Republicans Eye Billions in Side Deals to Win Obamacare Repeal Votes

By Josh Dawsey and Burgess Everett, Politico

28 June 17

The White House and Senate GOP leaders have nearly $200 billion in savings to divvy up among senators’ priorities to secure votes for the imperiled bill.

hite House and Capitol Hill officials are exploring potential deals to divvy up billions of dollars to individual senators’ priorities in a wide-ranging bid to secure votes for the imperiled GOP health care bill.

A Congressional Budget Office score that projected 22 million fewer Americans would have insurance under the plan sent some members fleeing Monday and left the bill in jeopardy of failing to have enough votes to even be called to the Senate floor this week.

But Republicans in the White House and in Congress were pleasantly surprised that the bill included more savings than they expected — and are trying to figure out if they can dole it out for votes.

The Senate has about $188 billion to play with.

Among the possible changes: More spending for health savings accounts to appease conservatives such as Sen. Ted Cruz and Sen. Mike Lee, according to three people familiar with the matter, and some additional Medicaid and opioid spending for moderates.

"We are still working with leadership to change the base bill," a Lee aide said.

Lee, Cruz and others on the right have been looking to wipe out as much of Obamacare as possible and replace it with health savings accounts, group plans and selling insurance across state lines, among other ideas. It’s not clear whether the Senate parliamentarian would allow all of those proposals through under strict reconciliation rules. And Lee will likely require far more dramatic changes to be won over.

Meanwhile, senators from Medicaid expansion states huddled after the CBO score revealed the nearly $200 billion in savings to see whether they could get GOP leaders to put more money into Medicaid and to thwart drug addiction. Those modifications might take place on the Senate floor, but Republicans are divided on how to use the money.

Negotiations are likely to continue quickly behind the scenes over the next 24 hours and could draw the ire of good government groups and advocates. Republicans hammered Democrats for supposedly crafting Obamacare in secret seven years ago and for handing out goodies to wavering Democratic senators.

But the GOP bill has been roundly criticized for being negotiated and written in secret — and the final terms are leaving even some Republicans queasy.

One Senate aide said that Tuesday would be "all about side deals," and another person familiar with the discussions said Senate Majority Leader Mitch McConnell had already begun talking about private deals.

"There's no one-size-fits-all to getting these people on board," said one White House official. "Each of them want different things, and we have to figure out if there is a path."

Defenders of the bill note that Obamacare's markets are struggling and the coverage losses are partially due to people choosing not to buy coverage, because there would no longer be a government mandate.

Any changes to appease moderates could face severe blowback from conservatives.

“There are some people who have some designs on that,” said Sen. John Thune, a South Dakota Republican. “It wouldn’t be a bad thing if we put the money toward deficit reduction."

The bill remains in peril. It is also unclear whether there is enough money to give out that could win over the divided GOP Conference.

Time is of the essence.

McConnell has said he wants a vote this week no matter what, even as some White House officials have said they wouldn't mind a delay and are fearful the votes aren't there with the current legislation.

“You could make an argument for delaying it if you could get a better policy, but this is the best we could do to satisfy all the different aspects of our conferences,” Thune said.

“There’s no reason not to get this done this week,” said Sen. Roy Blunt of Missouri. “And the CBO score was a little better than I thought it would be.”

White House officials said they were increasingly looking to Sens. Rand Paul (R-Ky.) and Dean Heller (R-Nev.) — and if the two maintained their opposition, the bill was likely dead. Senate leadership has largely written off Paul, and a Trump outside group has begun attacking Heller, drawing some head-scratching from Senate aides.