Can Senate Republicans get Obamacare replacement over the finish line?

As John noted earlier this week, Obamacare replacement legislation isn’t dead in the U.S. Senate after all. Senators Cassidy, Graham, and Johnson have come up with a bill that partially repeals Obamacare and turns power over to the states.

Their legislation would:

* Repeal Obamacare’s individual and employer mandates.
* Repeal the medical device tax.
* Enhance the states’ ability to waive Obamacare’s regulations.
* Give to the states in block grants dollars that currently are being spent by the federal government in the form of Medicaid expansion, tax credits, cost-sharing subsidies and basic health plans, with these dollars to be devoted to health care, mostly at the states’ discretion.
* Grant federal money to states in proportion to their population of poor people.

The window for passing bills under the reconciliation procedure (i.e., with 50 votes) closes on September 30. Thus, the question isn’t just whether the sponsors can muster 50 votes. It is also whether they can do so by the end of the month.

John noted one obstacle. The CBO might not be able to score the bill in time.

The other obstacle is opposition from the usual GOP suspects. Rand Paul has already said he won’t support the bill because it “redistributes,” rather than repeals, Obamacare.

Thus, the sponsors seemingly can only afford to lose one of the three GOP Senators who opposed “skinny repeal” (and no one, other than Paul, who supported it). The three are Sens. Collins, McCain, and Murkowski.

Collins seems unlikely to back the proposal because it defunds Planned Parenthood. McCain reportedly is well-disposed to the bill, which is sponsored by his pal Lindsey Graham. However, he is said to have cautioned that any repeal effort should go through the regular committee process. We’re already midway through September, which doesn’t leave much time for that.

Murkowski is also known to favor “regular order.” I suspect that, at a minimum, she wants to see the CBO’s analysis of the impact on coverage, dubious though that analysis may be.

Might the Cassidy-Graham-Johnson find support among any Democrats? The only candidate I can think of is Joe Manchin. Unlike the rest of the Democratic caucus, he’s a genuine moderate. Moreover, his state, West Virginia, would be a big winner in a system that grants federal money in proportion to the percentage of poor residents.

Even so, winning over Manchin seems like a long-shot. So time may well run out on the effort to pass this latest incarnation of Obamacare replacement legislation by the end of the month.

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