Activists opposed to the Republican plan to repeal and replace the Affordable Care Act (ACA) intend to make the most of a delay caused by the absence of John McCain as he recovers from surgery.



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Liberal grassroots groups have organized a slate of public rallies and protests to draw attention to the Republican effort to repeal the 2010 healthcare law, popularly known as Obamacare. On Monday afternoon, a coalition of groups joined Democratic members of Congress on Capitol Hill to denounce the latest version of the Senate Republican bill. Activists were also preparing to stage sit-ins in the offices of undecided Republican senators, to urge them to “kill the bill”.

Republicans had planned to hold a vote on a revised version of the healthcare bill this week. But on Saturday night, the majority leader, Mitch McConnell, announced that he would “defer consideration” of the bill because McCain would remain in Arizona for a week to recover from surgery to remove a blood clot above his left eye.

On Monday, Trump vowed to repeal what he called “job-killing Obamacare” and said multiple times that he expected McCain to recover and return to Washington because “we need that vote”.



“We hope John McCain gets better very soon because we miss him,” Trump said, during remarks at his “Made in America” products showcase event at the White House.



“He’s a crusty voice in Washington. Plus, we need his vote.”



Trump is escalating his outreach to wavering Republican senators and invited a handful of conservatives to a private meeting at the White House on Monday night.

“There’s been a very robust discussion with House and Senate leadership,” the White House press secretary, Sean Spicer, said during the daily briefing on Monday. “We’re going to do what we did last time.”



After a number of fits and starts, House Republicans narrowly passed a consensus healthcare bill in May with no Democratic votes. Trump celebrated the victory with a Rose Garden ceremony, though later derided the House bill as “mean”.

Republicans, who hold a slim two-vote majority, cannot pass the healthcare bill without McCain’s support. Two senators have already said they would vote against bringing the bill to the floor for a vote – and Democrats are uniformly opposed to the measure.



Last week, McCain predicted that the Republican effort to repeal the ACA would flounder under public pressure, when wavering senators returned home and faced strong opposition from voters. McConnell had hoped to hold a vote before the August recess, which he delayed because of divisions among his party.

Senate Republicans unveiled their revised healthcare draft last week, aiming to win over moderate and conservative holdouts. But the changes to the bill were swiftly rejected as insufficient by Susan Collins of Maine and Rand Paul of Kentucky, leaving leaders with only one vote to lose.

Collins lambasted the proposal’s steep cuts to Medicaid, the entitlement program that helps provide low-income Americans with access to healthcare. Paul complained that the new legislation did not go far enough.

The revised plan retains two ACA taxes on high-income earners, in order to generate revenue Republicans say can be directed toward subsidies for low-income people. It also includes $45bn in funding to address the opioid crisis, a top priority on both sides of the aisle. The bill nonetheless guts Medicaid by rolling back an expansion of the program under the ACA, in addition to altering the formula used to calculate its funding, which analysts said could leave states with substantially less coverage.

Some moderate holdouts – Rob Portman of Ohio, Shelley Moore Capito of West Virginia and Dean Heller of Nevada – were reluctant to embrace the bill, telling reporters on Capitol Hill their concerns over the impact on Medicaid remained.

On Sunday, Collins said there were “about eight to 10 Republican senators who have serious concerns about this bill”.

Some Republicans also took issue with the inclusion of a controversial amendment crafted by two of the chamber’s most conservative members, Ted Cruz of Texas and Mike Lee of Utah, that would allow insurers to offer bare-bones plans that do not meet the ACA’s coverage requirements as long as they also offer plans that do meet those standards.

Two of the country’s largest insurance groups, America’s Health Insurance Plans and Blue Cross Blue Shield Association, called the provision “simply unworkable”. In a letter to Senate leadership, the groups said the so-called Consumer Freedom Option would “undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market”.

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During his remarks on Monday, Trump said Republicans were “pushing very hard” on healthcare and that the “Republican senators are great people”. Discussing the delicate and protracted negotiations to craft a bill that could earn at least 50 votes, Trump explained: “Some states need this, some states need that.

“But we’re getting it together,” he said. “And it’s going to happen.”



Trump turned to the vice-president, Mike Pence, for assurance.



“Right, Mike?” he said.



“Yes, sir,” Pence replied.

A number of GOP leaders are openly skeptical that Senate Republicans can forge a consensus. But they also worry about the political consequences of failing to fulfill seven years of promises to repeal the ACA.

“This is a critical time for us as Republicans because we do have the Senate, and the House and the White House,” Ronna McDaniel, chairman of the Republican National Committee, told the conservative radio host Laura Ingraham on Monday.

“Now it’s our time to show not only that we can repeal and replace Obamacare, something that is failing across this country and crumbling, but also that we can govern when we’re given the majority.

“Republicans need to show that we can lead, and that we can tackle tough issues as a party, and that’s going to be important going into 2018 as to whether or not we can keep majorities in the House and expand our majority in the Senate, where we have a very favorable map.”

Healthcare activists will continue to target wavering Republican senators. On Wednesday, as many as 200 people from across the country who could be affected by changes to the healthcare law will come to Washington. A press release said activists would “occupy Capitol Hill offices” and deliver the message: “Kill the bill. Don’t kill us.”