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| G.O.P. Health Bill Close to Collapse as Critical Senators Balk | G.O.P. Health Bill Close to Collapse as Critical Senators Balk |
| (about 2 hours later) | |
| WASHINGTON — With time running short, the latest plan to repeal and replace the Affordable Care Act teetered closer to collapse on Sunday, even as the White House and the proposal’s backers tried to win over reluctant Republican senators. | WASHINGTON — With time running short, the latest plan to repeal and replace the Affordable Care Act teetered closer to collapse on Sunday, even as the White House and the proposal’s backers tried to win over reluctant Republican senators. |
| Senator Susan Collins of Maine made clear that she was all but certain to oppose the proposal. Senator Ted Cruz of Texas said he had not yet been won over and suggested that Senator Mike Lee of Utah had the same stance. And Senator Rand Paul of Kentucky once again criticized the bill in blunt terms, despite pressure from President Trump to rethink his opposition. | Senator Susan Collins of Maine made clear that she was all but certain to oppose the proposal. Senator Ted Cruz of Texas said he had not yet been won over and suggested that Senator Mike Lee of Utah had the same stance. And Senator Rand Paul of Kentucky once again criticized the bill in blunt terms, despite pressure from President Trump to rethink his opposition. |
| “It’s very difficult for me to envision a scenario where I would end up voting for this bill,” Ms. Collins said on CNN’s “State of the Union.” “I have a number of serious reservations about it.” | “It’s very difficult for me to envision a scenario where I would end up voting for this bill,” Ms. Collins said on CNN’s “State of the Union.” “I have a number of serious reservations about it.” |
| The cascade of critical comments left Mr. Trump and Republican leaders on the precipice of failure in their 11th-hour attempt to fulfill the party’s promise to dismantle a cornerstone of President Barack Obama’s legacy. | The cascade of critical comments left Mr. Trump and Republican leaders on the precipice of failure in their 11th-hour attempt to fulfill the party’s promise to dismantle a cornerstone of President Barack Obama’s legacy. |
| Already, two Republican senators have come out as firm opponents of the latest repeal bill: Mr. Paul and Senator John McCain of Arizona, who announced his position on Friday, issuing a plea for bipartisanship on a matter as consequential as health care. | Already, two Republican senators have come out as firm opponents of the latest repeal bill: Mr. Paul and Senator John McCain of Arizona, who announced his position on Friday, issuing a plea for bipartisanship on a matter as consequential as health care. |
| Republican leaders can afford to lose no others in the narrowly divided chamber, and they have only until the end of this month to pass the bill in the Senate using procedures that shield it from a Democratic filibuster. Democrats are unified in opposition to the repeal effort. | Republican leaders can afford to lose no others in the narrowly divided chamber, and they have only until the end of this month to pass the bill in the Senate using procedures that shield it from a Democratic filibuster. Democrats are unified in opposition to the repeal effort. |
| Senators are scheduled to return to the Capitol on Monday in what could be a bruising week for Mr. Trump and the Senate majority leader, Mitch McConnell of Kentucky. In addition to the health care drama that is looming in Washington, voters in Alabama will go to the polls on Tuesday for a closely watched Republican Senate runoff, and a loss by Senator Luther Strange would be a setback for both Mr. Trump and Mr. McConnell. | Senators are scheduled to return to the Capitol on Monday in what could be a bruising week for Mr. Trump and the Senate majority leader, Mitch McConnell of Kentucky. In addition to the health care drama that is looming in Washington, voters in Alabama will go to the polls on Tuesday for a closely watched Republican Senate runoff, and a loss by Senator Luther Strange would be a setback for both Mr. Trump and Mr. McConnell. |
| Speaking to reporters in New Jersey on Sunday, Mr. Trump seemed to be looking ahead to the next big legislative goal for Republicans — overhauling the tax code — even as he talked up the Graham-Cassidy bill and applied pressure to resistant senators. | Speaking to reporters in New Jersey on Sunday, Mr. Trump seemed to be looking ahead to the next big legislative goal for Republicans — overhauling the tax code — even as he talked up the Graham-Cassidy bill and applied pressure to resistant senators. |
| “Eventually, we will win on that,” he said of repealing the health law. “My primary focus, I must tell you — and has been from the beginning, as you can imagine — is taxes.” | “Eventually, we will win on that,” he said of repealing the health law. “My primary focus, I must tell you — and has been from the beginning, as you can imagine — is taxes.” |
| But the architects of the latest repeal plan, Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, were not giving up. | But the architects of the latest repeal plan, Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, were not giving up. |
| “We’re moving forward, and we’ll see what happens next week,” Mr. Graham said on ABC’s “This Week.” “I’m very excited about it. We finally found an alternative to Obamacare that makes sense.” | “We’re moving forward, and we’ll see what happens next week,” Mr. Graham said on ABC’s “This Week.” “I’m very excited about it. We finally found an alternative to Obamacare that makes sense.” |
| Marc Short, the White House director of legislative affairs, said on NBC’s “Meet the Press” that a Senate vote was planned for this week. But a spokesman for Mr. McConnell declined to affirm that timeline on Sunday. | Marc Short, the White House director of legislative affairs, said on NBC’s “Meet the Press” that a Senate vote was planned for this week. But a spokesman for Mr. McConnell declined to affirm that timeline on Sunday. |
