Senate Majority Leader Mitch McConnell is expected to brief the full 52-member caucus on Tuesday and Wednesday. | Austin Anthony/Daily News via AP GOP struggles to revamp ailing Obamacare repeal bill A key disagreement within the caucus centers on a conservative proposal from Mike Lee and Ted Cruz to slash Obamacare regulations.

Republican leaders are frantically pushing for a vote on the Senate’s ailing Obamacare repeal bill next week, with Senate Majority Leader Mitch McConnell racing to placate warring moderates and conservatives with a new draft due within days, according to senators and aides.

New bill text could be unveiled to senators as soon as Thursday, according to sources familiar with the proposal. A Congressional Budget Office score is likely to follow as soon as next Monday.


“My gut assessment is we need to start voting. … We need to get started, and the goal continues to be to do that next week,” said Senate Majority Whip John Cornyn (R-Texas). Pressed on whether his party will be successful, he said: “I never want to fight to lose. I want to fight to win. And that remains the goal.”

Senate Republicans have offered increasingly dour assessments of the bill’s prospects due to a push from conservative Sens. Ted Cruz of Texas and Mike Lee of Utah to drag the bill rightward and distaste from more moderate senators for future Medicaid spending cuts. Sen. John McCain of Arizona predicted Sunday the effort would be “dead,” yet Cornyn said he feels “pretty good about where we are.”

Other leaders said Republicans’ opposition was based on the first discussion draft of the bill, which drew opposition from all corners of the party for leaving 22 million fewer people with insurance and not doing enough to lower premiums, in the view of some in the GOP.

“This will hopefully address some of the concerns by individual members,” Sen. John Thune (R-S.D.) said of new changes to the bill. He said he hoped Republicans could reach an “understanding” to at least advance the bill on a procedural vote next week and begin consideration of the legislation. McConnell needs 50 senators to support opening debate on the bill and 50 to pass it, with Vice President Mike Pence able to serve as a tie-breaker.

The party spent Monday sniping over the future of the Lee and Cruz amendment, which would allow the sale of cheap insurance plans outside Obamacare’s regulatory structure.

GOP critics like Sens. Chuck Grassley of Iowa, Susan Collins of Maine and Shelley Moore Capito of West Virginia have worried that Cruz’s and Lee’s amendment would make it harder for people with pre-existing conditions to get covered — arguments being amplified by Democrats. Opposition from those senators alone would tank the amendment.

“I’m not sure it has the oomph to make it,” Senate Finance Committee Chairman Orrin Hatch of Utah told Politico, referring to the measure’s level of support.

Two GOP senators, Bill Cassidy of Louisiana and Mike Rounds of South Dakota, said they were hoping for changes to the amendment so that Cruz’s and Lee’s effort to lower premiums could be accommodated while not scaring off other Republicans by segmenting sicker people into one risk pool and healthy people into another.

“The original amendment I did not care for. But my understanding is they’re taking a look at connecting the pooling,” Rounds said. “If they put that provision in, I have a real interest in seeing the amendment move forward.”

Lee said of those sentiments: “News to me.”

Still, several more GOP senators joined in backing Cruz’s and Lee’s amendment on Monday evening, including Sens. Marco Rubio of Florida and Jeff Flake of Arizona. Flake is up for reelection, and the amendment is increasingly a referendum on the right.

“I do like that Cruz proposal,” Flake said.

Though Republicans are aiming to have a new CBO report of their latest proposal by early next week, it may not include an analysis of that amendment. Several Republicans said the so-called Consumer Freedom Act was not fully transmitted to CBO before the Fourth of July recess, which could result in the incomplete analysis.

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A conservative aide familiar with the negotiations said GOP leaders had sent only a summary of the legislation “for reasons unknown to us,” leaving supporters to answer other questions for CBO late last week. Allies of leadership, however, argued the conservatives had been unresponsive.

The White House continues to talk up the Cruz-Lee amendment. Pence told Rush Limbaugh on Monday that it was an example of “what freedom looks like.”

On Tuesday and Wednesday, McConnell is expected to brief the full 52-member caucus on proposed alterations sent to CBO regarding the Senate’s draft bill, which is far from the requisite 50 votes needed.

Republicans are leaning toward keeping some of Obamacare’s taxes to help lower premiums for low-income people, plowing $45 billion into fighting opioid addiction and allowing people to pay premiums with pre-tax money. How to get the support of senators from Medicaid expansion states is also unsolved.

Thune said the Cruz-Lee amendment will get a vote at some point next week, either to strip it out of McConnell’s substitute if it is included in the GOP’s draft, or to include it if leaders spurn it. A proposal to blunt some future spending reductions to Medicaid will likely receive similar treatment.

A McConnell spokesman had no announcements on timing for consideration of the bill.

Republicans would need “divine intervention” to get the negotiations back on track, said a Republican aide.

Another aide said the negotiations aren’t expected to move significantly until the new CBO scores are released. The score on the Cruz-Lee amendment, if CBO can finish it, could show premiums spiking high enough to kill the proposal. The amendment does not currently have the support to pass the Senate.

“They’ll give Cruz every opportunity to sell his solution this week,” said a person familiar with the negotiations. “He’s going to be the one making the sell this week. The question is whether the Cruz-Lee amendment costs you votes. The votes are clearly not there right now.”

The finger-pointing over the amendment’s status could have dire implications for the health care bill, which has now soaked up more than two months of the Senate’s time.

On Sunday, Cruz argued that his amendment is a compromise, not a shot from the right that should drive other Republicans away.

“The Consumer Freedom Amendment was designed to be a compromise, to bring together both conservatives and moderates to unify the party. How does it do that? Because it maintains preexisting conditions protections,” Cruz said on ABC’s “This Week.”

Yet if there is no CBO score on the provision, it would be impossible to evaluate whether the proposal would lower premiums and how it would affect insurance coverage numbers and the stability of insurance markets. Republicans must have a CBO score for their proposal to pass muster with the Senate parliamentarian.

Republicans are now wondering whether the conservative duo would accept something else as a condition for their support. A spokesman for Lee said he needs significant regulatory cuts in the Senate bill to support it.

Seung Min Kim and Eliana Johnson contributed to this report.

