Lacking votes, Senate GOP delay health care vote

WASHINGTON (AP) -- Sources tell the Associated Press that Senate Republican leaders have abruptly delayed the vote on their health care bill until after the July 4trecess.

That's the word Tuesday as the GOP faced five defections from its ranks just hours after the Congressional Budget Office said the bill would force 22 million off insurance rolls.

Utah's Mike Lee became the fifth Republican senator to oppose letting the chamber formally begin considering the proposal, which leaders have hoped the Senate would approve this week.

Lee was among four conservatives who announced last week that they were against the current version of the legislation. His spokesman, Conn Carroll, said Tuesday that Lee would not vote to commence debate on the bill "as it is currently written," a roll call that's expected Wednesday.

GOP defections have built after Congress' nonpartisan budget referee said Monday that their measure would leave 22 million more people uninsured by 2026 than President Barack Obama's law. The bill will be derailed if just three of the 52 Republican senators vote against it.

Senate Majority Leader Mitch McConnell, R-Ky., was hoping to staunch the rebellion and win Senate passage before a weeklong July 4 recess that leaders worry opponents will use to weaken support for the legislation.

"I would not bet against Mitch McConnell," his House counterpart, Speaker Paul Ryan, R-Wis., told reporters. But the Senate was convening later than usual Tuesday with no sign that debate on the health care measure would begin as leaders had hoped, underscoring McConnell's need to focus on closed-door deal-making to rescue the bill.

Another Kentuckian, Gov. Matt Bevin, offered reluctant support of the Senate's plan.

Bevin said the proposal is "not really a good bill," but added that conservatives should pass it anyway because it will start the process of giving control back to the states.

Bevin blamed the bill's shaky prospects on "mushy moderates" who "don't have enough spine" to pass it.

The CBO analysis suggested some ammunition GOP leaders could use, saying the Senate bill would cut federal deficits by $202 billion more over the coming decade than the version the House approved in May. Senate leaders could use some of those additional savings to attract moderate votes by making Medicaid and other provisions more generous, though conservatives would rather use that money to reduce red ink.

Minutes after the CBO report's release, three GOP senators threatened to oppose beginning debate. Moderate Sen. Susan Collins, R-Maine, said she would vote no. She tweeted that she favors a bipartisan effort to fix Obama's statute but added, "CBO analysis shows Senate bill won't do it."

One moderate who has criticized the measure's Medicaid cuts, Sen. Shelley Moore Capito, R-W.Va., said she expected McConnell to discuss revisions at a Tuesday lunch of GOP senators. Vice President Mike Pence was attending that session.

Capito and another moderate, Sen. Lisa Murkowski, said they were concerned about the bill but neither said they were ready to vote against debating it.

Conservative Sen. Rand Paul, R-Ky., said he would oppose that motion unless the bill was changed. Paul tweeted that he was meeting with Trump at the White House on Tuesday.

Later Tuesday afternoon, Paul tweeted that Trump is "open to making the bill better. Is Senate leadership?"

And fellow conservative Ron Johnson, R-Wis., said he had "a hard time believing" he'd have enough information to back that motion this week. Moderate Sen. Dean Heller, R-Nev., said Friday he'd oppose the procedural motion without alterations.

Lee and other conservatives have favored a fuller repeal of Obama's statute than the Senate bill would enact.

The 22 million extra uninsured Americans were just 1 million fewer than the number the budget office estimated would become uninsured under the House version. Trump has called the House bill "mean" and prodded senators to produce a package with more "heart."

The budget office report said the Senate bill's coverage losses would especially affect people between ages 50 and 64, before they qualify for Medicare, and with incomes below 200 percent of poverty level, or around $30,300 for an individual.

In one example, the report says that in 2026 under Obama's law, a 64-year-old earning $26,500 would pay premiums amounting to $1,700 a year, after subsidies. Under the Senate bill, that person would pay $6,500, partly because insurers would be able to charge older adults more.

The Senate plan would end the tax penalty that law imposes on people who don't buy insurance, in effect erasing Obama's so-called individual mandate, and on larger businesses that don't offer coverage to workers.

It would let states ease Obama's requirements that insurers cover certain specified services like substance abuse treatments, and eliminate $700 billion worth of taxes over a decade, CBO said, largely on wealthier people and medical companies that Obama's law used to expand coverage.

It would cut Medicaid, which provides health insurance to over 70 million poor and disabled people, by $772 billion through 2026 by capping its overall spending and phasing out Obama's expansion of the program. Of the 22 million people losing health coverage, 15 million would be Medicaid recipients.

CBO said that under the bill, most insurance markets around the country would be stable before 2020. It said that similar to the House bill, average premiums around the country would be higher over the next two years - including about 20 percent higher in 2018 than under Obama's statute - but lower beginning in 2020.

But the office said that overall, the Senate legislation would increase consumers' out of pocket costs. That's because standard policies would be skimpier than currently offered under Obama's law, covering a smaller share of expected medical costs.

Meanwhile, an analysis of premiums under the Senate bill by the nonpartisan Kaiser Family Foundation found more bad news for Republicans. Net premiums for midlevel silver plans that most consumers now buy would go up 74 percent on average under the Senate bill, from $197 a month to $342.

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