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Democratic leaders keep guard up in health law battle

Senator Elizabeth Warren spoke at last month’s state Democratic convention.
Senator Elizabeth Warren spoke at last month’s state Democratic convention.(Jonathan Wiggs/globe staff/file)

WASHINGTON — The Senate plan to repeal and replace the Affordable Care Act is struggling as lawmakers return to Washington this week, with the ability of Republicans to corral enough votes so uncertain that Senate majority leader Mitch McConnell has openly broached the prospect of failure.

But you wouldn’t know it from listening to Senate Democrats.

“The Republicans’ so-called ‘health care’ bill comes back to life more often than the lead zombie in a horror movie,” warned Massachusetts Senator Elizabeth Warren via Twitter after McConnell announced he was delaying a planned vote, a major sign of trouble.

“Mitch McConnell is now trying to make side deals in order to win votes. He is reaching out to this Republican senator and that Republican senator in order to sweeten the pot and get their votes,” Vermont independent Bernie Sanders said at a rally Sunday afternoon in Morgantown, W.Va.

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The state’s Republican senator, Shelley Moore Capito, is opposed to the current bill but is being wooed with a planned amendment that would add tens of billions more in funding to fight the opioid crisis, a big problem in West Virginia.

“I say to Senator Capito: Please do not fall for that old trick. This legislation is fatally flawed and no small tweak here or there will undo the massive damage that it will cause to West Virginia and the entire country,” Sanders said.

Returning senators will face an intense legislative battle after a week of hearing voters vent a lot of negative feelings about the GOP legislation over the Fourth of July recess.

Deeply unpopular, the Republican plan would reduce taxes for the rich, slash the Medicaid program for the poor, and reduce Affordable Care Act insurance subsidies for people purchasing coverage in the individual market. The Congressional Budget Office says 22 million fewer people would have insurance by 2026 under the Senate bill.

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On Sunday, two moderate Republican senators suggested that the bill could be “dead.”

‘‘My view is it’s probably going to be dead,’’ Senator John McCain of Arizona said on CBS’s ‘‘Face the Nation.’’

“Clearly, the draft plan is dead,” Senator Bill Cassidy of Louisiana told “Fox News Sunday.’’ “Is the serious rewrite plan dead? I don’t know.’’

McConnell warned last week that if Republicans fail to rally and pass a bill, there will be no other option left but to work with Democrats to shore up the Affordable Care Act, a stark departure from his earlier vow that the GOP would destroy the Obama-era law “root and branch.”

But that signal provided little comfort to Democrats who remain convinced that McConnell, known as a master tactician, could still pull a deal off. Front of mind is what happened in the House: Speaker Paul Ryan declared he was moving on to other legislation after failing to round up enough votes, Democrats did a victory lap, and then the bill suddenly came back to life six weeks later, catching opponents by surprise when it passed.

In a bid to keep up the political pressure, Sanders held two rallies against the Republican bill in key states Sunday, the one in West Virginia and another in McConnell’s backyard, drawing about 2,000 people to Covington, Ky., to demand Republicans drop their push to scrap the current health law.

A total of 10 Republican senators, from moderate to conservative, have said they won’t support the bill in its current form. McConnell can afford to lose only two of his caucus’s 52 members and still be able to pass legislation, with the help of a tie-breaking vote from Vice President Mike Pence.

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McConnell’s clear intention to keep trying to wrangle votes is keeping a sense of urgency alive for opponents. He continues to talk to members of his caucus, and he has sent several proposed changes to the Congressional Budget Office for review, including an amendment crafted by Texas Republican Ted Cruz that’s generating a lot of buzz among conservatives as a potential way to break the logjam.

Cruz’s proposal would allow insurers to sell stripped-down insurance plans that don’t comply with Obamacare’s mandates — including the one that bars insurers from discriminating against people with preexisting conditions — so long as they also offer at least one plan that does meet those standards.

Cruz and other supporters of his idea says it would ensure consumers have the option of lower-cost plans, fixing their big problem with the current law: skyrocketing premiums.

Another idea back on the table is having the Senate pass a straight repeal bill, then replace the Obama-era law afterwards. Trump floated that approach in a tweet after McConnell’s delay. But plenty of Republicans are skeptical about this tack, which had been rejected at the start of the year.

Democrats sought to keep media and public attention on the health care bill even as lawmakers scattered around the country last week. Senate minority leader Chuck Schumer has been encouraging members — particularly those from states where the other senator is Republican — to hold events, use social media, and write op-ed articles against the Senate bill in the period since McConnell delayed the vote.

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Activists haven’t taken a rest, either. More than 1,000 protesters allied with Sanders’s political advocacy group Our Revolution staged sit-ins in 36 GOP offices across 21 states in one day alone, with other protests scattered throughout the week. In several cases, protesters occupied offices overnight, and dozens were arrested.

Even in Maine, where GOP Senator Susan Collins looks to be one of the firmer “no” votes, bill opponents are keeping up the pressure. The state AARP chapter continues to hold a steady stream of education and outreach events so residents know how the bill would affect them, including a telephone “town hall” event June 26 with Maine Senator Angus King, an independent, that had 10,000 residents on the line at the peak.

The group also is turning stories from concerned Mainers into short videos to be posted on Facebook, Twitter, and YouTube — as well as sent directly to the state’s two senators.

“Please Senator Collins, stand strong for Maine,” Erica Magnus of Windham says to the camera, after recounting how Medicaid helped ensure quality nursing home care for her once-middle-class father when his Alzheimer’s got to the point she could no longer care for him herself, in a video posted July 5. “This bill will hurt too many, too much.”

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“We see the proposed changes in this legislation as so detrimental to Maine — to the economy, to jobs, to rural hospitals, and to Maine people — that we feel the need to keep fighting until this is resolved,” said Lori Parham, the senior lobby’s Maine state director.

Activists may have to sustain the energy for several more weeks. Republican senators have been warning that a vote could be weeks away.

“Things can change really, really quickly. That’s why it’s important to keep our focus and keep up the intensity,” said Topher Spiro, vice president for health policy at the left-leaning Center for American Progress, which is involved in helping mobilize grass-roots activists against the GOP bill.

The stakes are also higher with the Senate bill. While the Senate and House would have to work out differences between their bills before sending it to the president’s desk, most view that as an easily clearable final hurdle.

“We know that if the Senate passes this bill it will become law. That sense of alarm, that sense of finality is very clear to people, and we all understand what the stakes are,” said Spiro.


Victoria McGrane can be reached at victoria.mcgrane-@globe.com. Follow her on Twitter @vgmac.