WASHINGTON -- President Donald Trump spent the weekend calling senators to urge them to get their health care bill "across the finish line," Trump's top legislative aide said Sunday.
Marc Short, the White House's legislative director, said on Fox News Sunday that while Trump prefers that the Senate repeal and replace former President Barack Obama's health care law, the repeal-only option also remains in play.
Trump on Friday tweeted the suggestion of repealing the Patient Protection and Affordable Care Act right away and replacing it later. Democrats are united in opposition to the proposal to repeal and replace the law, meaning that Republicans can only lose two votes in their 52-48 Senate majority.
Senate Majority Leader Mitch McConnell, R-Ky., has dismissed the repeal-only suggestion and said he intended to proceed with legislation being negotiated over the July 4 recess. Conservatives say the Senate bill does not go far enough to repeal the Obama-era law, while moderates say the bill is too harsh in increasing premiums for older Americans.
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"It's not easy making America great again, is it?" McConnell said late Friday. He has previously indicated that if Republicans fail to reach agreement, he will have to negotiate with Democrats, who want to amend Obama's health care law without repealing it.
But Short said Trump is determined to repeal the law and the administration believes the GOP legislation "will help to lower premium costs, help provide better quality care for patients and return the relationship between the patient and his or her doctor without the government being in the middle."
"We hope when we come back, the week after recess, we'll have a vote," Short said. But he added: "If the replacement part is too difficult for Republicans to get together, then let's go back and take care of the first step of repeal."
Short said the White House remained hopeful after Senate Republicans submitted two versions of the bill to the Congressional Budget Office for scoring over the weeklong recess. Sen. Ted Cruz, R-Texas, is pushing a conservative version that aims to aggressively reduce costs by giving states greater flexibility to create separate higher-risk pools. The other version seeks to bolster health care subsidies for lower-income people, perhaps by preserving a tax boost on high earners.
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Health and Human Services Secretary Tom Price said negotiations over the Senate bill were focusing on ways to address the issue of Medicaid coverage so that "nobody falls through the cracks," fighting the opioid addiction crisis, as well as giving families more choices in selecting their insurance plan.
"We think that Leader McConnell and his senators within the Senate are working to try to get this piece of legislation on track," Price said on NBC's Meet the Press.
But Sen. Rand Paul, R-Ky., said he didn't think a bill to repeal and replace the law could win 50 votes. He has been urging McConnell to consider a repeal-only bill first.
"I don't think we're getting anywhere with the bill we have. We're at an impasse," Paul said on Fox News Sunday.
He criticized Senate leaders, saying they were seeking to win over moderates with multibillion-dollar proposals to address the opioid epidemic and boost tax subsidies to help lower-income people get coverage.
"We have nearly $200 billion in insurance bailouts," Paul said. "Does anybody remember us complaining that Obamacare had insurance bailouts? We now have codified nearly $200 billion. There's $45 billion in here for opioids. The bill is just being lit up like a Christmas tree full of billion-dollar ornaments, and it's not repeal. We don't repeal the regulations. We don't repeal the subsidies."
Disputes over add-ons
Gov. John Kasich, R-Ohio, took the opposite stance on the $45 billion proposal to fight opioid abuse.
"It's like spitting in the ocean," Kasich said on ABC's This Week. "It's not enough."
The governor said that if the law was going to allot $45 billion over 10 years, it would work out for Ohio to less than $1 billion over 10 years.
But Kasich stressed Sunday that "it's not just Medicaid and the fact that there's not enough money in Medicaid legitimately to treat people" that has prompted his opposition to the bill.
"It's the whole thing," he said. "It's the entire package, which I believe can and should be fixed."
If the Affordable Care Act exchanges are collapsing, he said, "you can't also give people three or four thousand dollars a year and think they can buy an insurance policy."
"What kind of insurance policy can you buy at three or four thousand dollars a year?" Kasich asked.
Kasich said both parties were focused on promoting their own agendas and not on working to improve the country.
"Right now, they don't want to concede anything," he said. "Right now, they're not ready, they are not ready to sit down and put the nation first, in my opinion."
Price said Americans were ready to focus on health care, and criticized Meet the Press moderator Chuck Todd for asking him about Trump's Twitter use.
