GOP senators may reach agreement on health care

A day after Senate Majority Leader Mitch McConnell said he didn’t know how he was going to find 50 votes to pass a bill to repeal and replace Obamacare, the No. 2 Senate Republican emerged from a key health care meeting saying he was suddenly “optimistic” about the negotiations over the thorny, high-stakes issue.

“I’m more optimistic leaving that meeting than I have been in a while,” said Sen. John Cornyn, R-Texas, as he exited a closed Capitol meeting of a Senate Republican working group on health care reform, which took place a day after Congressional Budget Office gave a key score of the House-passed bill that will be the starting point for Senate negotiations.

He attributed his optimism to “the general tone, and the willingness of people to make small concessions in order to build consensus. That’s what we need to do,” he said.

Cornyn’s upbeat assessment was difficult to interpret, especially because he acknowledged that while the group still had not reached consensus, staff would begin “drafting” legislative language over the one week recess that starts Friday. That drafting process, while preliminary, is often considered a sign that talks are moving forward and senators want to get into legislative text the ideas they are gelling around.

GOP aides and senators said privately they thought some differences were narrowed at the meeting but they also thought Cornyn was trying to spin some momentum for the bill, which has appeared stalled because of the sharp ideological and policy divisions in the GOP conference.

“As Sen. McConnell likes to point out, with 50 senators needing to agree on this bill, everybody is in a strong position. So, we can’t roll anybody,” Cornyn said.

Sen. Bill Cassidy, R-Louisiana, a leading GOP voice on health care reform, attended the session Thursday even though he is not formally a part of the working group. He agreed “totally” with Cornyn that progress was made.

“There were just some good points made,” he said. “There was common ground.”

Sen. Susan Collins of Maine, who co-authored a competing reform bill with Cassidy, also is not part of the group but was pleased to hear Cornyn’s assessment.

“I’m happy if they’re making progress,” she said. “I look forward to seeing what their product is. There does seem to be a consensus that the House bill could never pass the Senate and I’m certainly of that belief as well.”

But the reality is, Senate Republicans have a long way to go before reaching a deal and while GOP leaders have not put a deadline for completing a bill, many senators have said they hope to vote before the August recess.

In an interview with Reuters Wednesday, McConnell pointed to the difficult task Senate Republicans face trying to reach an agreement

“I don’t know how we get to 50 (votes) at the moment. But that’s the goal,” he said.

“Health care is hard. No surprise to us,” said Sen. Roy Blunt, R-Missouri, while noting President Donald Trump recently acknowledged his surprise about how complex health care policy is. “It’s really complicated.”

Blunt argued Republicans had no choice but to take on the task because as he put it Obamacare is collapsing, many insurance companies are pulling out of it altogether and millions of Americans could be left without coverage.

Senate Finance Committee Chairman Orrin Hatch, R-Utah, a key health care negotiator, agreed it will be difficult to get 50 votes out of the 52-member Republican conference, a threshold that would require Vice President Mike Pence to break a tie.

“We’ll get them but it’s going to be difficult,” he said. “There are a lot of sticking points. The hardest one is that everyone wants everything for the lowest cost possible and there is no way you can give everybody everything they want on health care.”

An example of the challenges facing negotiators is demonstrated by the comments of two GOP senators who attended the health care meeting.

Sen. Ted Cruz, R-Texas, a conservative said individual states need to be able to waive most regulations and decide for themselves what benefits insurance companies must provide.

“If we’re going to lower premiums we have to give consumers flexibility to purchase more affordable plans,” Cruz, a former Republican presidential candidate, said. “We have to give states flexibility to provide creative solutions so those in need provide better care.”

That was at odds with Sen. Dean Heller, a Republican who is up for re-election in purple Nevada. He is interested in preserving regulations that require coverage for pre-existing conditions and he also wary of his state giving up its expansion of Medicaid, which took place under Obamacare.

“I’m here to listen,” Heller said as he headed into the meeting. “I’ve got concerns about a lot of things. How they handle Medicaid is an important issue for me so I’ll be looking at that closely.”

In the meantime, Democrats who are not part of the negotiations are watching carefully.

“I don’t know what’s happening in their caucus,” said Sen. Debbie Stabenow, D-Michigan, who is heavily involved in health policy. “I can’t imagine there’s a way to get 50 members on something that doesn’t seriously hurt Americans and raise their costs. You cannot do that in a comprehensive way using anything close to the structure they’re talking about.”