Quiet is good.
That’s the message from one senior Republican aide as Senate GOP leaders try and wrangle the votes for the Graham-Cassidy health care bill, the party’s last ditch attempt to repeal and replace the Affordable Care Act. That doesn’t mean they’re any closer to 50 votes they need to pass the legislation, but every day Sens. Lisa Murkowski and John McCain don’t announce public opposition is another day the bill stays alive.
What to watch Friday:
Any movement on sweeteners and deals to win over hold out senators.
White House role
Aides tell me the White House has basically said they’ll do anything requested, but haven’t been overly forceful on this. They want to get it done, but there is clearly a level of gun-shy-ness after a few of their behind-the-scenes lobbying efforts blew up the first time around.
“We need their policy guys more than anything else right now,” one aide said of the administration. “And they’re giving them to us.”
As to the President?
“Do no harm,” the aide said. “That would be the first principle of the next few days.”
Trump was back at his Twitter account Friday morning, calling out key “no”-vote senators — include Sen. Rand Paul of Kentucky.
“Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as ‘the Republican who saved ObamaCare,'” Trump tweeted.
Paul responded shortly thereafter in a statement, “No one is more opposed to Obamacare than I am, and I’ve voted multiple times for repeal. The current bill isn’t repeal and I won’t vote for an Obamacare Lite bill that keeps 90% of the taxes and spending just so some people can claim credit for something that didn’t happen.”
The Murkowski deals
There are a number of proposals floating around, some real, some less so, that are outlining potential deals to get Murkowski on board. Here’s the smartest way to look at these right now: options to boost the federal match and ease the spending caps in the Medicaid overhaul are the most likely right now — or at least the most fully fleshed out and being put on the table, per two aides with knowledge.
As of now, Murkowski has not agreed to anything, per those aides. Her focus, as she has stated, has been about getting the best information she can from the Department of Health and Human Services and the Centers for Medicare and Medicaid Services.
Flashback: Murkowski in June told several reporters that a sweetheart deal to “get me” wasn’t something she was looking for. She wanted a system that worked nationwide and didn’t disproportionately hit her state. The Alaska governor, who is opposed to this, also said on NPR Thursday night that he didn’t like short term benefits for the state via “deals” because it would hit the state hard later.
About that CMS information:
Thursday night, Axios got a hold of CMS projections about what the bill would do, which CNN confirmed shortly thereafter. Short summary: they’re better than outside analyses, but still not good.
Spending by 2026:
Alaska: down 38%
Arizona: down 9%
Ohio: down 18%
West Virginia: down 23%
See them here.
Reading Friday:
CNN’s Tami Luhby with the complete fact check on pre-existing conditions.
Tami on coverage numbers — no CBO, but reductions in spending/Medicaid overhaul almost guarantee millions fewer covered.
Greg Krieg on something CNN is hearing a lot from lobbyists and health policy folks: how on earth would 50 states be able to put together their own systems in two years?
Quick primer on how this could work:
No vote is scheduled. Leaders clearly want one. But for awareness, here’s how it would all work:
– Senate Majority Leader Mitch McConnell would schedule a vote on the motion to proceed, or to take up, the health care bill. This would require a 50-vote threshold.
– If they get 50 votes, they would move back onto the effort that imploded in July. Of note — they have already completed debate on that bill. All that’s left is the vote-a-rama.
– At the very end of the vote-a-rama, Graham-Cassidy would be put in order. There would be a very short debate, then a vote. That would strip everything done prior and replace it, if adopted, with whatever the text of Graham-Cassidy is.
– Then they’d vote on final passage.
It goes without saying, but that motion to proceed vote could very well be the ballgame. If McConnell can get 50 to get onto the bill, there’s a pretty solid chance he’s got the votes to get it done at the end, too. And obviously if he can’t, the effort dies all together. So pay close attention to that vote, and if they get 50, eat energy bars and hydrate throughout the vote-a-rama, then pay very close attention to the last two votes.
One caveat that just like last time: Things can change very quickly. And just to reiterate, there is still no vote scheduled.