This week will be marked by raging debate over the Better Care Reconciliation Act, the Senate’s version of Obamacare-lite that is drawing a swarm of criticism from conservatives for failing to repeal Obamacare and from moderate and liberal Republicans for going too far toward repealing Obamacare. Over the weekend, several U.S. senators clarified their position on the bill – casting doubts on the feasibility of its passage in its current form.
Sen. Ron Johnson, R-Wisc., elaborated on his opposition to the current version of the BCRA in an op-ed published at the New York times, explaining that “it relies too heavily on government spending, and ignores the role that the private sector can and should play.”
“Once again, a simple solution is obvious,” Johnson writes. “Loosen up regulations and mandates, so that Americans can choose to purchase insurance that suits their needs and that they can afford.”
“Like many other senators, I had hoped that this was where things were headed during the last several weeks as the Republican bill was discussed. We’re disappointed that the discussion draft turns its back on this simple solution, and goes with something far too familiar: throwing money at the problem.”
Johnson was joined in his opposition to the bill last week by Senators Ted Cruz, R-Texas, Mike Lee, R-Utah, and Rand Paul, R-Ky. All have said they are open to voting for the BCRA if certain improvements are made. In an interview with ABC’s “This Week,” Sen. Paul said that he would “consider partial repeal” if the Senate were to reach an “impasse.” Senator Cruz has offered an amendment to permit insurers to sell plans that are not compliant with Obamacare regulations, in an effort to allow insurance companies to give greater choice to consumers and drive down prices.
Senator Lee has made his vote conditional on an “opt-out provision,” acknowledging that other attempts at compromise from his position of full repeal have failed to move the liberal Republicans in the Senate.
“Conservatives have compromised on not repealing, on spending levels, tax credits, subsidies, corporate bailouts, Medicaid, and the Obamacare regulations. That is, on every substantive question in the bill,” Lee wrote Friday. “Having conceded to my moderate colleagues on all of the above, I now ask only that the bill be amended to include an opt-out provision, for states or even just for individuals.”
The liberal Republicans are wavering on the bill for vastly different reasons. Senator Dean Heller, R-Nev., declared his opposition to the bill during a press conference Friday, saying, “This bill would mean a loss of coverage for millions of Americans, and many Nevadans.” The contentious issue for these Republicans are worries that rolling back Medicaid expansion will cause some Americans to lose their insurance coverage as an entitlement is taken away. Senators Shelley Moore Capito, R-W.Va., Lisa Murkowski, R-Alaska, and Bill Cassidy, R-La., are among the moderates expressing concerns.
Senator Susan Collins, R-Maine, is waiting for the Congressional Budget Office score of the bill before making a final decision. ‘‘I have very serious concerns about the bill,’’ she said on ABC’s ‘‘This Week,’’ acknowledging that the CBO score ‘‘will be so important.’’ The CBO is expected to release its score of the Senate bill later today.
In the same interview, Sen. Collins objected to defunding Planned Parenthood in the BCRA, saying, “It makes absolutely no sense to eliminate federal funding for Planned Parenthood.” The bill would block Medicaid reimbursements to Planned Parenthood for one year. Eliminating that provision would further alienate conservative senators who have made defunding Planned Parenthood a condition of their support. Taking the provision out will alienate Sen. Collins and other liberals.
As these battles play out, other senators remain undecided or silent. Still others don’t know what to think. Senator Joni Ernst, R-Iowa, is polling her constituents for their thoughts before taking an official position.
The bottom line is that intense negotiations on this bill will dominate the work of the U.S. Senate this week. The CBO score will complicate the matter. In all likelihood, the CBO will project that millions of Americans will lose their current health insurance coverage, just as it predicted (somewhat inaccurately) would happen in the House American Health Care Act.