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Despite GOP pledges, health care remains in limbo

President Trump, who was generally disengaged on the health care legislation, spoke during a meeting Tuesday with Senate Republicans.
President Trump, who was generally disengaged on the health care legislation, spoke during a meeting Tuesday with Senate Republicans.Alex Wong/Getty Images

WASHINGTON — Republicans have vowed, again and again for seven years, that they would repeal former President Barack Obama’s signature health care law if given the chance. Americans gave them that chance. But since capturing all the levers of power in Washington, they have so far failed to deliver.

In a spectacular collapse after at least a half-dozen Senate Republicans objected to their party’s health bill, majority leader Mitch McConnell on Tuesday was forced to pull back a promised vote on the legislation that would strip away large portions of Obama’s health care law.

The policy conflicts within their own party in Congress are too great, the pushback from the public too significant, the leadership from the White House too inexperienced and weak.


As a result, uncertainty about the future of the US health care system continues. Republicans have helped to unleash that uncertainty, but they can’t muster an agreement to replace the Obama-era Affordable Care Act.

Republicans put their best spin on the latest failure. And they sought to focus on failures of Obama’s health care law. But if the legislation was on life support earlier, it may now need a defibrillator.

“We’re still working toward getting at least 50 people in a comfortable place,” McConnell said. “Legislation of this complexity almost always takes longer than anyone would hope.”

Republicans are planning to continue debating the legislation after taking next week off. But when senators return to their home states for a break, they tend to grow hardened in their positions, not nudged toward compromise. And as they leave town for the Fourth of July break, a big number will be hanging over the senators as they greet their constituents back home: 22 million. That’s how many fewer Americans would have health insurance compared to current law, according to the Congressional Budget Office estimate released this week.


It remained unclear what, exactly, McConnell and other Republicans can do to muster the votes — at least not without dramatic revisions to the bill, which would deeply slash Medicaid and Affordable Care Act insurance subsidies for the working poor.

Senator Susan Collins, a moderate Republican from Maine who defied McConnell and helped force the delay in voting, said Tuesday that she has “deep problems” with the legislation.

“I have so many fundamental problems with the bill,” she told reporters outside the Capitol. “It’s difficult for me to see how any tinkering is going to satisfy my fundamental and deep concerns about the impact of the bill.”

President Trump was remarkably disengaged on the legislation, doing little to build any proactive case publicly for a new law. His most memorable comment was to call the House legislation “mean” — a comment that came a month after he celebrated its passage with a ceremony in the Rose Garden.

“It has been a challenge for him to learn how to interact with Congress and how to push his agenda forward,” Collins said of the president Tuesday.

About two hours later, she was seated next to Trump during a meeting at the White House.

In an oddly lukewarm statement about his chief legislative priority and key campaign promise, Trump said: “This will be great if we get it done. And if we don’t get it done, it’s just going to be something that we’re not going to like. And that’s okay, and I understand that very well.”


McConnell — normally a wily legislator who knows how to work the Capitol corridors to get his way — crafted the bill in private, unveiling it last week. Quickly, it came under fire from moderates such as Collins as well as conservative Senators Rand Paul of Kentucky and Mike Lee of Utah.

The estimate of 22 million uninsured by 2026 gave skeptical senators more reasons not to support it.

When McConnell started to move toward a vote, several Republicans took the rare step of saying they would oppose allowing it to come up for debate on the Senate floor.

With an open revolt, McConnell had little choice but to delay.

And shortly after the postponement, more Republicans came forward to say they would have voted against it.

The US Capitol was abuzz on Tuesday. Outside, pro-Affordable Care Act rallies covered every corner of the public lawn. Some came with signs and matching T-shirts. The protesters chanted through bullhorns, their pleas audible inside the Capitol.

Inside, Republicans scurried to get to a lunch meeting with McConnell. As they emerged, many tried to get away without making definitive comments about what could come next.

“It could be good, and it could be bad,” Pennsylvania Senator Pat Toomey, among the group of conservatives agitating to push the bill further rightward by cutting further from Medicaid, told reporters about the delay.

As senators boarded a bus to head for the White House later, they were greeted by protesters for Planned Parenthood, who had dressed up as characters from the dystopian novel and television show “The Handmaid’s Tale.”


When the lawmakers were driven away, protesters shouted “Shame! Shame! Shame!” as they held a banner that read #IStandwithPP. Some women, using a bullhorn, shared their tales about how Planned Parenthood saved their lives.

After the meeting at the White House, lawmakers spoke of how “productive” the meeting was. “Everyone in that room wants to get to ‘Yes,’ and I can now see a path to us getting there,” said Senator Roger Wicker, a Mississippi Republican.

“We had a pretty broad and open discussion,” said Senator Shelley Moore Capito, a West Virginia Republican and one of the late-breaking opponents to the current bill. “The president was very emphatic, and we’ll just see where it goes from here.”

But asked if it improved her confidence on being able to ultimately support the bill, she replied, “I still have my doubts.”

Collins said she and Senator Lisa Murkowski, an Alaska Republican, were crafting an amendment to restore Planned Parenthood funding in the GOP bill when — or now, if — it comes to the floor. The current bill cuts federal funding to the provider for one year.

But attempting to protect Planned Parenthood could risk losing the votes of conservative Republicans.

As reporters continued to press Collins, Democratic Senator Mark Warner plunged through the scrum into the just-opened elevator behind her, bringing Collins along.

“Bipartisan caucus!” Warner exclaimed.


Collins said she hoped a pulled vote would cause Republican leaders to start working with Democrats.

“I hope it will mean that we will go back to the drawing board and work in a bipartisan fashion to correct the very real problems that do exist with the affordable care act,” she said.

Don’t bet on it.

“President Trump, he said the House bill didn’t have a heart,” said Senator Joe Manchin of West Virginia, one of the most vulnerable Democrats in 2018. “Mr. President, if the House bill didn’t have a heart, the Senate bill doesn’t have a soul.”

Senate minority leader Chuck Schumer

called the GOP bill “rotten to the core.”

“We’re going to fight this bill tooth and nail; we have a darned good chance of defeating it,” Schumer said, “a week from now, a month from now, a year from now.”

Matt Viser can be reached at matt.viser@globe.com. Follow him on Twitter @mviser. Victoria McGrane can be reached at victoria.mcgrane@globe.com. Follow her on Twitter @vgmac. Astead W. Herndon can be reached at astead.herndon@globe.com. Follow him on Twitter @AsteadWH.