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Jimmy Kimmel re-enters health care debate with update on infant son

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Senate GOP gets new pressure from Trump on health care

President Donald Trump pressured Republicans Monday to approve the Senate’s wheezing health care bill, saying a showdown vote planned for this week is their “last chance to do the right thing” and erase the Obama law.

Trump’s prodding came a day before leaders say the Senate will vote on legislation shredding much of President Barack Obama’s health care law. Lacking the votes to push it through his chamber, Senate Majority Leader Mitch McConnell, R-Ky., postponed one roll call last month and hasn’t yet announced exactly what version of the measure lawmakers would consider Tuesday.

Complicating McConnell’s hopes of drumming up last-minute support, Ohio GOP Gov. John Kasich said it would be a mistake for the Senate to move ahead Tuesday “and force a one-sided deal that the American people are clearly against.” Kasich’s stance could make it harder for wavering Sen. Rob Portman, R-Ohio, who’s criticized the measure’s Medicaid cuts, to vote for the measure.

In his statement, Kasich panned the bill for a lack of “bipartisanship, transparency or open dialogue.” He said Congress should take no action on recrafting the nation’s health care system until it can “step back from political gamesmanship and come together with a workable, bipartisan plan.”

Democrats, the news media and his own attorney general, Jeff Sessions, about their handling of investigations into his 2016 campaign’s possible collusion with Russia.

Barrasso on health care: "It should be done in a bipartisan way"

As lawmakers in Washington remain divided over the future of health care in the United States, Sen. John Barrasso, R-Wyoming, says there should be a bipartisan approach when it comes to legislation.

“Should have been bipartisan when Obamacare was passed. It should be now as well,” Barrasso said Sunday on “Face the Nation.” 

“For big things that affect the country, it should be done in a bipartisan way,” he added. 

But while Barrasso is supportive of a bipartisan effort to changing existing health care laws, he said that “with this resistance movement to President Trump and the energy in the Democrat Party,” Republicans have been given the impression by top Democrats, like Chuck Schumer of New York and Elizabeth Warren of Massachusetts, that the GOP should “expect no cooperation” in the health care debate.

When pressed if any Republicans had reached out to Democrats in the hopes of creating a bipartisan effort on legislation, Barrasso said he’s visited the floor of the Senate with a number of Democrats, but that they have put forth their own contentions to major aspects of the bill.  

“They say, ‘Well, you know, we do want to work together, but there are a couple things. One is, don’t touch the mandate.’ Well, the mandate, the individual mandate that says people have to buy a government program, that’s the most hated part of Obamacare,” said Barrasso. 

Meanwhile, Republican Senator Susan Collins of Maine told “Face the Nation” that she would like to see Congress go back into committee and hold hearings on the matter.

“We could divide this issue into separate bills and take a look at the serious flaws in the Affordable Care Act, the most serious of which right now is the collapse of the insurance market in several counties throughout this country, so that people who have subsidies won’t have an insurer that can sell them insurance,” Collins said on “Face the Nation.”

“That would allow us to hear from expert witnesses, to get input from actuaries and governors and advocacy groups and health care providers, and most important, from members of both sides of the aisle, Republicans as well as Democrats,” she added.

Collins was one of three GOP holdouts who along with Sen. Shelley Moore Capito of West Virginia and Sen. Lisa Murkowski of Alaska effectively killed the Republican effort to vote on health care. They announced that they would oppose Majority Leader Sen. Mitch McConnell’s efforts to move forward with the latest bill.

While it is still unclear what form of the health bill the Senate will consider in a vote set for Tuesday, Barraasso says there are a variety of ways for the Senate to replace the “failing Obamacare health care plan,” adding that for his fellow Republicans who ran on repealing and replacing Obamacare, “This is our chance.”

“We are going to vote this week. And I think until the vote is actually on the floor of the Senate, some people may not tell you what they’re actually going to do,” he said.

Regarding the back-and-forth in Congress, he said, “I was in the Wyoming legislature for five years. That’s what legislation is all about. You get a bill on the floor of the House or the Senate. We get a bill, and then you start adding amendments. You bring your best ideas forward. And then people vote up or down.”

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Democrats open to single-payer health insurance, a party leader says

The Democratic Party will consider proposing a single-payer health insurance system, Sen. Chuck Schumer of New York said.

