The Congressional Budget Office’s score of the Senate healthcare overhaul bill appears to further imperil the measure’s chances of passing—though there is one upside that Republicans can use to their advantage.
As of Monday evening, at least four GOP senators said they would vote against the Better Care Reconciliation Act of 2017 (BCRA) without changes to the bill, The Hill reports. They include conservative senators Rand Paul of Kentucky and Ron Johnson of Wisconsin, who came out against the bill almost immediately after it was revealed, as well as Susan Collins of Maine and Dean Heller of Nevada.
Two other hardline conservatives who initially joined Paul and Johnson in opposing the bill, however, both are now avoiding committing to either a yes or no vote, The Hill notes. Another key swing vote, Alaska’s Lisa Murkowski, is still undecided.
UPDATE: Senate delays vote on ACA repeal, replacement bill
To be sure, the CBO’s score of the bill does not help win over those concerned about its effects on health insurance coverage. The agency said that relative to current law, BCRA would increase the number of uninsured individuals by 22 million as of 2026. That’s just slightly less than the CBO’s estimate for the House bill, which clocked in at 23 million additional uninsured.
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“Every member of Congress must weigh the policy and moral implications of taking insurance from 22 million people,” Robert Wood Johnson Foundation President and CEO Richard Besser, M.D., said in a statement. “The impact extends well beyond the health and welfare of their own constituents. This bill would negatively affect the most vulnerable Americans regardless of where they live.”
Indeed, the estimate seems to have pushed Collins to a solid “no,” based on her statements on Twitter.
I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won't do it. I will vote no on mtp. 1/3
— Sen. Susan Collins (@SenatorCollins) June 26, 2017
The CBO’s report also ramped up Democrats’ opposition to the bill, even spurring some senators like New Jersey’s Cory Booker to stage in impromptu “sit in” on the Capitol steps:
With @RepJohnLewis on Capitol steps fighting #Trumpcare. Health care is a human right. Join us & watch live: https://t.co/CSDVL92gKZ
— Cory Booker (@CoryBooker) June 26, 2017
Yet another major part of the CBO’s report—which estimated that the bill would result in a net deficit reduction of $321 billion by 2026—could help Republicans.
The estimated savings are higher than the CBO’s $119 billion prediction for the House healthcare bill, and the difference between the two estimates gives Senate Majority Leader Mitch McConnell “spending money to shore up programs sensitive to key voters,” Jefferies analysts wrote in a research note. That could include funding to fight the opioid epidemic, which might help win over senators Rob Portman, R-Ohio, and Shelley Moore Capito, R-W.Va.
McConnell has already begun to discuss such private deals—though such negotiations may rankle some watchdog groups, according to Politico.
Wheeling and dealing also might not be enough. As the Jefferies analysts note: “opposing forces within the GOP are still running away from one another, suggesting continued challenges in locking down the needed 50 votes heading into the vote expected by the end of this week.”