Senate Republican leaders are desperately searching for the 50 votes they need to open a debate on ObamaCare repeal-and-replace legislation after a Wednesday scolding at the White House from President Trump.
Leaders have reopened negotiations on their previous bill, reversing course from their plans to move to a vote on a straight repeal of ObamaCare.
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But it's not clear if they will have any more luck this time in corralling enough centrist and conservative Republicans to move the bill forward.
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Senate Majority Leader Mitch McConnell (R-Ky.) needs to win 50 votes to proceed and has faced opposition from conservatives, who believe the previous bill kept too much of ObamaCare, and centrists, who think it would leave too many people without affordable insurance.
GOP leaders haven't closed the door on bringing a straight repeal of ObamaCare, with a two-year delay, to the floor.
But Trump, who has given mixed messages on whether he wants to just repeal or simultaneously repeal and replace ObamaCare, on Wednesday told Republican senators at a White House lunch that repealing ObamaCare without a replacement was not an option.
"We can repeal it, but we should repeal it and replace, and we shouldn't leave town until this is complete, until this bill is on my desk," Trump said.
GOP reeling after healthcare collapse
Republicans offered competing ideas for what to do next on healthcare Monday night, now that the current ObamaCare replacement effort has fallen apart.Senate Majority Leader Mitch McConnell (R-Ky.) acknowledged late Monday that the chamber's current approach would fail after two more senators announced opposition to the current heal thcare draft. Trending Now: The 10 Best Balance Transfer Cards See The Cards Sponsored by NextAdvisor Without the needed votes, he said, the Senate will take up a repeal-only bill that Congress passed in 2015.
McConnell appears to believe that if he can get the Senate to agree to open debate on an ObamaCare measure, he'll have an opportunity to clear legislation by grinding away at his members. As the pressure intensifies, he clearly hopes that opposition will fall away.
But he first must get past the motion to proceed.
"Next week, we'll be voting on the motion to proceed, and I have every expectation that we'll be able to get on the bill," McConnell told reporters Wednesday at the White House.
McConnell has failed three times so far to win the support that he needs.
A mix of conservative and centrist senators said they would oppose a procedural motion to begin work on an initial repeal-and-replace bill.
That led to a new round of negotiations and a second repeal-and-replace measure largely similar to the first bill.
On Monday, it became clear that the new bill also lacked the support to advance in the Senate.
Tensions reach new high between Trump, GOP
Tensions are bubbling over between President Trump and Senate Republicans. White House officials are blaming Senate Majority Leader Mitch McConnell (R-Ky.) for getting stuffed at the goal line on ObamaCare repeal-and-replace legislation, while GOP senators say Trump failed to provide any meaningful political momentum for the prized measure. The Highest Paying Cash Back Card Is Here See The Top Rated Card Sponsored by CreditCards.com "He was of no help," grumbled one GOP senator, who doubted that Trump would have done much to defend lawmakers from political attacks if the bill passed.
McConnell then signaled he'd abandon repeal-and-replace, saying the Senate would seek to advance legislation repealing ObamaCare - with no guarantee on any replacement.
Centrists then came out against that plan, too.
After the Trump meeting, GOP leaders changed course and signaled a third effort to win support for a repeal-and-replace bill.
Senate Majority Whip John Cornyn (R-Texas) told reporters after the lunch that while the repeal-only bill might come to the floor, he preferred to negotiate a version of the repeal-and-replace bill, known as the Better Care Reconciliation Act (BCRA).
"If we can get an agreement here, my preference would be to start with the BCRA, agree to language - and I think we're getting closer," he said.
Senators were expected to meet Wednesday evening in Sen. John Barrasso's (R-Wyo.) office with Vice President Pence, Health and Human Services Secretary Tom Price and Seema Verma, administrator for the Centers for Medicare and Medicaid Services, to discuss the bill. At press time it was not clear which senators would attend the meeting.
Trump: Republicans 'never discuss how good their healthcare bill is'
President Trump on Wednesday praised the GOP healthcare plan and said it will only improve. He also blasted ObamaCare, tweeting that the healthcare legislation is dying. "The Republicans never discuss how good their healthcare bill is, & it will get even better at lunchtime," Trump tweeted Wednesday."The Dems scream death as OCare dies!"The Republicans never discuss how good their healthcare bill is, & it will get even better at lunchtime.The Dems scream death as OCare dies!- Donald J.
"There are going to be some meetings tonight up here with people who still have outstanding issues, and I think the question will be, yeah, can we find a way to get to yes?" said Sen. John Thune (S.D.), the Senate's No. 3 Republican.
Leaders face the same problem that has bedeviled them since the beginning. If the bill is moved to the right, moderate senators are lost. If the bill moves to the center, conservative senators defect.
The bill's treatment of Medicaid is a major sticking point for moderates.
The latest attempt to win over members is being called a "Medicaid wraparound."
This would allow states to take money allocated to them through Medicaid and use the money to cover healthcare expenses for people who no longer qualify for Medicaid because the program's expansion ended.
The idea is to make up for the reduction of federal funding for ObamaCare's Medicaid expansion, which would be curtailed by the Senate bill. Under the previous bill, states are given federal tax credits to help people who would no longer quality for Medicaid, but senators have expressed fears that this will not be a big enough pool - particularly considering the nation's opioid epidemic.
But the plan would actually involve taking more money away from Medicaid, which would already see its federal funding reduced under the Senate bill.
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OPINION | Americans may very well vote to repeal and replace Republicans in November 2018. Maria Cardona is a principal at the Dewey Square Group, a Democratic strategist and a CNN/CNN Espa ol political commentator. Follow her on Twitter @MariaTCardona.The views expressed by contributors are their own and not the views of The Hill.
Verma discussed the proposal at the White House lunch.
"She explained very briefly, very, very briefly some of the parameters of what they're calling this wraparound for Medicaid," said Sen. Lisa Murkowksi (R-Alaska), one of the moderates who has threatened to vote against a motion to proceed to the bill.
Despite all the problems they've had with their ObamaCare effort, a number of Senate Republicans said they believe they are close to getting enough votes on a repeal-and-replace bill.
McConnell's move to bring a repeal-only bill to the floor "brought it to a head, and he offered one way forward," Sen. Mike Rounds (R-S.D.) told The Hill after the lunch at the White House. "A lot of us went back in and talked with leadership and said, 'Look, we're close enough on this, we put a lot of work into this, we don't want to go that route.' "
They are also facing increasing pressure from groups warning of political repercussions if they fail.
The conservative group FreedomWorks said they will hand out "traitor" awards to Republicans who oppose a healthcare procedural vote next week.
And the conservative Club for Growth said it will track the motion to proceed leading to a vote on a repeal-only bill as a "key vote," warning that voting against it would be "tantamount to supporting ObamaCare."
Alex Bolton contributed.