“We’re going to look at broader things [for the nation’s health care system.] Single-payer is one of them,” Schumer said to ABC News Chief Anchor George Stephanopoulos on “This Week” Sunday.

The top Democrat in the Senate added that single-payer is among a number of health insurance options.

“Many things are on the table,” Schumer said. “Medicare for people above 55 is on the table. A buy-in to Medicare is on the table. Buy-in to Medicaid is on the table.”

The Senate’s Republican leadership may hold a vote this week to start debate on its health care bill, but Schumer said he doesn’t believe the GOP plan, which he said is “rotten to the core,” will pass.

Schumer, the Senate minority leader, also previewed his party’s new economic agenda, dubbed “A Better Deal,” which he said will be rolled out Monday.

“This is sharp, bold, and will appeal to both the old Obama coalition and the Democratic voters who deserted us for Trump,” the New York senator said.

According to the most recent ABC News/Washington Post poll, only 37 percent of Americans say the Democratic Party “stands for something,” while 52 percent believe that the party stands only for opposing President Trump.

Schumer told Stephanopoulos that the Democrats made a mistake in the 2016 presidential election of not making clear what they represent.

“The number one thing we did wrong is we didn’t tell people what we stood for,” the senator said. “When you lose an election, you look yourself in the mirror and say, ‘What did we do wrong?’”

The party’s new economic agenda is an effort to set out a plan for the country that is not “left or right” but for everyone, he said.

The economic plan is “just the beginning,” Schumer said. “Week after week, month after month, we’re going to roll out specific pieces here that are quite different than the Democratic Party you heard in the past.”

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5 reasons why health care bill would fail, 3 why it may not

There are many reasons why the Senate will probably reject Republicans’ crowning bill razing much of former President Barack Obama’s health care law. There are fewer why Senate Majority Leader Mitch McConnell might revive it and avert a GOP humiliation.

Leaders say the Senate will vote Tuesday on their health care legislation. They’ve postponed votes twice because too many Republicans were poised to vote no. That could happen again.

The latest bill by McConnell, R-Ky. — and it could change anew — would end penalties Democrat Obama’s health care law slapped on people without insurance, and on larger companies not offering coverage to workers. It would erase requirements that insurers cover specified medical services, cut the Medicaid health insurance program for the poor and shrink subsidies for many consumers.




In an Associated Press-NORC Center for Public Affairs Research poll this month, 51 percent supported the health care program while just 22 percent backed GOP legislation.

Perhaps more ominously for Republicans, the AP-NORC poll found that by a 25-percentage-point margin, most think it’s the federal government’s responsibility to ensure all Americans have coverage. That’s a growing view — there was just a 5-percentage-point gap in March. It underscores a harsh reality for the GOP: It’s hard to strip benefits from voters.



The nonpartisan Congressional Budget Office says under McConnell’s plan, 22 million more people would be uninsured by 2026, mostly Medicaid recipients and people buying private policies. For single people, the typical deductible — out-of-pocket expenses before insurance defrays costs — would balloon that year to $13,000, up from $5,000 under Obama’s law.

Note to the entire House and one-third of the Senate, which face re-election in 2018: 15 million would become uninsured next year. And though CBO says average premiums should fall in 2020, they’ll head up in 2018 and 2019.

Oh, yes. The bill would let insurers charge people approaching retirement age higher prices than they can now, boosting premiums “for most older people,” CBO says.

Older people like to vote.



With a 52-48 GOP majority, the bill would survive if no more than two Republicans oppose it. With the indefinite absence of the cancer-stricken Sen. John McCain, R-Ariz., McConnell’s margin of error shrinks to one.

At least a dozen senators have expressed opposition to the legislation or been noncommittal. Lawmakers and aides say others haven’t publicly surfaced.

Moderate senators from states with vast Medicaid populations want to protect those voters. Conservatives consider it their mission to eliminate the law they’ve campaigned on abolishing for years. These aren’t easily resolved disputes.



President Donald Trump wants “Obamacare” repealed.

He also has public approval ratings below 40 percent — Bad! — and a propensity for turning on people.

Just ask House Speaker Paul Ryan, R-Wis., and Attorney General Jeff Sessions.

