President Donald Trump's offerings to the Senate may not be enough for the health care bill to pass in that chamber. | Getty Trump's Obamacare repeal concessions likely can't pass Senate 'There’s only so much they can get through over there,' Orrin Hatch says.

President Donald Trump and House Speaker Paul Ryan are considering throwing red meat at the right to push their Obamacare repeal bill through the House. But senators from both parties are signaling those conservative goodies will have a hard time surviving the Senate.

Democrats say they are certain they can kill any language in the repeal bill that erases Obamacare’s mandate for minimum benefits in insurance plans. And top Republicans are making no promise that the last-ditch changes to win over conservatives will fly in the more centrist Senate, which is beginning to write its own health care plan that’s likely to look far different from what the House is set to vote on Thursday night.


“We’ll certainly try if the House sends it to us,” said Senate Majority Whip John Cornyn (R-Texas) in an interview. “I don’t think there are any guarantees in this process. The only guarantee is we’re going to do our best.”

"I don't think it can be repealed except statutorily," said Sen. Bill Cassidy (R-La.). "People keep saying it has the ability to pass the parliamentarian. It never had before."

Senate Republicans may simply oppose the effort to sweep aside requirements that health insurance plans cover items like mental health care and maternity care — not to mention a separate proposal being floated in the House to allow insurers to once again block people with pre-existing conditions from coverage and to no longer allow young adults to stay on their parents’ health care plans until age 26. Those Obamacare provisions are popular among Senate Republicans and likely to remain in any final bill.

But parliamentary rules could be the bigger problem. The budget reconciliation procedure being used by Senate Majority Leader Mitch McConnell has strict rules that could kill language added by the House that does not have a direct budgetary effect. And that could ruin an attempt to pass a repeal on a simple majority, party-line vote.

Republicans would also face a problem if there are so many Byrd violations that the parliamentarian rules that the whole bill is invalid.

"It’s sort of a weighing test of [whether] a reconciliation bill is weighed down with a large number of rule violations," said Ed Lorenzen, senior adviser at the Committee for a Responsible Federal Budget. "But that’s not [just] one or two violations, that presumably is in the category of multiple violations."

In an interview, Sen. Patty Murray (D-Wash.), a former chairman of the Senate Budget Committee, said the House is now indiscriminately rewriting its legislation with no regard for what can become law. Democrats are confident they can win the parliamentary battle on several key provisions in the repeal process.

“I’m pretty sure it will come out,” Murray said of the latest possible changes to the bill. “They are selling not only the wrong policy, but they are selling the House Republicans something that isn’t ever going to see the light of day.”

It’s a process that cannot start in earnest until the House passes its repeal bill and the legislation is before the Senate, where Democrats and Republicans will haggle with parliamentarian Elizabeth MacDonough over what is acceptable under reconciliation — a critical “Byrd bath” process that will determine whether portions of the health care proposal will need 60 votes to survive. Republicans are working on ensuring the bill fits parliamentary rules, including potentially replacing the House bill with an entirely new substitute if needed.

“There’s only so much they can get through over there. And we’ll have to see what we can do,” said Senate Finance Chairman Orrin Hatch (R-Utah). “It has to be acceptable to the rules. We cannot afford to [mess up] reconciliation.”

Senate Republicans briefly discussed targeting the law’s essential benefits with the parliamentarian when they drafted a repeal bill in 2015. Republican sources say the parliamentarian sent signals that Obamacare’s coverage protections couldn’t be repealed, but they never fully litigated the issue.

Senate Democrats say they have enough votes to block any Republican attempt to repeal Obamacare's covered benefits at a 60-vote threshold. Forty-two Senate Democrats sent a letter to rank-and-file House Republicans Thursday that they shouldn't expect Democrats to cave on future legislation the GOP may include in its "third phase" of repeal or in reconciliation.

House Minority Whip Steny Hoyer of Maryland, who navigated the reconciliation process when Obamacare was originally passed, said he is confident that even if the bill gets through the House, many pieces would get struck in the Senate for violating the rules.

“Many of the promises Republican leadership is making to hard-liners to try to get them to vote for this bill are empty promises. They’re empty in the sense that under reconciliation, much of what they’re promising … [will be] objected to and be struck from the bill,” Hoyer said.

Republicans familiar with the issue say there is a good chance Democrats are correct, but they add that it’s too early to tell how things will play out. Depending on how the language is written, the GOP could argue the minimum insurance requirements affect the budget by making insurance plans more expensive and win the argument.

But if the parliamentarian rules against the GOP, they almost certainly will not encourage Vice President Mike Pence to overrule her, as some conservatives are demanding in order to load up the bill with conservative priorities. Internal guidance from top Republican aides shows that Senate leaders oppose any effort to overrule the parliamentarian via the executive branch.

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If the House manages to pass something this week, it will only be the beginning of the process. The legislation will change dramatically in the Senate, where Republicans are hammering out their own version of Obamacare repeal that can get 50 of 52 GOP votes — a far narrower margin than in the House.

“There’s going to be some changes made in the Senate,” Cornyn said. “There will have to be a conference or some sort of a means to reconcile the difference.”

Adam Cancryn contributed to this report.