Much work ahead

WASHINGTON—Senate Republicans held meetings Tuesday to set in motion what could be a long struggle to get 50 senators to coalesce on a healthcare bill, with some senators indicating they may scrap a plan passed by the House last week.

The House narrowly passed the American Health Care Act (AHCA) last week and joined President Donald Trump in front of the White House to celebrate. But healthcare reform still has several major hurdles to clear before a new law can take effect. Republicans in the Senate have a slimmer majority than the House, not to mention a broader spectrum of political ideology and opinion to complicate matters.

Sen. Ted Cruz, R-Texas, told me he’s glad House Republicans united to pass the AHCA and specifically praised the House Freedom Caucus for “making the bill better.” But he added, “With that being said, there is still considerable work to be done here in the Senate.”

Cruz explained that a 13-member group of Republican senators formed by Senate Majority Leader Mitch McConnell (R-Ky.) intends to draft legislation—raising the question of how much of the House bill will remain intact. He added that Senate Republicans will not commit to an artificial timeline to pass a healthcare bill and will let the process play itself out.

Other GOP senators say talks are at the beginning stages and it’s far too soon to discuss specific changes to the House plan—let alone schedule a vote—but they know the Senate will need to act quickly.

“We are going to move with a sense of urgency because we have millions of Americans who might not be able to use their subsidies to buy insurance in 2018, but we’re going to take the time to get it right,” Sen. Lamar Alexander, R-Tenn., told me. “We’re spending every day on it.”

Alexander, who chairs the Senate Committee on Health, Education, Labor, and Pensions, will lead the discussions on healthcare and attempt to sketch out a bill 50 senators can agree on. Republicans can afford to lose just two votes within the Senate to pass a healthcare bill through the reconciliation process—and in that scenario, Vice President Mike Pence would still need to break a 50-50 tie.

McConnell’s 13-member working group includes himself, Alexander, influential committee chairmen Orrin Hatch of Utah and Mike Enzi of Wyoming, and three other members of the Senate leadership team: John Cornyn of Texas, John Thune of South Dakota, and John Barrasso of Wyoming. Other participants represent different factions of the ideological spectrum within the party, such as Cruz, Mike Lee of Utah, Pat Toomey of Pennsylvania, and Rob Portman of Ohio. Tom Cotton of Arkansas and Cory Gardner of Colorado round out the group.

The group met Tuesday afternoon and focused its discussions on what to do about Obamacare’s large Medicaid expansion. McConnell asked GOP Sens. Shelley Moore Capito of West Virginia and Ron Johnson of Wisconsin to join today’s meeting since they represent two states that expanded the program under Obamacare. The GOP leader said the group would meet again tomorrow and Thursday.

“We all want to get to a point where we can pass something for the American public,” Sen. Johnson told reporters. “I’m very pleased with my initial meeting here.” He added that the Senate will use the House bill as a basis for discussion but wouldn’t discuss which parts will stay and which will go: “It’s way too soon to be talking about any specifics.”

Senate Republicans plan to pass a healthcare bill without any support from across the aisle, and Democrats cemented that fate Tuesday.

Senate Minority Leader Chuck Schumer of New York got the entire 48-member Democratic caucus to sign a letter Tuesday pledging not to work with Republicans on any plan that would gut Obamacare. Instead, they want Republicans to scrap what they’re doing and come up with a bipartisan plan to improve the current law.

“We write to request that the Senate work in a bipartisan, open, and transparent way to improve and reform the healthcare system,” the letter reads. “Democrats stand ready—as we always have—to develop legislation with Republicans that will improve quality, lower costs, and expand coverage for all Americans. But Republicans need to set aside their current partisan efforts and work with us to get this done.”

But Republican leaders see such an offer as disappointing and a refusal to participate in the legislative process.

“I would love to have them work with us, but right now they are just sitting on the sidelines and doing nothing,” said Sen. Cornyn. “We aren’t going to do that. We are going to fulfill our promises.”