After Ryan labored for months before the House approved its health care bill and earned a Rose Garden celebration, Trump called the measure “mean.” Trump said he wouldn’t have picked Sessions for his job had he known he’d recuse himself from investigations into Russian meddling in last year’s campaign.

Some lawmakers might not be blamed for declining to carry Trump’s water.



The bill’s rejection would still let lawmakers cast votes showing their positions. Supporters could say they honored their repeal “Obamacare” pledges, foes could say they protected their states or adhered to conservative principles.

Defeat would let the Senate refocus on tax cuts or other initiatives, though it’s unclear what major issues don’t divide Republicans.

A loss means there won’t be a GOP law voters might blame for health care problems they encounter. Though Republicans may already own the issue in the public’s eye, since they run the government.




This isn’t happening, right? Republicans have run on repealing “Obamacare” for years.

The administration won’t let the effort fail without a fight.

Trump lunched with senators at the White House last week and tweeted that Republicans “MUST keep their promise to America!”

On Friday, Vice President Mike Pence urged leaders of conservative, anti-abortion and business groups to pressure senators. Medicaid administrator Seema Verma has tried luring senators unhappy with Medicaid cuts, including Ohio’s Rob Portman and West Virginia’s Shelley Moore Capito, with more flexibility for governors to use Medicaid funds to help pay expenses for beneficiaries shifting to private insurance.



The health bill’s floundering has tarnished McConnell’s reputation as a legislative mastermind. Many Republicans privately say if the votes were gettable, he’d have gotten them already.

But the 33-year Senate veteran is wily and doesn’t want his record stained with this failure. He understands what GOP senators need and has time, and if anyone can rescue the legislation, it’s him.



GOP senators cross Trump at their own peril. Eight in 10 Republicans still rate him favorably. In the 2018 midterm elections, when turnout is traditionally down, those loyal voters could make a difference.

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Rural Californians Want Price Relief From GOP Health Bill, But Most Won’t Get It

Aaron Albaugh runs a cattle ranch in Lassen County, in Northern California. Living in a remote area, he says he’s learned to “do without” a lot of things, including health care.

April Dembosky/KQED

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Aaron Albaugh runs a cattle ranch in Lassen County, in Northern California. Living in a remote area, he says he’s learned to “do without” a lot of things, including health care.

April Dembosky/KQED

Aaron Albaugh peers out from under the brim of his cowboy hat, surveying the acres of hay fields in front of him. The fourth-generation rancher is raising about 450 cattle this year, in this remote corner of Lassen County, California.

His closest neighbor lives a half mile away. “And that’s my brother,” Albaugh says.

“If I want to go see a movie, it’s 70 miles, round-trip,” he adds. “If I want to go bowling, that’s 100 miles, round-trip.”

Doctor Shortage In Rural Arizona Sparks Another Crisis In 'Forgotten America'

Living a half day’s drive from civilization, you learn to do without, he explains. If your refrigerator breaks, you put your food on ice until the weekend when you can go buy a new one. With health care, it’s the same thing.

“Put a Band-Aid on it,” Albaugh says. “I was raised: ‘You don’t need to cry’ and ‘Suck it up, buttercup.’ That’s the way I still live, and I try to treat my kids the same way.”

When people are already used to doing without health coverage, it’s particularly annoying to have the government say you have to buy it, say Albaugh and many of his neighbors in Lassen, Modoc and Shasta Counties.

While Obamacare is largely viewed as a success in California – the state marketplace, Covered California, is one of the most financially stable in the country – it has not worked as well for folks in this rural, northeast corner of the state.

There are two insurers selling plans in each county here, but residents say that has not created enough competition to bring down prices. Plus, many doctors these residents are used to seeing don’t take the marketplace plans.

Help Wanted: Last Pediatrician On Mendocino Coast Retires

“Being told you have to have insurance you can’t afford, and then that doesn’t cover what you need? You are stuck,” says Modoc County resident Althia Cline, who decided to forego coverage – and a surgery she needs to help with her asthma.

Just like the movie theater and the bowling alley, most medical specialists are miles away. In Modoc County, there’s no hospital or birthing center where a woman can have a baby. Tessa Anklin, who lives in Canby, Calif., gave birth to her son and daughter over the border in Oregon, an hour and a half away from home.