| The Graham-Cassidy bill is the latest attempt to develop a repeal proposal that can win the support of 50 of the Senate’s 52 Republicans — a goal that has proved elusive so far this year. It would repeal the expansion of Medicaid under the Affordable Care Act, as well as the tax credits that are provided to help people buy insurance on the individual market. In their place, it would provide block grants to the states to use for health care. | The Graham-Cassidy bill is the latest attempt to develop a repeal proposal that can win the support of 50 of the Senate’s 52 Republicans — a goal that has proved elusive so far this year. It would repeal the expansion of Medicaid under the Affordable Care Act, as well as the tax credits that are provided to help people buy insurance on the individual market. In their place, it would provide block grants to the states to use for health care. |
| The bill would also allow states to seek federal waivers that would allow insurers to charge higher premiums to people with pre-existing medical conditions and to omit certain benefits, like maternity and mental health care, that they are currently required to provide. | The bill would also allow states to seek federal waivers that would allow insurers to charge higher premiums to people with pre-existing medical conditions and to omit certain benefits, like maternity and mental health care, that they are currently required to provide. |
| But the proposal has come under heavy criticism, including from governors, patient advocacy groups and health care providers. In a striking display of the widespread concerns over the proposal, groups representing insurers, hospitals and doctors released a joint statement on Saturday urging the Senate to reject the measure. | But the proposal has come under heavy criticism, including from governors, patient advocacy groups and health care providers. In a striking display of the widespread concerns over the proposal, groups representing insurers, hospitals and doctors released a joint statement on Saturday urging the Senate to reject the measure. |
| Ms. Collins was one of three Republicans who doomed the Senate’s last repeal attempt, in July, along with Mr. McCain and Senator Lisa Murkowski of Alaska, who has yet to take a position on the new proposal. | Ms. Collins was one of three Republicans who doomed the Senate’s last repeal attempt, in July, along with Mr. McCain and Senator Lisa Murkowski of Alaska, who has yet to take a position on the new proposal. |
| Ms. Collins had previously expressed broad reservations about the Graham-Cassidy bill. She said she had spoken at length with Vice President Mike Pence on Saturday. But on Sunday she continued to voice deep concerns about the proposal. | Ms. Collins had previously expressed broad reservations about the Graham-Cassidy bill. She said she had spoken at length with Vice President Mike Pence on Saturday. But on Sunday she continued to voice deep concerns about the proposal. |
| “I’m concerned about the impact on the Medicaid program, which has been on the books for more than 50 years and provides health care to our most vulnerable citizens, including disabled children and low-income seniors,” Ms. Collins said. She added that she was also concerned about “the impact on costs and coverage,” as well as “the erosion of protections for people with pre-existing conditions like asthma, arthritis, cancer, diabetes and what it would mean to them.” | |
| Still, she stopped short of declaring that she would vote against the measure, saying she wanted to wait for an analysis from the nonpartisan Congressional Budget Office that is expected to be released early this week. | Still, she stopped short of declaring that she would vote against the measure, saying she wanted to wait for an analysis from the nonpartisan Congressional Budget Office that is expected to be released early this week. |
| The analysis is unlikely to transform her views. The budget office said last week that it was aiming to provide a preliminary fiscal assessment of the bill by early this week, but would need more time to provide an analysis of the bill’s effects on health insurance coverage and premiums. | The analysis is unlikely to transform her views. The budget office said last week that it was aiming to provide a preliminary fiscal assessment of the bill by early this week, but would need more time to provide an analysis of the bill’s effects on health insurance coverage and premiums. |
| In another sign of the difficult task confronting Republican leaders, Mr. Cruz said he and Mr. Lee were seeking changes to the repeal bill in an effort to drive down health insurance premiums. | In another sign of the difficult task confronting Republican leaders, Mr. Cruz said he and Mr. Lee were seeking changes to the repeal bill in an effort to drive down health insurance premiums. |
| “Right now, they don’t have my vote, and I don’t think they have Mike Lee’s either,” Mr. Cruz said at The Texas Tribune’s annual festival in Austin, adding that he wanted to end up in support of the legislation. | “Right now, they don’t have my vote, and I don’t think they have Mike Lee’s either,” Mr. Cruz said at The Texas Tribune’s annual festival in Austin, adding that he wanted to end up in support of the legislation. |
| A spokesman for Mr. Lee, Conn Carroll, said the senator was seeking “technical changes” to the proposal. “We are working with Cassidy, but we haven’t committed to anything yet,” he said. | A spokesman for Mr. Lee, Conn Carroll, said the senator was seeking “technical changes” to the proposal. “We are working with Cassidy, but we haven’t committed to anything yet,” he said. |
| Mr. Paul, a relentless critic of the repeal plan in recent days, continued to assail the bill on Sunday, even after Mr. Trump had publicly expressed hope that the senator would change his mind. | Mr. Paul, a relentless critic of the repeal plan in recent days, continued to assail the bill on Sunday, even after Mr. Trump had publicly expressed hope that the senator would change his mind. |
| “I haven’t given up on him because I think he may come around, O.K.?” Mr. Trump said on Friday night at a rally in Alabama for Mr. Strange. | “I haven’t given up on him because I think he may come around, O.K.?” Mr. Trump said on Friday night at a rally in Alabama for Mr. Strange. |
| But on “Meet the Press,” Mr. Paul once again argued that the bill did not go far enough in uprooting the Affordable Care Act. He expressed willingness to support a narrower repeal measure, but made clear that he objected to the fundamental architecture of the Graham-Cassidy bill. | |
| “This is a bad idea,” he said. “It’s not repeal.” | “This is a bad idea,” he said. “It’s not repeal.” |