Health-care bill vote delayed; McCain ill

Top Trump administrators woo governors

Govs. Brian Sandoval (left), a Nevada Republican, and Terry McAuliffe, a Virginia Democrat, attend the closing session Saturday of the National Governors Association meeting in Providence, R.I. The nation’s health care system was front and center at this summer’s session.
Govs. Brian Sandoval (left), a Nevada Republican, and Terry McAuliffe, a Virginia Democrat, attend the closing session Saturday of the National Governors Association meeting in Providence, R.I. The nation’s health care system was front and center at this summer’s session.

PHOENIX -- Senate Majority Leader Mitch McConnell announced Saturday night that he will postpone consideration of the Senate's health care legislation while Sen. John McCain recovers from surgery for a blood clot.

The announcement came as President Donald Trump's administration struggled Saturday to raise support from U.S. governors for the revised health care bill.

Doctors at Phoenix's Mayo Clinic Hospital said McCain underwent a "minimally invasive" procedure Friday to remove the nearly 2-inch blood clot above his left eye. Doctors said in a statement that the surgery went "very well."

McCain was advised by doctors to remain in Arizona this week, his office said.

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"While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act," McConnell, R-Ky., said in a statement Saturday. A procedural vote originally had been expected in the coming days.

A close vote already had been predicted for the GOP health care bill, with all Democrats and independents coming out against it and some Republicans opposed or undecided. With the GOP holding a 52-48 majority, the party can afford to lose only two members. Vice President Mike Pence would break a tie for final passage.

Two Republicans, Rand Paul of Kentucky and Susan Collins of Maine, have already said they'll vote against the measure, leaving McConnell with no margin of error.

McConnell and other GOP leaders have been urging senators to at least vote in favor of opening debate, which would allow senators to offer amendments.

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Governors get pitch

Before McConnell's announcement, Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma made the administration's pitch Saturday morning during a closed meeting of the National Governors Association.

The White House is attempting to win over governors, especially Republicans who expanded Medicaid in their states. Some of those governors are concerned about cuts to Medicaid and what they see as shifting costs for the program.

Arkansas Gov. Asa Hutchinson, a Republican, said he thinks the bill has been improved from an earlier version, with $70 billion added to help stabilize health insurance exchanges and with grants to help people transition from Medicaid to private insurance. He said he's "open" to the bill but is waiting for the final version.

"The bill that we're looking at today is probably not the bill that's actually going to be voted on," Hutchinson told reporters after meeting with Price and Verma. "Our job is to influence the direction of that and try to make the improvements that work for the states."

Nevada Gov. Brian Sandoval, one of the bill's most prominent Republican skeptics, said Saturday that it's unlikely the administration has changed anyone's mind about the plan to replace the Patient Protection and Affordable Care Act.

"I am struggling to validate the numbers that are being presented to me by the administration, versus what I'm hearing from independent [experts], what I'll likely hear from the [Congressional Budget Office], what I'm hearing from back home," Sandoval said after the meeting Saturday.

Sandoval has expressed concern about the legislation's cuts to the Medicaid program for the poor and disabled. His position is important because of the pressure he could place on Nevada's Republican U.S. Sen. Dean Heller, a possible swing vote on the measure.

Sandoval said "Sen. Heller's his own man," but he's trying to give Heller the best information about how the legislation would affect their state.

"He's the United States senator. At the end of the day, he's the one who pushes the button," Sandoval said. "I'm going to inform him about how I feel about the bill."

Connecticut Gov. Dannel Malloy, chairman of the Democratic Governors Association, said the mood at the Saturday breakfast meeting was "tense" and that "there are a lot of Republican governors who apparently have a neck problem, because they were all looking down."

Malloy said a few Republican governors did ask questions. Others said they raised their concerns with the White House in one-on-one meetings.

Pence met several of the governors privately after his public address at the Rhode Island conference Friday.

A former Indiana governor who expanded Medicaid in his state, Pence acknowledged in Friday's speech the concerns that governors of both parties have raised about the proposed cuts to Medicaid. He said the Senate measure would restore Medicaid to its original purpose of helping the poor and disabled while giving states the flexibility to administer the aid properly.

Participants said Saturday's meeting included an appeal from Democratic Sen. Tom Carper, who is a former governor of Delaware, asking the Trump administration to put the debate on hold and look for a bipartisan solution.

"We don't need a Democratic victory, we don't need a Republican victory here, we don't need a victory for the president," Carper told reporters. "We need a victory for our country and for 50 states, and the voices of the governors is critical."

'Unworkable,' groups say

The effort to assuage governors' concerns comes as two of the insurance industry's most powerful organizations say a provision in the Senate bill allowing the sale of bare-bones policies is "unworkable in any form."

The language was crafted by U.S. Sen. Ted Cruz, R-Texas, and leaders have included it in the overall bill in hopes of winning votes from conservatives. But moderates have worried that it will cause people with serious illnesses to lose coverage, and some conservatives say it doesn't go far enough.

The criticism of Cruz's provision was lodged in a rare joint statement by America's Health Care Plans and the BlueCross BlueShield Association. The two groups released it late Friday in the form of a letter to McConnell.

"It is simply unworkable in any form," the letter said. The groups said it would "undermine protections for those with pre-existing medical conditions," increase premiums and lead many to lose coverage.

The provision would let insurers sell low-cost policies with skimpy coverage, as long as they also sell policies that meet a stringent list of services they're required to provide under the Affordable Care Act, like mental health counseling and prescription drugs.

Cruz said the proposal would drive down premiums and give people the option of buying the coverage they feel they need.

Critics say the measure would encourage healthy people to buy the skimpy, low-cost plans, leaving sicker consumers to confront unaffordable costs.

The two groups say premiums would "skyrocket" for people with pre-existing conditions, especially for middle-income families who don't qualify for the bill's tax credits. They also say the plan would leave consumers with fewer insurance options, so "millions of more individuals will become uninsured."

The bill provides $70 billion for states to use to help contain rising costs for people with serious conditions. But the insurance groups said that amount "is insufficient and additional funding will not make the provision workable for consumers or taxpayers."

McConnell and other Republicans are considering ways to revise the Cruz provision in hopes of winning broader support.

The nonpartisan Congressional Budget Office is expected to release its analysis of McConnell's revised bill this week, including an assessment of Cruz's plan.

The office estimated that McConnell's initial bill would have caused 22 million additional people to be uninsured over the next 10 years.

Information for this article was contributed by Matt O'Brien, Alan Fram and staff members of The Associated Press; by Mark Niquette, Laura Litvan and Steven T. Dennis of Bloomberg News; and by Sean Sullivan of The Washington Post.

A Section on 07/16/2017

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