Tessa Anklin says Covered California health plans are too expensive for her family.

April Dembosky/KQED

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Tessa Anklin says Covered California health plans are too expensive for her family.

April Dembosky/KQED

Anklin makes about $33,000 a year as a dental receptionist. Her husband does seasonal work baling hay and herding cattle at local ranches. While their kids are covered by Medi-Cal, neither parent gets health insurance through work, and before the Affordable Care Act passed, Anklin and her husband did without coverage for a while.

Two years ago, they bought a plan through Covered California. Their monthly premium was just $2 a month after the ACA subsidy, but their deductible was $10,000.

“We paid for all of our medical services and our prescriptions,” she says. “We had no help until we reached the $10,000 deductible. So really, we had nothing.”

Then, last year, their monthly premium jumped to $600. The plan was the same, Anklin says, and their household income was the same. And they still faced the same hour and a half drive to see doctors they almost never needed.*

Anklin thought of all the other ways she could spend that money.

“It makes the car payment. Almost your mortgage payment. Groceries for at least four months,” she says. “That’s a big difference, when you think about how little you actually use the health coverage.”

That’s the reason she decided to cancel her health plan this year and go without insurance. But she’ll still have to pay a penalty when the next tax season comes around.

“It basically penalizes us one way or the other because we can’t afford the coverage,” she says. “So, that’s kind of difficult — to be that middle-class person.”

Anklin says she’d be happy to see Republicans get rid of Obamacare.

“To me, it’s no good, if you have to force people to pay yet another something out of their paycheck,” she says, “when they’re already trying to survive with what they have. It should be an option.”

But the Republican repeal and replace plan wouldn’t make things much better for Anklin and her neighbors. Average premiums in California would double under the GOP plan, according to a recent analysis from the Kaiser Family Foundation. Anklin could end up paying more than $2,000 a month for coverage, according to Kaiser’s county-by-county projections.

That’s not what she had in mind as a fix.

“I’d love that insurance could be more affordable for families that need it, for families that work hard for it,” Anklin says.

Lifesaving Flights Can Come With Life-Changing Bills

With the Republican bill now in flux, Democrats have been more willing to admit to Obamacare’s flaws. The Dems agree that the rising costs of marketplace plans are the chief complaint they hear about, too.

Democrats have also said if the Republican bill fails, they’d be willing to work together on solutions, but it’s not clear the parties could agree on one that would help people like Anklin.

If they can’t, Anklin says she has no choice but to continue to go without coverage. Financially, it makes sense in the short term, but she still worries about an unforeseen surgery, serious illness or accident.

“If I ever have a problem,” she says, “I know I will be paying for the rest of my life.”

*Premiums in this part of California went up an average of 10.6 percent in 2016, according to Covered California’s rate booklet, and most premium increases are matched with an increase in subsidy. So the most likely explanation for why Anklin’s premium jumped this much is that she lost her subsidy. This can happen if customers, intentionally or unintentionally, do not check a box on their application form that allows the federal government to verify their income, or, if customers do not file tax returns.

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Who Spun It Best: President Trump on health care

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Mixed signals from Trump White House on health care strategy

Repeal and replace “Obamacare.” Just repeal. Or let it fail — maybe with a little nudge. President Donald Trump has sent a flurry of mixed messages, raising questions about the White House strategy on health care.

Democrats say Trump’s confusing signals are part of a strategy to destabilize the Affordable Care Act, as a way to force recalcitrant Republicans in Congress to repeal former President Barack Obama’s signature law.

White House officials say they remain focused on trying to get a bill passed and have declined to delve deeply into their health care options if legislation fails.

“The White House does not have a strategy,” said health industry consultant Robert Laszewski, an “Obamacare” critic who believes the administration is at a loss.

Another theory: Trump may have to cut his losses and take modest steps to sustain subsidized insurance markets if the GOP’s legislative drive fails. A Senate vote is planned Tuesday.

Ironically, insurance markets don’t appear to be on the verge of collapse as Trump and other Republicans keep saying. About 10 million people have individual policies under that part of “Obamacare.”

“Improving but fragile,” is how Standard Poor’s analyst Deep Banerjee describes the insurance exchanges. “We expect on average for insurers to hit break even” in 2017.

