The latest effort by Senate Republicans to revive their plan to repeal Barack Obama’s Affordable Care Act (ACA) was teetering on the brink of collapse again as a new prediction said it would mean 22 million people losing their health insurance by 2026.
A fresh assessment by the nonpartisan Congressional Budget Office said Thursday that the latest repeal-and-replace plan would cut the federal deficit by $420bn over a decade. But the changes would still see 22 million lose their insurance cover over the same period, no improvement on an earlier version of this bill.
At the moment, 90% of Americans under the age of 65 have health insurance, but that would fall to 82% if the latest Republican plan passed a vote in the Senate and was signed into law by Donald Trump.
The new analysis does not consider a controversial amendment offered by Ted Cruz, a conservative opponent of the healthcare law, that would allow health insurers to offer “barebones” coverage as long as they also offer plans that meet the law’s strict standards. The amendment, which was included in an earlier draft and remains under consideration, could be the key to winning the votes of conservative members who want to see the healthcare law repealed “root and branch”. The plan faces sharp opposition from the insurance industry, and two of the largest insurance companies called it “unworkable”.
The report comes as Republicans work furiously to fulfill their seven-year promise to repeal the ACA, popularly known as Obamacare, after months of fits and starts that have appeared to imperil the bill on several occasions.
At least 20 senators met on Wednesday night to try to find common ground on a healthcare repeal plan after Trump directed them to remain in Washington through the summer recess until a solution is found.
Though the meeting ended inconclusively, several senators left the meeting feeling optimistic that progress toward a healthcare plan had been made.
But they too acknowledged the difficulty of moving a healthcare bill forward without John McCain, the Arizona Republican, who has been diagnosed with brain cancer. The Arizona senator’s illness leaves Republicans with just 51 votes, a slim majority at a time when the caucus is bitterly divided over healthcare and other legislative priorities.
Mitch McConnell, the Senate majority leader, has resolved to hold a vote next week, despite appearing to lack the votes to pass a Republican replacement plan or a repeal-only measure.
As recently as Monday, the Senate Republican replacement plan, which mirrors the House bill that narrowly passed the chamber in May, was at least two votes short of 50.
After two Republican senators announced their opposition to the healthcare plan, imperilling the effort, McConnell conceded that the party’s effort to repeal and immediately replace Obamacare “will not be successful”. Instead, he outlined a plan that would eliminate major pieces of the ACA, with a two-year transition period before the repeal takes place.
That plan, which the CBO estimated would leave 32 million Americans without healthcare coverage by the end of the next decade, was endorsed by Trump, who advised Republicans to “let Obamacare fail”. Almost immediately, three senators announced their opposition, appearing to doom the bill. McConnell said he would hold a vote anyway, perhaps as a way to formally end the six-month saga.
Then, by lunchtime on Wednesday, Trump switched course again, and demanded Republicans repeal, and preferably replace, the law before leaving Washington. The lunch breathed life into the doomed replacement effort. But within hours, senators were expressing doubts about which option McConnell would bring up for a vote next week.
“We don’t have a clear determination as to what it is that we would be voting for,” Lisa Murkowski, a Republican from Alaska, told reporters when asked if she would support a procedural vote to open debate on a healthcare plan. “It’s very difficult for me to say that yes or no to proceed – we’re not certain what we would be proceeding to.”
