate Republicans could regroup over the break and then return with a new plan. But they want to move more quickly than that. Senate Republican Conference Chairman John Thune, R-S.D., told me GOP leaders want a revised draft done by the end of this week.
- POTUS factor? There are conflicting schools of thought on President Donald Trump’s impact on the legislation. Multiple people echoed various versions of the same concern: That Trump would agree with the issues that senators who oppose the bill have, but in the end be unable to deliver and address all their concerns in the final bill. The uncertainty pointed to Trump’s still-evolving relationship with Congress. Several senators told me that they felt Trump would understand their concerns better than the Senate GOP leadership has. One the other hand, others, including Sen. John McCain, R-Ariz., insisted that a significant push from the White House is needed now to help Republicans reach a consensus.