And Obama’s Medicaid expansion —which provides coverage to another 11 million— is unaffected by problems on the exchanges.

Sen. Ron Wyden, D-Ore., who has previously worked with Republicans on health care, sees a White House bent on mischief.

“They are doing everything they can to stoke the fires of uncertainty, which is what really damages this law,” Wyden said. “You can say ‘I’d like to change the law,’ but you don’t just say ‘We’re going to do everything in our power to undermine a law that is on the books.’ This is about being willing to hurt people in order to get a political advantage, and I’ve never seen a president doing it in such a brazen way.”

The Trump administration says what’s really hurting people is higher premiums and dwindling choice under “Obamacare.” Some major insurers have bailed out or scaled back their offerings on the exchanges, leaving many consumers with limited options.

But Democrats cite the administration’s pullback of open enrollment ads early this year as evidence of “sabotage,” along with the recently disclosed termination of federal contracts for sign-up assistance in 18 cities. Also the 2018 enrollment season has been shortened to 45 days, about half the time previously provided.

And the Health and Human Services Department has posted internet videos of small business owners blaming high insurance costs on “Obamacare.” Those videos are “important and educational testimonials” that show the ACA has made affordable insurance “impossible for millions of Americans,” said agency spokeswoman Alleigh Marre.

It definitely looks like a hostile takeover, said economist Joe Antos of the business-oriented American Enterprise Institute, “but usually with a hostile takeover there is a business objective that is relatively clear.” In this case, he said, objectives seem to shift.

Laszewski, the consultant, put it this way: “First, it was the Democrats will come begging (Trump) to fix it. Then it was repeal and replace, then it was just repeal, and now it is repeal and replace again.”

The most immediate question is whether the Trump administration will continue monthly payments to insurers on subsidies that reduce deductibles and copayments for consumers with modest incomes. “Cost-sharing reductions” total $7 billion a year.

The payments are embroiled in a lawsuit brought by House Republicans over whether the ACA specifically included a congressional appropriation for the money, as required under the U.S. Constitution. Elsewhere, the ACA text plainly says the government “shall” make the payments. But Trump recently suggested to GOP senators he might just stop.

“We pay hundreds of millions of dollars a month in subsidy, that the courts don’t even want us to pay,” the president said. “And when those payments stop, it (Obamacare) stops immediately. It doesn’t take two years, three years, one year — it stops immediately.”

With key 2018 decision deadlines nearing, insurers want a guarantee that the administration will keep making the payments, as it has since Trump took office. State insurance commissioners and congressional leaders of both parties are seeking a similar acknowledgement. White House officials say the issue remains under review from month to month.

Rohit Kumar, a former top aide to Senate Majority Leader Mitch McConnell now with accounting firm PwC, said that while the administration has engaged in “saber rattling,” it would likely take steps to shore up the individual market if the legislative push fails.

It would be difficult for Trump to avoid the backlash if the health care markets collapsed during his watch. “Whatever political fallout results from the destabilization of the exchange and rising costs, I don’t think they’re going to be able to successfully put that on the previous administration,” Kumar said.

Republican Mike Leavitt, who served as health secretary for President George W. Bush, has some advice for the administration: “First, remain patient but keep the pressure on Congress,” he said. “It’s going to take more time, but they can still produce a health care bill.”

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These Americans Hated the Health Law. Until the Idea of Repeal …

“I can’t even remember why I opposed it,” said Patrick Murphy, who owns Bagel Barrel, on a quaint and bustling street near Mr. Brahin’s law office here in Doylestown.


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He thought Democrats “jammed it down our throats,” and like Mr. Brahin, he worried about the growing deficit. But, he said, he has provided insurance for his own dozen or so employees since 1993.

“Everybody needs some sort of health insurance,” Mr. Murphy said. “They’re trying to repeal Obamacare but they don’t have anything in place.”

Five years ago, people here could barely turn on their televisions without seeing negative ads warning that the Affordable Care Act would lead to rationed care and bloated bureaucracy. The law’s supporters, meanwhile, including the president whose name is attached to it, were not making much of a case.

To win support, Democrats were emphasizing that little would change for people who already had coverage; President Barack Obama famously promised that you could keep your plan and your doctor, even as a few million people’s noncompliant plans that did not offer all the law’s required benefits were canceled as the law was rolled out.

