WASHINGTON -- Senate Majority Leader Mitch McConnell is aiming to send a revised version of his health care bill to the Congressional Budget Office by as soon as Friday, according to Capitol Hill aides and lobbyists.
That comes as President Donald Trump promised a surprise on the matter, though he did not specify what.
"Health care is working along very well. ... We're going to have a big surprise," Trump told reporters at the White House on Wednesday. "We have a great health-care package."
Trump offered no details, only reiterating, "We're going to have a great, great surprise."
Billions of dollars in U.S. health spending are at stake for hospitals, insurers and doctors, who are worried by the Congressional Budget Office estimate that projects that 22 million Americans would lose coverage under the Senate bill by 2026.
[INTERACTIVE: Compare House, Senate bills with Affordable Care Act]
The revision effort reflects the tight timeline McConnell faces in his attempt to hold a vote before a Congress recess in August -- and the pressure he is under to make changes that improve the Congressional Budget Office's figures on the bill's impact on coverage levels and federal spending.
McConnell is trying to move quickly to achieve a new Congressional Budget Office rating on the bill by the time lawmakers return to Washington in mid-July, giving the Senate about two weeks to fulfill the majority leader's goal of voting before the August break.
McConnell and his aides plan to continue negotiations through the end of this week and will be in frequent communication with the Congressional Budget Office, according to McConnell spokesman David Popp.
It remains unclear exactly what parts of the Better Care Reconciliation Act are being revised -- or whether McConnell is trying to move the measure to the right, with greater savings or regulatory adjustments, or to the left, with more coverage protections.
Some senators emerged from a party lunch saying potential amendments were beyond cosmetic, with changes to Medicaid and President Barack Obama's consumer-friendly insurance coverage requirements among the items in play.
"There's a whole raft of things that people are talking about, and some of it's trimming around the edges and some of it's more fundamental," said Sen. Bill Cassidy, R-La. "Right now, they're still kind of, 'Can we do it?' and I can't answer that."
McConnell, R-Ky., needs to get on board about nine senators who have said they wouldn't vote for the bill in its current form. The bill will be defeated if three of the 52 GOP senators oppose it.
Sen. John McCain, R-Ariz., said "of course" his support was uncertain because he wants to ease some of the measure's Medicaid cuts, and Sen. Ben Sasse, R-Neb., told The Omaha World-Herald that the bill was not a full repeal, adding, "Nebraskans are dissatisfied with it and so am I."
Several senators scoffed at McConnell's July timetable on the bill, with McCain saying, "Pigs could fly."
Rework has begun
On Wednesday, several GOP aides at the White House and on Capitol Hill spoke, on condition of anonymity, about private talks surrounding the health bill.
One aide described the situation as akin to the weeks leading up to the draft bill's release, when McConnell presented chunks of the emerging legislation to the Congressional Budget Office to expedite the analysis process. The aide expected GOP leaders to present bill tweaks to the budget office for review as soon as this week.
Another aide said that after a Tuesday meeting with Trump at the White House, Republicans have a better sense of what everyone wants. A draft is not yet ready, but the reworking process has begun.
Republican leaders bowed to pressure from within their ranks Tuesday and postponed the planned vote this week on the bill. While they bought themselves more time to work out disagreements, the delay raised new doubts about their ability to ever get to the point of a holding a final health bill vote.
"Once in Glacier National Park I saw two porcupines making love," said Sen. Pat Roberts, R-Kan. "I'm assuming they produced smaller porcupines. They produced something. It has to be done carefully. That's what we're doing now."
Conservatives are blasting the Senate bill for leaving in place too much of the 2010 Patient Protection and Affordable Care Act passed under Obama. Meanwhile, a coalition of patient advocates, doctors and senior citizens groups have joined Democrats in condemning its proposed cuts to the Medicaid program and the rollback of taxes on the wealthy.
Some Republicans are anxious about what reception senators will receive when they return home for the July Fourth recess.
Sen. Patrick Toomey of Pennsylvania acknowledged that the delay McConnell announced Tuesday could just as easily jeopardize the bill's prospects. More time, he said, "could be good, and it could be bad."
Having seen the House pass its health care package in May six weeks after an earlier version collapsed, Democrats are far from performing a victory dance.
"I expect to see buyouts and bailouts, backroom deals and kickbacks to individual senators to try and buy their vote," said Senate Minority Leader Charles Schumer, D-N.Y. "What I don't expect to see, yet, is a dramatic rethink of the core" of the bill.
Democrats, who have been uniformly critical of the Republican bill, said it's time for the GOP to begin a bipartisan conversation on health care.
Sen. Chris Murphy, D-Conn., said McConnell had not given moderates in his party "license" to negotiate with Democrats on narrower legislation that would stabilize the insurance markets.
"I think there's a conversation to be had," Murphy said in an interview Wednesday with MSNBC.
But McConnell has opposed such bipartisan actions.
"Either Republicans will agree," McConnell said Tuesday, "and change the status quo, or the market will continue to collapse and we'll have to sit down with Sen. Schumer, and my suspicion is that any discussion with the Democrats would include none of the reforms that we'd like to make both on the market side and the Medicaid side."
Asked whether he might negotiate with Schumer, Trump criticized the minority leader as lacking seriousness.
"I don't think he's serious. He hasn't been serious," Trump said. "Obamacare [the Affordable Care Act] is such a disaster. And he wants to try and save something that's hurting a lot of people. It's hurting a lot of people."
Trump is also trying to help get support for the bill, mainly by wooing skeptical conservatives, which he has struggled to do. He convened a meeting of all GOP senators at the White House on Tuesday after McConnell announced that the vote would be delayed.
But the White House appears less involved in crafting specific policy tweaks. From the outset of the health bill effort, McConnell and a small clutch of aides have controlled that process.
The New York Times said an unidentified senator who supports the bill left Tuesday's White House meeting with Trump "with a sense that the president did not have a grasp of some basic elements of the Senate plan."
The Times also reported that Trump was less involved in the press for the Senate bill than with the earlier House bill, making fewer phone calls to senators, for instance.
The president took issue with a that story, tweeting, "The failing nytimes writes false story after false story about me."
Trump added: "Some of the Fake News Media likes to say that I am not totally engaged in healthcare. Wrong, I know the subject well & want victory for U.S."
Information for this article was contributed by Paige Winfield Cunningham, Sean Sullivan, Robert Costa, Kelsey Snell, Paul Kane, Juliet Eilperin and Abby Phillip of The Washington Post; by Alan Fram, Erica Werner, Stephen Ohlemacher, Kenneth Thomas, Kevin Freking and staff members of The Associated Press; and by Laura Litvan, Sahil Kapur, Justin Sink and Steven T. Dennis of Bloomberg News.
A Section on 06/29/2017
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