The Senator who put a poison spike into the heart of Trump’s health care plan two months ago now says there is an ObamaCare replacement he can support – but there may be too many fighting factions and too little time to pull it off.
Senator John McCain (R-AZ), who left his sick bed at the end of July to cast the vote that derailed a last ditch effort to repeal ObamaCare and launch a “skinny bundle” version of TrumpCare, now says he would vote for a new version of the health care bill that would give the states a chunk of money to run the health care programs that they choose.
The new bill isn’t among those fashioned during weeks of ultra-secret negotiations by Senate Majority Leader Mitch McConnell (R-KY). Instead, it has been crafted primarily by three Republican Senators who have been critics of McConnell’s approach.
The bill is the work of McCain’s best friend in the Senate, Lindsey Graham of South Carolina, along with Bill Cassidy of Louisiana and Dean Heller of Nevada.
It also has gained support from Rep. Mark Meadows (R-N.C.), who is chairman of the far right wing, the ultra-conservative group known as the House Freedom Caucus.
Trump did not create this latest bill but apparently is willing to support it, or anything like it, that would give him a rare legislative victory after months of frustration with Congress.
Meadows’ support is an indicator the new bill will not have a single Democrat supporting it, which means once again Republicans will need every vote among their members. That means it must be passed by September 30 to pass with only 51 votes under a reconciliation resolution that requires the bill also reduce the federal budget.
That is no sure thing. Even among the Republicans, there are a host of factions who will fight for or against certain parts of the bill, which could make it hard to get passed so quickly. McConnell has yet to make clear his position, which in itself could block progress.
McCain coming out in support is somewhat surprising since this latest bill does not appear to meet the criteria he set out in July in explaining his earlier opposition.
At that time McCain said he wanted a bill that went through a normal Senate process of seeking input through public hearings and various committee votes. To pass this by September 30, none of that would be possible.
Previously McCain also said he was concerned that the “skinny” TrumpCare bill would essentially decimate if not kill Medicaid. Although there is no analysis yet by the Congressional Budget Office, it appears the nature of the new plan would be even worse in terms of keeping Medicare alive.
The new version proposes “block grants” to the states of the money that currently is spent on ObamaCare. Then it would be up to the states to decide how it is spent. McCain apparently has gotten support for this from various governors, including in his home state of Arizona, who think that giving them the cash and the power is a great idea.
Two other Republican Senators who voted against TrumpCare in July, Susan Collins of Maine and Lisa Murkowski of Alaska, have not yet weighed in on this new version, and their opposition could again be a problem, possibly joined by other moderate Republicans.
The handful of moderate Republicans who seemed to be unhappy that McConnell’s bill would have thrown millions off the ranks of the insured, and there is no indication that things would be better if states like Alabama, Mississippi and Texas are free to shape their own plans. It actually would probably be a lot worse.
The Congress will also be pre-occupied at least in the early weeks of the fall session with other business, most notably agreeing with Democrats on a spending bill to raise the federal debt limit and avoid an embarrassing, expensive government shutdown.
The Congress may also want to take time to pass a DACA replacement so that the DREAMERs – Latinos who came to the U.S. as little children and have become good citizens – are not deported by Trump.
There is also Trump’s iffy relationship with Republicans. In recent weeks he has spoken out and tweeted things that could have left some members of his own party angry at him, which could make any new negotiations tense.
Then, of course, there is the boiling anger among millions of Americans who believe the Republican health care bill is just another way to give the super rich a tax break while breaking the backs of working people who finally got coverage under ObamaCare.
For many Americans, the realization has come that ObamaCare was actually not too bad, and includes many things they like including rules that force insurance companies to give them policies at reasonable rates even if they have pre-existing medical conditions.
So while McCain may think this latest effort is the answer, lots of other factions are going to disagree, which could mean yet another embarrassing defeat for Trump and his Republican allies.