"Chuck, you know, this is really remarkable," Price said. "You've got incredible challenges across this nation, incredible challenges around the world. The challenge that I've been given is to address the health care issues. And your program, a program with the incredible history of 'Meet the Press,' and that's what you want to talk about?"
"Mr. Secretary, I don't," Todd said. "With all due respect, you're blaming me for what the president of the United States has spent his entire week focused on?"
"No. Listen to me, with all due respect," Price responded. "The American people are concerned about a health care system that is not providing choices, where premiums are going up, where insurance companies are vacating markets all across this land. And that's what they want us to concentrate on. And that's what they want us to fix. And that's what I and the president are working on."
Price said Trump was not distracted by media feuds or other topics.
"The president's held multiple meetings within the White House itself, with physicians, with small-business groups, with other folks who have been harmed by Obamacare, with patients, individual stakeholders from across this land who tell him and have told us repeatedly that the current system is collapsing," Price said. "And that's what the president talks about."
CBO-score aftermath
Price also expressed frustration at media coverage of the projections of McConnell's draft bill by the Congressional Budget Office, which estimates that it would lead to 22 million fewer people being uninsured within a decade -- 1 million fewer than under the House-passed legislation that Trump privately told senators was "mean."
"That's precisely because the Congressional Budget Office and all of these analyses don't look at the entire plan," Price said. "If you look at it in its totality, and nobody's looking at it in its totality, we will bring down premiums. We will increase coverage. We will increase choices. And I believe we will increase the quality of care provided in this nation."
At least nine GOP senators expressed opposition after the analysis last week.
Democrats who criticized the bill after the Congressional Budget Office analysis included Sen. Brian Schatz, D-Hawaii.
"CBO confirms this thing is a %#$@ sandwich," he tweeted, adding later that Democrats' fight against the legislation "is a test of the morality of our country. We have to win this one."
Schatz later admitted that despite doling out advice on how progressives should pressure Republicans during the recess, he hadn't determined what he will do. Senate Minority Leader Charles Schumer and House Minority Leader Nancy Pelosi, D-Calif., have urged Democrats to hold news conferences, rallies with progressive groups and submit opinion columns to newspapers.
Schatz said that's not good enough.
"You can't fill a calendar and think that's a plan," he explained, meaning that he will avoid a strategy that dictates, "I'm going to use Facebook on Tuesday and use Twitter on Wednesday and then I'm going to send an op-ed in and hold a news conference on Friday.
"It's a pretty chaotic environment out there," he said. "We need to be a little more flexible."
Pressure back home
Schatz and other lawmakers returned to their home districts late last week, bracing for a flood of phone calls, emails and television advertising from both conservative and liberal groups aimed at pressuring senators.
Sen. Bill Cassidy, R-La., held a town hall meeting Friday to talk about flood recovery in Baton Rouge, but audience members angry over the GOP health care bill at times chanted over Cassidy's answers and criticized the secretive legislative process.
"I wish we weren't doing it one party," Cassidy said Sunday on NBC's Meet the Press, adding that he remains undecided on how he will vote.
Sen. Ben Sasse, R-Neb., has said he would like to see a bill that would repeal the Affordable Care Act "with a delay."
"If we can do a combined repeal and replace over the next week, that's great," Sasse said on CNN's State of the Union. "If we can't, though, then there's no reason to walk away."
"I would want a delay, so that we could get straight to work. And then I think the president should call on the Senate to cancel our August" recess, Sasse said.
Liberal groups were using the congressional recess to build opposition to the Senate bill. They believe tens of thousands of phone calls, emails and in-person pushes will force senators to reject the legislation.
The fresh activism is coming with encouragement from Democrats who find themselves in the minority in all three branches of government.
"Six months ago, everyone in that building thought that repeal of the Affordable Care Act was a done deal," said Ben Wikler, the Washington director of MoveOn.org, pointing to the Capitol. Since then, he said, Democrats had learned to take some cues from the "resistance."
"Democrats can see with their eyes where the energy is in American politics right now," Wikler said. "It's to abandon politics as usual and put up a bare-fisted fight. That's really sinking in."
Information for this article was contributed by Hope Yen and Michele Salcedo of The Associated Press and by Ed O'Keefe, David Weigel, John Wagner and Karoun Demirjian of The Washington Post.
A Section on 07/03/2017