Amid Health Care Chaos, Graham and Cassidy Still Lacking Votes

Finance hearing rocked by protests, S&P prediction dire

A protester is taken out of a Senate Finance Committee hearing in the Dirksen Senate Office Building on the proposal by Sens. Lindsey Graham and Bill Cassidy to change the U.S. health insurance system. (Tom Williams/CQ Roll Call)
A protester is taken out of a Senate Finance Committee hearing in the Dirksen Senate Office Building on the proposal by Sens. Lindsey Graham and Bill Cassidy to change the U.S. health insurance system. (Tom Williams/CQ Roll Call)
Posted September 25, 2017 at 5:45pm

The Senate on Monday was consumed by a now-familiar sense of chaos as Republicans continued their quest to pass in an accelerated fashion a major overhaul of the U.S. health care system, even as protests erupted in the hallways of the Capitol and independent forecasters predicted dire consequences in the form of lost jobs and diminished economic activity. 

Sponsors of the bill, which would essentially turn all federal funding included in the 2010 health law into massive block grants to states, tried mightily to gather support, but the effort continued to hit fierce head winds.

While White House Legislative Affairs Director Marc Short said on national television Sunday he expected a vote on the repeal bill on Wednesday, senior Republican leaders did not appear to have such a schedule in mind. 

“All I know is what you guys have been writing, so now I need to go
talk to the source,” Senate Majority Whip John Cornyn said as he emerged from an elevator in the Capitol en route to Majority Leader
Mitch McConnell’s office. He didn’t answer a question on whether Republicans would put a repeal bill on the floor if it didn’t have enough votes to pass. “I’m in the fact gathering mode,” Cornyn said as he stepped into the leader’s office.

Meanwhile, people stood in massive lines that spanned multiple office buildings in an attempt to enter the hearing room where the Senate Finance Committee was holding the one and only public examination of the latest repeal proposal.

The committee’s Republican majority rejected a request from the panel’s Democrats to move the hearing to a larger venue.

And the bill seemed to be changing by the hour as Republicans scrambled for votes.

“And why the rush job, you might ask? It’s because the coach turns back into a pumpkin at the end of the month,” Finance ranking member Ron Wyden said. “That’s when the reconciliation fast-track to pass this partisan bill expires.”

Demonstrators, several in wheelchairs, were dragged out of the room chanting, “save our liberty” and “no cuts to Medicaid.”

Outside of the hearing room, Republicans lawmakers were openly questioning whether they had enough support to advance the bill — from Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, Ron Johnson of Wisconsin and Dean Heller of Nevada — as concerns over the legislation came from all sides of the GOP political spectrum.

This scene has become all too common for the chamber.

The prior attempt to repeal the law was symbolized by backdoor dealmaking, as Republican leadership scrambled in the days leading up to a vote on the measure to find the 50 “yea”s necessary to pass the bill under the fast-track budget procedure known as reconciliation.

The carve-outs for specific states hashed out in private — which Republicans chastised Democrats for including in order to pass the initial health law — continued this time.

The GOP quartet unveiled an update to their proposal Monday that appeared to include policy sweeteners for states with senators or governors skeptical of it, like Alaska, Nevada and Maine.

Alaska, for example, would receive extra money under a revised formula that directs more federal dollars to states with low population densities. It would also grandfather Native Alaskans into the health care law’s Medicaid expansion, which would be phased out in 2020 under the bill.

That did not seem to move lawmakers like Sen. Susan Collins of Maine and Lisa Murkowski of Alaska, who continue to express serious reservations about the proposal. Sens. Rand Paul of Kentucky and McCain have both come out in opposition to it.

Sen. Ted Cruz of Texas has also said he is not yet ready to vote for it and is focusing on more freedom in the waiver process, as well as further reductions in regulations. Senior aides said Cruz thought the sponsors of the bill had essentially agreed to some of his requests, but they were not included in a Monday morning draft.

Three “nay” votes would sink the bill intended to achieve the seven-year GOP campaign promise to overhaul the law.

Cassidy even tried to portray the bill as an opportunity for Collins, if she were to become governor of Maine, to essentially create a new insurance market for the state.

“There’s going to be a billion dollars for Mainers who are lower-income to have coverage which they do not now have,” he said during a CNN interview. “Susan Collins knows a smart governor who knows insurance well, as she does, could do a heck of a lot to provide coverage for the people of Maine.”

Collins has yet to announce whether she will run for governor in 2018.

The updated version also appeared to do little to assuage concerns that the legislation would undermine protections for vulnerable Americans and lead to higher health care costs for individuals with existing medical conditions.

“I think the assurance of adequate and affordable coverage is essentially meaningless,” Timothy Jost, emeritus professor at the Washington and Lee University School of Law, said. “The waivers allowed by the law would give insurers plenty of ways to exclude high cost individuals. And the law provides no way for HHS to revoke a waiver granted a state if coverage is in fact not affordable and adequate.”  

Without any chance of a full report from the Congressional Budget Office, Democrats and other opponents were highlighting a dire forecast from S&P Global Ratings about the latest proposal’s effect on insurance coverage and the economy at large.

S&P forecast macroeconomic effects, including “580,000 lost jobs and $240 billion in lost economic activity by 2027, ensuring that the GDP growth remains stuck in low gear of around 2% at best in the next decade.”

Kellie Mejdrich contributed to this story