Several senators are expressing skepticism about the emerging Republican plan to pass a bill rolling back “skinny” pieces of the 2010 health care law and then hope for a broader agreement in a conference committee with the House.

Kansas Republican Jerry Moran, who was one of the senators who came out against the broader Senate health care bill, told Roll Call he is concerned about entering a conference without a real Senate position.

“I am very concerned about anything that is just a vehicle to go to conference, and then having all the uncertainty,” Moran said. “I would want to have a better understanding of what would be the goal of coming back to the Senate, before I would be interested in sending anything to conference.”

Among the provisions that Senate Majority Whip John Cornyn of Texas has said could be added in conference with the House is a measure from Sen. Rob Portman of Ohio that would add an additional $100 billion to a stability fund that would help states transition individuals off Medicaid.

There’s also always the possibility that the House could just take up and clear whatever bill passes the Senate by Friday morning with at least 50 votes at the end of the budget reconciliation vote-a-rama.

“I’m wary about what, again, you may see in conference,” said Sen. Lisa Murkowski.

The Alaska Republican was one of two members of the conference to vote against the motion to proceed to the underlying House-passed reconciliation measure that is the vehicle for the fast-tracked legislation.

“Keep in mind we’ve been working through a process that has not been very open, and in a conference, more often than not, is a closed process, Murkowski said. “The more open we can be with the public about what we’re doing here, I think the better off we are.”

She also said that while senators are aware that a conference report must comply with the Senate’s budget rules in order to eventually pass the Senate with at least 50 votes, she had her doubts that most people watching the process would.

Procedure problems

Moran and Murkowski likely have decidedly different views on what the final product that reaches President Donald Trump’s desk should look like, but they seem to share some procedural concerns.

One requirement might be an assurance from House leadership that the legislation, if it really is a shell bill, would not be called up and cleared without amendment.

“I would want to be supportive of something that if it became law, I would think was progress, an improvement,” Moran said. “And I’d want to make certain that, as best I could, that if it wasn’t accepted by the House [and] went to conference, that we’re not then starting over.”

Senate Majority Leader Mitch McConnell has been working behind the scenes to try to craft a compromise “skinny” bill that would likely repeal the individual and employer mandates and remove an excise tax on medical device manufacturers included in the 2010 health care law, lawmakers say.

It remains to be seen whether the Kentucky Republican can gather the 50 votes necessary to pass such a measure under the fast-track budget reconciliation process, with the assistance of Vice President Mike Pence, who would break a tied vote to approve such a measure.

“We’re trying to explore the way forward and to me, that seems to have a lot of benefits,” Cornyn said Wednesday. “All we’re looking at is a way to get to that conference quick.”

More can-kicking?

Sen. Ron Johnson said Wednesday that it appeared the Senate was moving toward the so-called skinny repeal or some sort of a legislative shell. The Wisconsin Republican said the advantage of the process, which he conceded was can-kicking, would be the ability to get more information, including additional scores from the Congressional Budget Office.

“The problem-solving process starts with information; it’s not the endpoint. We haven’t had information until the very end here. So when you go to conference, there will be more opportunities for some of these ideas,” he said. “For those things to really be scored and really understand what the effect of those policy suggestions would be.”

As chairman of the Health, Education, Labor and Pensions Committee, Sen. Lamar Alexander would likely play a key role as one of the leaders of the Senate conferees.

“The so-called skinny bill is obviously not a solution to the current problems with Obamacare, but it is a solution to how we get to the next step, the Senate-House conference where we would hope to solve the problems,“ the Tennessee Republican told Roll Call, echoing GOP leaders’ sentiments about the strategy.

On Wednesday, senators rejected an amendment to repeal significant portions of the 2010 law with a two-year delay.

Seven GOP senators joined with Democrats to sink the proposal, 45-55. The failure highlights the continued struggle Senate Republican leadership is facing in coalescing their conference around one health care proposal. Alexander, Murkowski, Portman, Shelley Moore Capito of West Virginia, Susan Collins of Maine, Dean Heller of Nevada and John McCain of Arizona voted no. 

Alexander said it was unclear whether McConnell and the Senate Republican Conference would ultimately succeed.

“One does not know. No one knows,” he said of the prospects for the GOP getting to 50 votes on anything.

Andrew Siddons and Joe Williams contributed to this report.