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Title : After fellow Republicans kill his bill, McConnell adopts an idea he had dismissed: repeal Obamacare now, replace later
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After fellow Republicans kill his bill, McConnell adopts an idea he had dismissed: repeal Obamacare now, replace later

Sen. Mitch McConnell (Getty Images)

By Al Cross
Kentucky Health News

With his health-insurance bill killed by fellow Republicans late Monday, Senate Majority Leader Mitch McConnell quickly adopted a version of idea he had dismissed: repealing the Patient Protection and Affordable Care Act, but with a two-year delay.

McConnell thus rejected what he had suggested would be his alternative if Republicans couldn't pass a comprehensive bill on their own: join with Democrats to stabilize the market for private health insurance.

Instead, he will use the bill the House passed May 4 as a vehicle for a repeal-now, replace-later strategy advocated by his Kentucky seatmate, Republican Rand Paul. President Trump also suggested that, and did it again Monday night.

Not long afterward, McConnell issued this statement: “Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful. In the coming days, the Senate will vote to take up the House bill with the first amendment in order being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Obama: a repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.” He declined to be more specific about “the coming days.”

Sens. Jerry Moran, Mike Lee (N.Y. Times)

Around 9 p.m. Monday, Sens. Jerry Moran of Kansas and Mike Lee of Utah joined Paul and moderate Republican Susan Collins of Maine in publicly opposing McConnell's revised bill. That left McConnell two votes short of the 50 he needed from Republicans to advance the bill.

After Moran and Lee's joint announcement, President Trump more or less revived an idea advanced earlier by Paul and rejected by McConnell, that Republicans simply repeal the 2010 law and draft a new plan "that will start from a clean slate. Dems will join in!" That scenario appears highly unlikely, based on what Democrats have said about defending President Barack Obama's signature law.

McConnell said in early June that he wasn't working with any of the 48 Democrats because "They're not interested in doing anything we're interested in doing" on health care, but in late June he warned Republicans that if they couldn't pass a comprehensive overhaul on their own, they would have to join with Democrats to stabilize the market for private health insurance, including taxpayer-subsidized plans.

"My suspicion is in any negotiation with Democrats will include none of the reforms that we would like to make on the market side and the Medicaid side," McConnell said then.

Before McConnell's announcement, Senate Democratic Leader Chuck Schumer of New York called for a bipartisan effort. “This second failure of Trumpcare is proof positive that the core of this bill is unworkable,” Schumer said. “Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health-care system.”

McConnell had promised a vote on his bill this week, but had to back off when Sen. John McCain of Arizona was sidelined by surgery. Paul said the delay would give conservatives more time to realize that the bill wasn't what they want.

McConnell had hoped to get Lee's vote by allowing insurance companies to sell the sort of low-cost, low-coverage plans that the 2010 law prohibited. Lee's office said the language was not exactly what he wanted. Meanwhile, insurance companies said the language would split the insurance market between the health and not so healthy, driving up costs for the latter.

"Moran faced pressure at home about how the bill would affect Kansas, including its rural hospitals," The New York Times noted, "The Kansas Hospital Association said last week that the latest version “comes up short, particularly for our most vulnerable patients.”

The Kentucky Hospital Association likewise opposed McConnell's plan to phase out federal funding for expansion of Medicaid, which has boosted many Kentucky hospitals. It said that if the expansion was phased out, Congress should restore the 2010 law's cuts in special reimbursements to rural hospitals for care of Medicare patients.

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