Sen. Ted Cruz (R-Texas) is pursued by reporters as Republican senators are questioned aboutGOP health-care bill at the Capitol Wednesday. (Jahi Chikwendiu/The Washington Post)

President Trump put the onus squarely on Senate Republicans on Wednesday to pass a health-care bill, declaring that he will be “very angry” if the chamber falls short on a long-standing promise of his party.

The comments, coming in an interview at the White House with televangelist Pat Robertson of CBN News, intensified public pressure on Majority Leader Mitch McConnell (R-Ky.), who plans to release a revised version of his health-care legislation Thursday morning.

“I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me,” Trump said. “It has to get passed. They have to do it. They have to get together and get it done.”

The president’s remarks also came amid concerns from conservative lawmakers and activists that McConnell’s revamped measure would not undo the Affordable Care Act aggressively enough.

Those worries, alongside lingering anxiety among centrist Republicans that the bill is going too far, threatened to leave the rebooted effort short of the votes it will need to pass next week, when McConnell hopes to bring it to a vote. He can only afford two Republican defections.

(Reuters)

“As far as I can tell, the new bill is the same as the old bill, except it leaves in place more taxes,” Sen. Rand Paul (R-Ky.) said on a Wednesday conference call with reporters. “I can’t support it at this point.”

Paul was referring to two taxes for high-earning Americans that McConnell is prepared to preserve, according to Republican senators and aides: an investment income tax and a Medicare payroll tax on wages and self-employment income.

In McConnell’s original draft bill, the taxes were repealed. But some Republican senators pushed for keeping them and using the revenue to provide more assistance to help lower-income Americans pay for health care. At least two Republican senators predicted Wednesday that the way the new bill addresses insurance subsidies will be different from the old version.

“The insurance subsidies are going to be beefed up,” said Sen. Bob Corker (R-Tenn.). Sen. Patrick J. Toomey (R-Pa.) said, “I think there will be some changes there.”

Amid the discord, some signs emerged that McConnell was making progress. Sen. Ron Johnson (R-Wis.), one of five GOP senators who so opposed the original draft that they planned to block the bill from moving to the Senate floor for debate, said Wednesday that he no longer plans to do that.

Johnson said the extra two weeks since the collapse of the original bill gave him sufficient time to talk to experts and constituents. Now, he said, he is open to starting debate.

The bigger concern among most hard-right activists and lawmakers was whether a controversial amendment that Sen. Ted Cruz (R-Tex.) has been pushing would be included in the package that McConnell releases Thursday.

Sen. Ron Johnson (R-Wis.) is surrounded by reporters at the Capitol Wednesday. (Jahi Chikwendiu/The Washington Post)

“It needs to be in the underlying text,” Cruz told reporters, dismissing the suggestion that he could instead introduce it during an open amendment process if and when the bill heads to the Senate floor. Conservatives worry that the Cruz plan probably would not have enough support to pass as a stand-alone amendment.

Corker said he believes McConnell will release two versions of the revised bill on Thursday — one with Cruz’s amendment and one without it. GOP leaders were more circumspect.

“There should be a lot of information released,” Senate Majority Whip John Cornyn (R-Tex.) told reporters. “But I can’t speak to the exact format.”

Cruz’s proposal would allow insurers to sell plans that don’t comply with Obamacare coverage requirements as long as they offer at least one plan that does. Cruz argues that it provides consumers with more choice. But critics assert that it would lead to less healthy people ultimately paying more for coverage.

America’s Health Insurance Plans, a major trade association of insurers, took aim at Cruz’s amendment in a two-page statement Wednesday. “This proposal would fracture and segment insurance markets into separate risk pools and create an unlevel playing field that would lead to widespread adverse selection and unstable health insurance markets,” the group said.

Leading conservative activists, however, demanded that McConnell either include the Cruz proposal as a core element of the final Senate bill or move on to the original GOP pledge to simply repeal the law.

“We were promised [repeal] many times by leaders in the White House as well as Congress,” former South Carolina Republican senator Jim DeMint said during a conference call with reporters. “Now we’re looking at a version that basically is trying to fix Obamacare in different ways.”

Meanwhile, Toomey, who opposes the Obamacare taxes, nevertheless indicated that preserving them wouldn’t be a dealbreaker.

Toomey said he expected the updated bill to index Medicaid growth to the same rate as the original draft. But that could turn off some Republicans who worry about long-term federal spending cuts to the program.

As the Republican push to revamp the ACA has stalled again, even some Trump boosters have questioned whether he has effectively used the bully pulpit afforded by his office. They also have been increasingly frustrated by what they view as distractions related to the Russia investigation.

The urgency that Trump placed on the effort to pass the bill Wednesday stood in sharp contrast to his comments last month, when he said that it would be unfortunate if the bill didn’t reach his desk but that it would be “okay.”

In the interview with Robertson, Trump suggested that McConnell was most responsible now for the fate of the bill overhauling the ACA.

“He’s got to pull it off,” Trump said. “Mitch has to pull it off. He’s working very hard. He’s got to pull it off.”

Trump has spoken out repeatedly about the shortcomings of Obamacare, which he brands a “disaster.” But he has made relatively little effort to detail for the public why Republican replacement plans would improve on the former president’s signature initiative.

Trump’s public efforts to dismantle the health-care law contrast sharply with former president Barack Obama’s efforts to build support in advance of its 2010 passage. Obama gave a joint address to Congress on health care. He fielded questions at town-hall meetings around the country. He even bantered on live television with hostile lawmakers at a Republican retreat.

McConnell is expected to present his new bill to GOP senators at 11:30 a.m. Thursday, according to Republican senators and aides.

On Wednesday, many GOP senators said they had yet to see the full picture of what McConnell plans to release and would reserve judgment until they do.

Said Sen. Lisa Murkowski (R-Alaska): “I am going to choose to not comment on what may show up tomorrow.”

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