“The best way to get something passed was to argue it was small change,” said Stanley Greenberg, a veteran Democratic pollster. “It was only when Republicans got control that people then on their own discovered that this is what the benefits are.”


Patrick Murphy, 50, owner of Bagel Barrel, in Doylestown on Thursday. “I can’t even remember why I opposed” the Affordable Care Act, he said.

Jessica Kourkounis for The New York Times

Jennifer Bell, sitting outside Mr. Murphy’s bagel shop with a friend, was raised a Democrat and always supported the health care law. But it was only after she was injured in a serious car accident in 2013 that she thought to advocate for it. She used to get health insurance through her job as a teacher. Now disabled with extensive neurological damage, and working part-time in a record store, she qualifies for Medicaid, and without it, she said, could not afford her ongoing treatment.

“It’s very, very scary to think about not having health insurance,” she said.

“If the condition doesn’t kill you, the stress of having it does, in this country,” she added. “The fact that people do without health insurance is a sin, in my opinion.”

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Ms. Bell, 35, joined about 2,000 others for a women’s march in Doylestown after the inauguration, and now makes calls to Representative Brian Fitzpatrick and Senator Patrick J. Toomey, both Republicans, urging them to protect the Affordable Care Act. She is working to elect a Democrat challenging Mr. Fitzpatrick, who voted against the House bill to replace the law, saying he worried about people losing coverage.


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More vigorous support among the law’s natural constituents since Mr. Trump’s election has helped lift public opinion. The Kaiser Family Foundation polls tracking monthly support for the law have shown the greatest gains among Democrats and independents, with an increase of 10 to 12 points among each group over the last year, while Republicans’ opinion has remained as unfavorable as ever.

“When something is threatened to be taken away, people start to rally around it,” said Liz Hamel, the director of public opinion and survey research for Kaiser, a nonpartisan group.

There has been an increase in the percentage of Republicans and Democrats saying that Medicaid is important for them and their families; between February and July the percentage of Republicans saying so had increased 10 points, to 53 percent.


Obamacare Included Republican Ideas, but the G.O.P. Health Plan Has Left Democrats Out

How much input did the opposing party have in shaping the Affordable Care Act versus the Republican health care plan?

The law still faces hurdles even beyond the debate in Congress. Five years ago, Cindy McMahon, who works at the store on the vegetable farm her family has owned for nearly a century, was not intending to buy health insurance, despite the law’s requirement that people have it or pay a tax penalty. She remains uninsured (and the Trump administration has suggested it may not enforce the penalty).

“If I had to pay a penalty, it’s still less than I have to pay for having health care all year,” Ms. McMahon said. At 52, she has diabetes and says the strips to test her blood sugar are so expensive that sometimes she tests once a month rather than daily. She has not looked into whether she might qualify for the Medicaid expansion; she was not aware Pennsylvania had expanded the program.

Frank Newport, the editor in chief of Gallup, said that the area of biggest agreement in polls is that Americans want the law changed. In the most recent poll, 44 percent of Americans said Congress should keep the law but make “significant changes.” That compares with 23 percent who want to keep it as it is, and 30 percent who support the Republicans’ plan to repeal and replace it.

Mr. Greenberg said the growing belief that the government should make sure people have health coverage was less an outbreak of compassion than a matter of affordability. In focus groups he conducted, Trump voters said they wanted the president and Congress to lower their health insurance premiums; they did not want to lose the Affordable Care Act’s protections against insurers charging more to people with pre-existing conditions, or denying coverage of basic health benefits.

Mark Goracy, an insurance consultant in Langhorne, near Doylestown, calls the coverage he and his wife get through the individual market “a joke.” Their premium is $1,415 a month, with combined deductibles of more than $12,000.


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Still, Mr. Goracy, 62, said he nonetheless wants the law’s mandate blocking insurers from charging people more because of pre-existing conditions to survive.

While he once wished for “root-and-branch” repeal of the Affordable Care Act, he is not disappointed about the Republican failure to repeal it.

“Unlike when Democrats passed A.C.A. with not one Republican vote, what the Republicans need to do is get together with 20 or 25 Democrats and pass some kind of reform,” he said. “That, to me, is how legislation is supposed to proceed.”

