GOP health bill again in jeopardy

WASHINGTON — Sen. Susan Collins all but closed the door Sunday to supporting the last-ditch Republican health care bill, leaving her party’s drive to uproot President Barack Obama’s health care law dangling by an increasingly slender thread.

Already two GOP senators, Rand Paul of Kentucky and John McCain of Arizona, have said they would vote against the legislation. All Democrats oppose the measure, so “no” votes from three of the 52 GOP senators would kill the party’s effort to deliver on its perennial promise to repeal “Obamacare.”

“It’s very difficult for me to envision a scenario where I would end up voting for this bill,” said Collins, a Maine moderate.

Collins’ all but certain opposition leaves the White House and party leaders desperate to rescue their promise to repeal Obama’s Affordable Care Act with one immediate option: trying to change the mind of at least one opponent.

Republicans have said they’re still reshaping the bill in hopes of winning over skeptics. Collins said sponsors were making last-minute adjustments in the measure’s formulas used to distribute federal money to the states, and the measure’s sponsors said they still intended to plow ahead.

“So yes, we’re moving forward and we’ll see what happens next week,” said one of the authors, Sen. Lindsey Graham, R-S.C.

Paul criticized the GOP bill anew as “not repeal.” He said he opposed a key pillar of the legislation — transforming much of the federal spending under Obama’s law into block grants of money that states could spend with wide latitude. He said the GOP bill left too much of that spending intact and simply gave states more control over it.

“Block granting Obamacare doesn’t make it go away,” Paul said.

Collins said she had a lengthy conversation Saturday with Vice President Mike Pence, who she said urged her “to think more thoroughly about some issues.” Graham suggested backing a proposal sought by Paul that would make it easier for people to join or form group insurance plans so they would have lower premiums.

Collins said she was troubled by the bill’s cuts in the Medicaid program for low-income people. She expressed concerns that the measure would result in many people losing health coverage and didn’t like a provision letting states make it easier for insurers to raise premiums on people with pre-existing medical conditions.

As GOP leaders scramble for votes, a chief target is Sen. Lisa Murkowski, R-Alaska, whose state has unusually high health care costs because of its many remote communities. Collins and Murkowski were the only Republicans who voted “no” on four pivotal votes on earlier versions of the GOP legislation this summer.

Murkowski has remained uncommitted on the newest bill, saying she’s studying its impact on Alaska. Her state’s officials released a report Friday citing “unique challenges” and deep cuts the measure would impose on the state.

A showdown vote would have to occur this week to give Republicans any shot at reversing their debacle on the issue in July, when the GOP-run Senate rejected their initial attempt to dismantle Obama’s law. When September ends, Republicans will lose procedural protections that have blocked Democrats from successfully stalling the bill; after that, Republicans would need 60 votes to move ahead.

White House legislative liaison Marc Short said he expected a vote to occur Wednesday.

Senate Majority Leader Mitch McConnell, R-Ky., has said he intends to have a vote this coming week but has stopped short of firmly committing to it. If party leaders expected to lose, they would have to choose between conservatives demanding no surrender in the GOP’s attempt to scrap the law and others seeing no point in another demoralizing defeat.

The renewed GOP drive has encountered widespread opposition from health industry groups, which have strongly opposed the effort.

On Saturday, organizations including America’s Health Insurance Plans representing insurers, the American Hospital Association and the American Medical Association released a statement urging the Senate to reject the legislation. They wrote that the bill would leave the individual health insurance market “drastically weakened,” cause “drastic cuts” in Medicaid and undermine safeguards” for people with pre-existing medical conditions.

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