Republicans Struggle to Marshal Votes for Health Care Bill
WASHINGTON — Republican leaders madly scrambled for support on Tuesday ahead of a vote to take up legislation repealing President Barack Obama’s signature health care law, negotiating, pressuring and cajoling Republican senators as White House officials prepared for another embarrassing setback delivered by members of their own party.
Republican leaders seemed to be taking a page from the playbook used to get a bill over the line in the House, trying to find ways to appease the most conservative members of their conference while pressuring moderates to fall in line with fewer concessions. Senator Mitch McConnell of Kentucky, the majority leader, cast his lot early on by allowing the bill to be more conservative than his moderate members wanted, setting the tone for the debate.
Conservatives now want to allow states to waive the Affordable Care Act’s prohibition on insurance companies charging sick people more for coverage and are asking for a more expansive waiver system for state regulators. They are also demanding more money for tax-free health savings accounts to help people pay for private insurance.
Senators from states that expanded the Medicaid program — and Senator Susan Collins, Republican of Maine — would likely not brook many of those changes, especially the measure to severely undermine protections for people with pre-existing medical conditions. They want more money for mental health benefits for people addicted to opioids and money for states to cover people left behind by the rollback of the Medicaid program in both the House and Senate versions.
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