At least one Republican senator predicted a consensus was still ‘several more weeks away’, and few senators have been willing to defend the bill publicly

Republican senators left Washington more than a week ago without voting on a long-promised repeal of the Affordable Care Act or their unpopular plan to replace it. The GOP lawmakers return on Monday with the daunting task of crafting a bill still very much in front of them, amid swirling doubts about the prospect of finding a solution any time soon.

“My view is it’s probably going to be dead,” Arizona senator John McCain told CBS on Sunday. “I fear that it’s going to fail.”

McConnell hints healthcare vote could fall short: 'I'm a guy with a Rubik's cube' Read more

A vote is unlikely to take place this week, with at least one Republican senator predicting that his colleagues are still “several more weeks away” from reaching a consensus on a healthcare replacement. Last week at a town hall, Senate majority leader Mitch McConnell compared the process of negotiating healthcare reform with intransigent Republican senators to solving a Rubik’s cube.

“I’m in the position of a guy with a Rubik’s cube, trying to twist the dial in such a way to get at least 50 members of my conference who can agree to a version of repealing and replacing Obamacare,” McConnell said. “That is a very timely subject that I’m grappling with as we speak.”

Republicans were not meant to still be grappling with healthcare over the Fourth of July recess. When Trump took office and the GOP kept control of Congress, they laid out an ambitious agenda that included repealing Obamacare as early as January and then moving on to tax reform and infrastructure.

But intransigent Republican opposition – and a groundswell of political activism in the wake of Trump’s election – derailed that timeline. Now it’s summer and with only a handful of working weeks left before the August recess, the Senate Republican leadership is still searching furiously for 50 votes, a tally that would only push them over the finish line with a casting vote from the vicepresident, Mike Pence.

The clearest sign of Republican resistance to the bill was how few senators were willing to defend the bill publicly. During the Fourth of July recess politicians typically relish the opportunity to march in patriotic parades and clasp hands with constituents. But this year those appearances were scarce.

And the few Republican senators who made public appearances were met with protests and pleas from constituents concerned about the Republican healthcare plan.

Facebook Twitter Pinterest Susan Collins. Photograph: J Scott Applewhite/AP

At a parade in Eastport, Maine, Susan Collins, whose opposition to an initial draft of the healthcare law helped delay the vote, said her constituents were singularly focused on healthcare.

“There was only one issue. That’s unusual. It’s usually a wide range of issues,” Collins told the Washington Post. “I heard, over and over again, encouragement for my stand against the current version of the Senate and House healthcare bills. People were thanking me, over and over again. ‘Thank you, Susan!’ ‘Stay strong, Susan!’”

Where a Republican senator refused to hold a town hall, voters made their views known. Tens of thousands of liberal activists and concerned constituents turned out for dozens of rallies across the country to urge their senators to “vote no” on the healthcare bill. Some groups organized protests and staged sit-ins at senators’ offices, and in Columbus, Rob Portman’s constituents held a cookout.

As initially drafted, the Republican healthcare plan would repeal major pieces of the ACA, including the mandate that all Americans purchase health insurance or face a penalty. It would also make deep cuts to Medicaid, a joint state-federal public health program for low-income Americans, compared with spending under the current law.

An analysis by the nonpartisan Congressional Budget Office (CBO) estimated that 22 million people would lose healthcare over the next decade under the Republican healthcare plan. In a new report that assessed the plan’s impact over two decades, the agency estimated that spending on Medicaid under the replacement plan would be 35% lower by 2036 than under current law.

McConnell has introduced a number of changes, including adding $45bn to combat the opioid epidemic. Also under consideration is a compromise amendment by Ted Cruz, the conservative Texas senator who opposed the bill because it did not go far enough in repealing Obamacare.

Under the Cruz proposal, insurance companies could sell non-ACA-compliant healthcare plans as long as they also offered at least one that met the law’s mandates, including coverage for maternity care, mental health treatment and prescription drugs. Though the proposal is gaining traction among conservatives, healthcare experts on both sides of the political debate believe the measure would likely result in prohibitively high costs for comprehensive plans, which sicker Americans would need.

Activists cry cowardice as Republican senators shut doors to healthcare town halls Read more

McConnell sent an updated version, including the Cruz amendment, of the healthcare plan to the agency, and a new report is expected this week. The CBO is expected to release another analysis sometime next week, a likely indicator that Senate Republicans will not vote on the plan until later this month.

“I think we are making steady progress,” Cruz told ABC on Sunday. “The conversations have been collaborative and in good faith.”

If Republicans fail to reach an agreement on a replacement plan, McConnell said he would work with Democrats to stabilize the insurance markets.

“No action is not an alternative,” McConnell told constituents at a Rotary Club lunch on Thursday, according to the Associated Press. “We’ve got the insurance markets imploding all over the country, including in this state.”

But Cruz said he agreed with a proposal by Trump – seen as unhelpful and unrealistic by many Republicans – that the GOP should try to repeal Obamacare without agreeing a replacement if the Senate bill fails.

“If we can’t get this done right now, I agree with the president, then let’s honor the promise on repeal and spend more time to get it done,” Cruz said on Sunday.

“I believe we can get it done.”

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