Republicans have been searching for eight months now to repeal and replace the Affordable Care Act. That effort effectively died on the floor of the Senate in July when the party couldn’t get 51 votes do little more than punt the serious health care policy questions to a conference committee.
Still, a small group of Republicans led by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana are trying to bring the effort back before it’s too late.
The Senate’s parliamentarian has suggested that the GOP only has until the end of September before their reconciliation vehicle — the budget bill that allows them to pass health care with a simple majority — expires.
Graham and Cassidy are expected to unveil Wednesday their latest proposal to overhaul health care, but rank-and-file members aren’t sounding too optimistic. Timing is a big reason.
“We are in the fourth quarter with about 30 seconds left,” said Sen. Tim Scott, a Republican from South Carolina who added that the bill was the last “bullet left in the chamber.”
There are no signs that the Graham-Cassidy plan would have momentum after months of exhaustive GOP health care soul searching. Sens. Lisa Murkowski and Susan Collins — two of the most notable hold outs on the last effort — have given no indication they’d sign on. And, Sen. Rand Paul, a Republican from Kentucky who did vote for the “skinny repeal” in July, has said he wouldn’t support it. It only takes three Republican senators to object and the bill can’t pass under reconciliation.
Asked what chance Graham-Cassidy had of passing by the end of the month. Paul was blunt.
“Zero,” he said. “I’m not hearing anybody talk seriously about it.”
Even GOP leadership has given no indication that another health care bill is on its way to the floor. House Speaker Paul Ryan has shifted his focus to tax reform and Senate Majority Leader Mitch McConnell said Tuesday at a stakeout with reporters that the path forward wasn’t clear on health care.
Sen. Roy Blunt, a member of the GOP’s leadership, told CNN that “there doesn’t seem to be a clear path to 50, but I think there is a possible path to 50 if both governors … and the President got behind it.”
Graham-Cassidy isn’t the only health care bill out there and it isn’t the only one that could run into trouble. Sens. Lamar Alexander, a Republican from Tennessee, and Patty Murray, a Democrat from Washington, are working to craft a narrow, bipartisan bill to try to stabilize the Obamacare insurance markets. Even that, however, has hit snags.
On Monday night, a member of the GOP’s leadership seemed to throw cold water on the basic framework of their bill.
“I say God bless them,” Sen. John Cornyn, the Republican Whip, said. “We are not going to pass just an insurance company bail-out bill.”
Alexander has sought to loosen some of the regulations around Obamacare in exchange for funding for payments to insurers to keep costs down, but Cornyn said the bill would have to be broader to earn his support.
“I’m looking for more then something relatively minor,” Cornyn said. “There needs to be some structural reform or we are going to find ourselves right back in the same situation.”
Among rank-and-filers the support is also tenuous.
“I’d say there is 50% chance something comes out of there,” Paul said. “I think there is about 100% chance it will be bad from my perspective.”
There is some optimism, however, that Murray and Alexander might just pull it off.
“Thinking small is the only way to get health care done right now,” Scott said. “Dealing with the individual market is a small enough bite that we can actually digest it.”