GOPs efforts at health care reform fail again

WASHINGTON, D.C. — Efforts by Senate Republicans to replace or outright repeal the Affordable Care Act (ACA) sputtered Monday and Tuesday, clouding the path forward for President Donald Trump’s other domestic policy goals and rattling financial markets.After two Republicans said they would not back the latest rollback bill, Senate Republican Leader Mitch McConnell (R-Ky.) threw in the towel and was weighing a vote on simply repealing the 2010 health care law, known as Obamacare, with no replacement. But those efforts also fell short when three Republican senators quickly came out Tuesday against the repeal option.As the ACA rollback collapsed in the Senate, counterparts in the House of Representatives unveiled a budget plan putting a proposed tax code overhaul on the same partisan procedural path that led to the anti-Obamacare initiative’s chaotic downfall late on Monday.Sens. Mike Lee (R-Utah) and Jerry Moran (R-Kan.) joined colleagues Susan Collins (R-Maine) and Rand Paul (R-Ky.) in opposing the legislation to dismantle ACA, passed under Democratic former president Barack Obama. McConnell said in a statement, “Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful.”Sens. Richard Burr and Thom Tillis, both Republicans from North Carolina, have called for the repeal and replacement of Obamacare, but Burr has been seemingly undecided on recent efforts, while Tillis has been more supportive.In a Tuesday morning Twitter message, Trump said, “We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!”In the face of full opposition from Democrats, Monday’s defections left McConnell without enough votes to pass the bill in the 100-member Senate.Trump also urged an outright repeal, even as other Republicans sought a shift toward bipartisanship with Democrats, but those efforts were quickly shot down Tuesday afternoon when Collins was joined by Sens. Shelley Moore Capito (R-W.Va.) and Lisa Murkowski (R-Alaska) in saying they would oppose that course of action.Democrats have remained united against Republican efforts to undo Obama’s signature domestic achievement that aimed to reduce the number of people without health insurance and help lower costs, even as they acknowledged changes were needed.Late Monday, Senate Minority Leader Chuck Schumer (D-N.Y.) urged Republicans to start over and work with Democrats.Some Republican and Democratic governors, who help oversee the joint federal-state Medicaid program for the poor as well as private health insurers, have balked at Republican lawmakers’ efforts to undo a law that expanded Medicaid in some states and reduced the number of uninsured people.Virginia’s Terry McAuliffe, a Democrat who heads the National Governors Association, on Tuesday told CNN that a repeal-only measure “will only bring more uncertainty. Uncertainty is crushing this market because the insurance companies don’t know what to do.”Shelving the current bill means that insurers once again face uncertainty about whether the administration will cut off funding for the subsidies used to make Obamacare individual plans affordable, putting 2018 coverage and long-term planning at risk.For hospitals, the move relieves the near-term pressure of massive Medicaid reform, but the long-term plan for federal spending for states’ Medicaid expansion is now murky.Republicans in Congress had hoped to finish with health care before an upcoming August recess so they could tackle a wide-ranging rewrite of the U.S. tax code in September. Separate talks on taxes appear unlikely to reach Trump’s pledged 15 percent corporate rate.But their failure exposed the sharp divide within their own ranks between moderates concerned about Medicaid cuts and conservatives who back them and want even more dramatic changes.A similar version of the Senate bill passed the House in May but legislation must pass both chambers for Trump to sign into law. “I’m worried that Obamacare will stand and the law will continue to collapse and people will get hurt in the process,” House of Representatives Speaker Paul Ryan (R-Wis.) said on Tuesday.Rep. G.K. Butterfield (D-N.C.), who has been critical of Republicans’ efforts to repeal Obamacare, in a tweet Monday night called for the GOP to work across the aisle with Democrats on new health care legislation.”#Trumpcare is dead- for now. Time for GOP to throw in the towel and work with Dems to lower premiums and improve care for all.”