Republican Make Last-Ditch Attempt To Repeal Affordable Care Act Republican senators hope to beat a Sept. 30 procedural deadline that allows them to pass a bill bill without Democratic votes. It would be the fourth health care bill before Senate this year.
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Republican Make Last-Ditch Attempt To Repeal Affordable Care Act

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Republican Make Last-Ditch Attempt To Repeal Affordable Care Act

Republican Make Last-Ditch Attempt To Repeal Affordable Care Act

Republican Make Last-Ditch Attempt To Repeal Affordable Care Act

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Republican senators hope to beat a Sept. 30 procedural deadline that allows them to pass a bill bill without Democratic votes. It would be the fourth health care bill before Senate this year.

AILSA CHANG, HOST:

The Republican-led fight to end the Affordable Care Act is not over. A group of Senate Republicans is pushing a last-ditch effort on a new proposal to dismantle Obamacare. This would be the fourth health care bill to come up in the Senate this year. The other three proposals all failed on the Senate floor back in July. NPR congressional correspondent Susan Davis joins us now to explain this latest health care plan and whether it has any chance of passing the Senate. Hey, Sue.

SUSAN DAVIS, BYLINE: Hey, Ailsa.

CHANG: So wait. Senate Republicans sounded like they were ready to move on from health care after the bill failed in July. What is driving this latest push to repeal Obamacare?

DAVIS: You're right. It seemed like health care had completely fallen out of the headlines. But enough Republicans really did hear it back home over the summer. Vote - their voters were angry at the party for failing to do what they said they were going to do on health care. And I am told there is a consensus among Senate Republicans that they at least need to try again ahead of September 30. Why September 30? That's the end of the fiscal year and the end of the timeline being able to use the special budget rules they've been using to get around the filibuster in the Senate.

CHANG: Right. OK, so this is the fourth health care bill floated in the Senate. Republicans have already rejected the House-passed health care bill, a pared-down Senate version of that bill and a bill that would have just repealed the existing health care law. So what would this bill do?

DAVIS: This is a proposal being led by Republican Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana. It's both pretty simple and pretty complex. The simple parts are the familiar parts. You've heard this before. Like the other bills, it would end the individual mandate. It ends the tax credit system used to help people buy insurance. And it ends the Medicaid expansion. It would also let states seek waivers for some of those insurance coverage protections under existing health care law.

What's different is how it spends health care money. It would essentially end the federal guarantee for Medicaid. And it would take the revenues from Obamacare, and it would cut checks to the states, essentially block granting all that money based on a new funding formula. And what it aims to do is just give each individual state dramatically more leeway in deciding how they get to spend their health care dollars. Now, Graham and Cassidy think this is the way because ideologically it's small-government, conservative ideas.

CHANG: Right.

DAVIS: Give the power to the states. And they say if the states want to keep some aspects of the Affordable Care Act, they can if they choose to.

CHANG: So do you have any sense of where the votes are for the Graham-Cassidy bill? I mean are they even within striking distance?

DAVIS: Well, we're going to get a sense probably by the middle of the week.

CHANG: OK.

DAVIS: Of course the Senate can't vote on anything until it gets a nonpartisan analysis from the Congressional Budget Office. That's expected to come out early next week. Senate Republicans are going to meet tomorrow to see if they think they have the votes. If they do, they could push for that vote as early as next week. You know, remember; they only need 50 votes.

CHANG: Right.

DAVIS: And the orbit of that 50 votes hasn't really changed from the past. Rand Paul of Kentucky is still a very hard no vote, which means they only have - they can only lose one more Republican in the Senate. And the focus is on those three names we know so well in these health care debates...

CHANG: (Laughter).

DAVIS: ...Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona.

CHANG: And of course McCain is one of Lindsey Graham's closest friends...

DAVIS: Right.

CHANG: ...In the Senate. So how much of that is going to play into this, you think?

DAVIS: That is definitely part of the intrigue. And one intriguing thing today in that is Arizona Republican Governor Doug Ducey came out in favor of Graham Cassidy today. That's certainly going to weigh on McCain's decision-making process. He has been very clear that he hates the way Republicans are making these laws by kind of jamming them through the Senate. What's unclear is if he's going to be willing to hold his nose and vote for something that his governor and one of his best friends in the Senate are asking for his vote.

CHANG: What about the other key senators, Susan Collins of Maine and Lisa Murkowski of Alaska - any indication of where they are on the Graham Cassidy bill?

DAVIS: They haven't said how they're going to vote. But remember; their no votes made them very popular back home, so it's hard to see what would get them to yes. There's also an early assessment that suggests that this proposal could actually direct less money to states like Maine and Alaska. I don't think you have to be a health care policy expert to know that senators don't like to vote for things that take things away from their states. So that I think is one of the reasons why it's still fueling a lot of skepticism on Capitol Hill that this is going to be the bill. But if it is, we're going to know pretty soon.

CHANG: All right. That's NPR's Susan Davis. Thanks, Sue.

DAVIS: You bet.

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