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Confusion Grips Senate GOP Ahead of Expected Health Care Vote

WASHINGTON — Senate Republicans are scrambling to reach consensus on a way to move forward with health care reform as they begin a critical weekend. A vote is expected to take place next Tuesday, but senators don’t yet know whether they will be voting on a straight repeal of Obamacare, a repeal with a replacement bill or perhaps something else.

And as senators left the Capitol Thursday, Republicans appeared no closer to the 50 votes they would need to be successful in any scenario.

Failure to find enough support for a health care replacement plan delayed a vote on the bill that was planned for earlier in the week, but a renewed push to find a compromise is underway at the urging of President Donald Trump.

So far, that push has continued to run into familiar roadblocks, with moderates and conservatives unable to come to an agreement that satisfies both factions.

Related: Senate Republicans Try to Revive Health Care Bill

Even as senators continue to work on the details of the legislation in mostly informal discussions, many remain noncommittal on whether they’ll vote to even begin a Senate floor debate because they aren’t sure what the bill looks like and they fear starting a process with an unknown ending.

Senate Majority Leader Mitch McConnell said that he would bring a straight repeal to a vote after the replacement bill faltered. He has since left the door open to take up a repeal-and-replace bill, such as the latest version of the Better Care Reconciliation Act, leaving senators unsure exactly what they’ll be voting on.

Republicans filing out of their weekly Thursday lunch were asked if they were given any clear path on what the contents of their health care votes will be. Most gave a short, one-word answer: “No.”

“I don’t even know what we’re proceeding to next week,” said Sen. Susan Collins, R-Maine.

Collins, who is opposed to both a straight repeal and the latest Senate replacement bill, said again on Thursday that she’s unlikely to vote for anything that includes major reductions in Medicaid spending.

“To do that without holding a single hearing on what the implications would be for some of our most vulnerable citizens, for our rural hospitals, for our nursing homes is not an approach I can support,” Collins said.

Sen. Rand Paul, R-Ky., who is opposed to the Senate replacement bill but supports a straight repeal of Obamacare said through a spokesman that he’s still undecided on how he’ll vote next week.

“We don’t know which bill will be brought up yet, so we can’t comment until next week,” the spokesman, Sergio Gor, told NBC News.

Leadership argues that members should vote to allow the replacement bill to be brought to the floor for debate, then they can offer amendments and help to craft a bill they like. But that brings with it political risk — members don’t want to take dozens of tough votes to possibly vote against the bill at the end and even if they bring up an amendment they like, it might not pass.

“There’s so many moving parts, I don’t know what the motion will be a part of,” said Sen. Dean Heller, R-Nev.

The path to finding 50 Republican votes was a daunting task that has been made even more difficult with the likely and unfortunate absence of Sen. John McCain, R-Ariz., who was diagnosed with an aggressive brain tumor this week after a surgery that may keep him away from Washington for an extended period of time.

At least two Republicans have said they would oppose either option currently on the table and without McCain’s vote, the GOP would fall short on either, unless the replacement plan changes dramatically in the next four days.

But there are some areas to watch for potential compromise. The latest version of the replacement bill provides an additional $200 billion in savings — confirmed by the Congressional Budget Office Thursday — that could be used to pay for additional benefits and court the support of some moderates.

But that could also turn off some conservatives because that money might possibly be used as part of what’s being called a Medicaid “wraparound” to provide federal assistance to people who might lose their Medicaid in the Senate bill.

“It’s beginning to feel a little bit like a bazaar, if you will,” said Sen. Bob Corker, R-Tenn. “Let’s throw $50 billion here, $100 billion there. And I’m beginning to feel that the best route forward there is just to talk about a repeal with the transition that forces the two sides together to sit down and actually pass something that will stand the test of time.”

But Sen. Rob Portman, R-Ohio, called the additional money “progress.”

Sen. Pat Roberts, R-Kan., urged all of his Republican colleagues to simply get the process started and vote to open debate on the measure.

“To improve this bill you’ve got to get to the bill, otherwise it’s like Thelma and Louise and we’re about to sail into the canyon and we’ve got to get out of the car,” Roberts said. “So let’s go to the bill.”

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