Senate Republicans’ carefully-laid plans to use a powerful fast-track tool to send an Obamacare repeal to President Barack Obama is running into fresh resistance, with new opposition from high-profile conservatives and bubbling concerns from moderates.

For months, the GOP-led Congress has planned to use the procedural maneuver known as “reconciliation” to finally shepherd a major Obamacare repeal bill to the president’s desk. The fast-track process ensures Democrats in the Senate can’t filibuster the legislation and foil yet another attempt to gut the law.


But three conservative members of Senate Majority Leader Mitch McConnell’s conference — Sens. Ted Cruz of Texas, Marco Rubio of Florida and Mike Lee of Utah — have already vowed to vote against the current reconciliation package that repeals major parts of Obamacare, arguing it doesn’t go far enough. If those votes don’t budge, McConnell can’t afford to lose any more votes from his 54-member ranks.

Meanwhile, a provision in the reconciliation bill that defunds Planned Parenthood for one year could cause some heartburn for moderates who don’t support stripping money from the women’s health group. The group has come under significant Capitol Hill scrutiny, particularly from Republicans, over whether the organization profited from sales of fetal tissue.

“It is a mistake to do anything less than a full Obamacare repeal on reconciliation,” Cruz, who is vying for the 2016 GOP presidential nomination, told Politico in a brief interview. “That’s what Republicans promised the voters we would do, and that’s exactly what we should do.”

From the other ideological end of the GOP spectrum, Maine Sen. Susan Collins said she was concerned that the reconciliation bill defunded Planned Parenthood. Still, she said: “I would look at the whole bill.”

Another moderate Republican, Sen. Mark Kirk of Illinois, has voted against measures to defund the women’s health group, and would likely come under criticism in his uphill reelection bid in the blue state if he switched course on Planned Parenthood on reconciliation. He referred a reporter to a spokeswoman, who declined to comment.

Alaska Sen. Lisa Murkowski is a third Senate Republican who has voiced objections in the past to broadly defunding Planned Parenthood. A Murkowski spokeswoman said it was premature to comment on the reconciliation package.

With a 240-189 vote on Friday, the House passed the reconciliation bill repealing key elements of Obamacare, including the individual and employer mandates as well as two taxes in the health care law – the Cadillac tax on pricey benefit plans and a tax on medical devices. The bill now goes to the Senate, where leaders have not indicated when senators will take up the legislation.

But Senate conservatives, as well as activist groups off the Hill, are prodding Republican lawmakers to do more to rip apart Obamacare. Lee said significant portions of the health care law could be addressed through reconciliation, but those provisions are not included in the current version. For example, Lee would like the measure to roll back provisions such as Medicaid expansion and subsidies provided to millions of consumers who purchase health care coverage through the Obamacare exchanges.

“If we’re going to be using reconciliation at all, we ought to use it to repeal as much of Obamacare, as much as we can,” Lee said. “If we’re not going to do that … we ought not to use it.”

The Utah senator joined Cruz and Rubio — who like Cruz is a 2016 presidential contender — to issue a statement last week that said the trio of conservatives would vote against the reconciliation bill unless it’s changed to repeal as much of Obamacare that is allowed under Senate rules.

That group didn’t include Sen. Rand Paul of Kentucky, who is also running for the GOP presidential nomination and would likely feel pressure to align with Cruz and Rubio in making more conservative demands on gutting the health care law.

“If it’s repealing Obamacare, I’ll be a yes,” Paul told Politico. When asked whether the partial repeal in the House package is problematic for him, Paul responded: “I’m for repealing the whole thing. I don’t know exactly what will come forward yet.”

Paul, along with Cruz, voted against the Senate Republican budget earlier this year that helped set up the fast-track procedures.

The reconciliation push is largely a political exercise, since Obama will veto any legislation that shreds key elements of his signature domestic policy achievement. But Republicans want to put the president in a position that forces him to take out his veto pen on an Obamacare repeal — a position that unifies the GOP, more than five years after the controversial law was enacted.

The Senate is working with a narrower margin of error than in the House, where just seven House GOP lawmakers opposed the reconciliation package on Friday. And some of those Republicans are moderate members who have previously opposed their party’s attempts to strip funding from Planned Parenthood.

The limited dissension from House Republicans, some aides said, also showed some waning influence of the feisty outside group Heritage Action, which lobbied GOP lawmakers to oppose the package because it didn’t go far enough to dismantle the health care law.

“The only thing that’s changed since the budget debate is that the House ignored Heritage Action’s attempt to get members to vote against Obamacare repeal and for Planned Parenthood funding,” one senior Republican aide said. “Even the Freedom Caucus thought that was a ridiculous demand.”

Heritage Action, like the three conservative Senate Republicans who have vowed to oppose the reconciliation bill as written, are pushing GOP lawmakers to go much bigger and more fully repeal Obamacare under the fast-track budget procedure.

But the Senate is limited by special procedural rules that precisely define what can actually be done under reconciliation. The chamber’s parliamentarian, Elizabeth MacDonough, would have the final word on what would be allowed under the so-called Byrd rule, named after the late Sen. Robert Byrd (D-W.Va.).

Earlier this year, MacDonough privately hinted to Senate Republican aides that a full repeal of the health care law would not be allowed under the Byrd rule. But, when asked about the parliamentarian’s role in the reconciliation fight, Cruz said last week that “at the end of the day, the Senate parliamentarian is an employee of the Senate” and stressed that all Republicans campaigned on Obamacare repeal.

But McConnell will allow amendments to the House reconciliation package, and conservatives are sure to offer changes to shape the Obamacare measure more to their liking. There has also been speculation on the Hill that the Planned Parenthood provisions might be subject to the Byrd rule.

Regardless, Democrats are likely to use the health care package — particularly its measures stripping funding from Planned Parenthood — as a political cudgel against Senate Republicans up for reelection in blue and purple states in 2016.

“Vulnerable Republican senators who have already voted repeatedly to defund Planned Parenthood are desperate to erase their records of reducing access to women’s health care,” said Sadie Weiner, a spokeswoman for the Democratic Senatorial Campaign Committee. “But voters in 2016 will know without a doubt that these senators are more interested in scoring political points than in supporting women’s health care.”

