Democrats Eager To Work On Bipartisan Health Care Effort If GOP Bill Fails

Senate Republican leader Mitch McConnell warned his GOP colleagues they may have to work with Democrats if they can't pass their own health care bill. NPR takes a look at what Democrats would want if that happened.

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We're going to take a few minutes now to talk about what might happen if Senate Majority Leader Mitch McConnell does not get the votes he needs to repeal and replace key portions of the Affordable Care Act. Senate Republicans plan to release an updated version of their health care bill tomorrow. McConnell would probably want to take it to a vote next week. But he says if it fails, he might work with Democrats on a bipartisan replacement for Obamacare. NPR's Scott Detrow reports from the Capitol that Democrats say they are ready to have that conversation.

SCOTT DETROW, BYLINE: There's not much Democratic senators can do right now as Republicans rework their health care bill.

DICK DURBIN: What we do every day here - wait for McConnell to get his act together.

DETROW: Dick Durbin of Illinois is the No. 2 Democrat in the Senate. He and other Democrats aren't holding their breath for McConnell to call and invite them into negotiations. Here's Claire McCaskill of Missouri.

CLAIRE MCCASKILL: I don't think they'll do it until they're sure they can't do it their way. Hopefully it'll happen eventually.

DETROW: If it does, Democrats have been making it clear to Republicans and really to anyone tuning in to C-SPAN that they're ready and willing to talk. Minority Leader Chuck Schumer said so again earlier this week.

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CHUCK SCHUMER: We want to sit down. We've asked for months to sit down with our Republican colleagues and come up with a proposal that improves the existing system.

DETROW: Schumer and other Democrats have repeatedly highlighted health care bills they've introduced. They say a main focus would be stabilizing the existing health care markets with subsidies and more choices for people in markets with limited coverage options. Virginia Democrat Tim Kaine says he'd be happy to vote for any health care bill that fulfills the broad promises that President Trump made on the campaign trail.

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TIM KAINE: You can call it whatever you want - Trumpcare, anything. If it meets those promises - nobody loses coverage, nobody pays more, nobody gets kicked around, if it has a pre-existing condition, they're not going to cut Medicaid - I'll vote for it.

DETROW: Republicans also made broad statements about what they wanted when they were in the minority only to suddenly struggle to find common ground in the majority. Working with a bill that only needs 50 votes to pass, McConnell hasn't found a way to keep both moderate and conservative Republicans happy. If he had to restart the process on a broader bill, it would need 60 votes to advance. Then moderate Democrats would suddenly become the new swing votes, Democrats like Heidi Heitkamp of North Dakota and Jon Tester of Montana, who are both up for re-election next year in deep red states. Both say they'd be happy to deal but that Republicans would need to drop their push to scale back Medicaid spending.

HEIDI HEITKAMP: That has to come off the table. We cannot be turning back the clock on Medicaid.

JON TESTER: Eliminating Medicaid or trimming it back or however they want to put it is a price for admission, then it's going to be very difficult.

DETROW: Interestingly, Tester doesn't have as firm a line on another defining aspect of Obamacare - its mandates, like the one requiring that every adult American purchase health insurance.

TESTER: I hate them, but they're there for pre-existing conditions and lifetime caps and 26-year-olds. If you figure out a way to do it different, I'm - my ears are open.

DETROW: Another Democratic condition for negotiations - scrap the tax cuts included in earlier versions of the Republican bill. So Democrats are ready to drive a hard bargain, but there's one increasingly popular Democratic idea that senators say they wouldn't bring to the negotiating table - single-payer health care. In recent years, more and more Democrats have rallied around a large government-run health care program as their preferred position. Vermont's Bernie Sanders has led that push but concedes it would be a nonstarter.

BERNIE SANDERS: No. Look; I have no illusions (laughter) that under a Republican Senate and a very right-wing Republican House and an extremely right-wing president of the United States that suddenly we're going to see a Medicare-for-all, single-payer passed. You're not going to see it. That's obvious.

DETROW: Sanders says he's planning on rolling out a single-payer bill in the coming weeks. But right now he and other Democrats say their focus would be keeping as much of Obamacare in place as possible. Scott Detrow, NPR News, the Capitol.

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