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June 27, 2017

Senate GOP leaders delay health care vote until after July 4th recess

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This is a developing story.

Senate GOP leaders are now planning to delay a vote on their health care bill until after the July 4th recess, two senior GOP aides told Axios.

Senate Majority Leader Mitch McConnell (R-Ky.) reportedly told lawmakers about the change of plans during Tuesday's Senate GOP lunch.

GOP leaders had planned to vote on the Better Care Reconciliation Act (BCRA) this week, with Senate Majority Whip John Cornyn (R-Texas) saying earlier Tuesday that the vote would happen on Wednesday. But after the Congressional Budget Office released its score of the BRCA, several GOP senators said they would vote against taking up the bill without significant changes.

A GOP aide told Axios, "McConnell wants to win." The plan, the aide said, is to make changes to the bill, get a new CBO score, "and win."

Original story continues below

The Congressional Budget Office on Monday projected the Senate GOP's health care bill would lead to 22 million more uninsured Americans by 2026 while cutting $772 billion in Medicaid spending across the next decade—prompting some GOP senators to say they would vote "no" on a motion to proceed to debate on the bill.

Understand the no-regrets priorities at the top of every finance leader's agenda

The so-called CBO "score" factored in a new bill provision announced Monday morning that would impose a waiting period of at least six months on new individual market enrollees who did not maintain continuous coverage during the previous year.

Senate bill's estimated effect on insurance coverage broadly parallels CBO's estimate for the House-passed version of the bill, which found that 23 million fewer people would have health insurance by 2026 than under current law. The House-passed bill, however, would have reduced deficits by a smaller amount—about $119 billion over 10 years, according to CBO.

Following score, some GOP senators say they would vote 'no' on bill

As of Monday night, Senate GOP leaders did not appear to have the 50 votes needed to pass the bill or even to begin debating it, the New York Times reports.

Three GOP senators—Sens. Susan Collins (Maine), Rand Paul (Ky.), and Dean Heller (Nev.)—as of Monday night had said they would vote "no" on the motion to begin debate on the bill. Sen. Ron Johnson (R-Wis.) suggested he also was leaning no, telling reporters, "It's worse to pass a bad bill than pass no bill." GOP senators can only lose two votes if all Senate Democrats vote no, as is expected.

According to Politico Pro's "Pulse," the Senate is in recess until 2 p.m. Tuesday, giving Senate GOP leaders an additional four hours, beyond their normal 10 a.m. start, to attempt to address any lingering concerns related to the bill.

The Senate must wait 28 hours after the CBO score's release before it can vote on a motion to proceed on the House-approved American Health Care Act (AHCA). That bill, in turn, would function as a "shell" for the Senate bill, providing the legislative base from which the Senate could proceed.

Despite the uncertainty of the vote count, Majority Whip John Cornyn said tomorrow's procedural vote on the bill will happen "tomorrow sometime." According to Axios, Cornyn's comments "didn't leave any room for the possibility that the leadership might cancel the vote if they think it's going to fail." 

Industry reaction continues to pour in

The Senate draft bill on Monday continued to draw criticism from some industry stakeholders, adding to a wave of mostly critical reactions in recent days.

The National Association of Medicaid Directors (NAMD) in a statement called that the per capita caps in the Senate bill "a transfer of risk, responsibility, and cost to the states of historic proportions," adding, "While NAMD does not have consensus on the mandatory conversion of Medicaid financing to a per capita cap or block grant, the per capita cap growth rates for Medicaid in the Senate bill are insufficient and unworkable."

6 key projections in CBO's Senate health bill score

Richard Besser, president and CEO of the Robert Wood Johnson Foundation, in a statement said, "This bill puts the protections and peace of mind that come with comprehensive health insurance out of reach for millions of people—including children, the elderly, and those with disabilities," adding, "Every member of Congress must weigh the policy and moral implications of taking insurance from 22 million people. … Cutting a lifeline to affordable health care is a step in the wrong direction."

The American Medical Association (AMA) in a letter to Senate leaders reiterated its opposition. AMA Executive Vice President and CEO James Madara said, "Medicine has long operated under the precept of Primum non nocere, or 'First, do no harm,'" adding, "The draft legislation violates that standard on many levels."

However, Anthem on Monday came out in support of the bill, saying it would "markedly improve the stability of the individual market and moderate premium increases" in part by "aligning premium subsidies with premium costs" (Kaplan/Pear, New York Times, 6/26; Frieden, MedPage Today, 6/26; Armour et al., Wall Street Journal, 6/26; Goldstein/Snell, Washington Post, 6/26; Young, CQ News, 6/26 [Subscription required]; Diamond, "Pulse," Politico Pro, 6/27; CBO score, 6/26; BCRA updated bill, 6/26; Axios, 6/27; Owens, Axios, 6/27).

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