GOP health-care divisions multiply as Trump presses Senate

WASHINGTON -- Republican divisions over health care multiplied Monday as President Donald Trump pressured GOP senators to act quickly.

Vice President Mike Pence suggested they might have to revert to a straightforward "Obamacare" repeal if they can't agree on an alternative.

Consensus on a replacement seemed more remote than ever as senators returned to the Capitol from a Fourth of July recess.

Some lawmakers spent the break facing critics of Senate Majority Leader Mitch McConnell's bill or voicing criticism of their own.

But Sen. John Cornyn of Texas, the No. 2 Republican, told reporters a revised bill would be unveiled this week, and "the goal continues to be to" vote next week.

Donald Trump

McConnell postponed a vote last month, lacking GOP support for legislation he wrote largely in secret.

To succeed, the new legislation will have to address concerns of conservatives such as Mike Lee of Utah and Ted Cruz of Texas, who want a more full-blown repeal, and moderates such as Susan Collins of Maine and Lisa Murkowski of Alaska, who want the opposite -- a more generous bill.

McConnell has little room for error as he tries to pass a bill with 50 GOP votes, and Pence as the tie-breaker, in a Senate split 52-48 between Republicans and Democrats.

Some GOP senators are questioning McConnell's partisan approach, and the majority leader himself acknowledged to a home-state audience in Kentucky last week if he can't get the job done with Republicans alone, he'll have to turn to Democrats to shore up the market for individual insurance buyers.

Collins, referring to President Barack Obama's Affordable Care Act, passed in 2010 without one Republican vote, told reporters: "I believe that we should not repeat the mistake that President Obama made in passing major legislation with no support from the other party."

The Republican Party has been campaigning against Obama's law since, but having ridden the issue to control of the House, Senate and White House, they're finding it nearly impossible to coalesce around an alternative.

Underscoring divisions in the GOP and an occasional communications vacuum between the White House and the Senate, Pence appeared on conservative host Rush Limbaugh's radio show to rule out working with Democrats.

"The president's made it very clear. We believe if they can't pass this carefully crafted repeal and replace bill, do those two things simultaneously, we ought to just repeal only," then turn to replacement legislation later, Pence said, although Trump at times has dangled the prospect of working with Democrats.

Few Republicans on Capitol Hill believe a repeal bill could pass Congress without a replacement.

Pence made his comments after Trump began his day with a tweet aimed at McConnell and his Republicans: "I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!"

Congress is beginning a three-week sprint toward its traditional five-week August recess, which some lawmakers have suggested should be shortened or canceled if they can't get health care done first.

The House managed to pass health care legislation in May after plentiful struggles of its own to reach agreement. Both the House and Senate bills eliminate Obamacare's mandates for people to buy insurance and individuals to provide it, gradually undo an expansion of Medicaid and reduce the size of the federal-state health care program for the poor and disabled. The measures would cut taxes for the wealthy.

Both bills would result in more than 20 million people kicked off insurance rolls over the next decade, numbers that have spooked lawmakers eyeing re-election.

Around 80 demonstrators opposed to the legislation were arrested around the Capitol complex Monday, according to U.S. Capitol Police.

As McConnell reworks his bill, Cruz, R-Texas, has proposed letting insurers sell any policies they'd like, as long as they also sell one that covers a list of services like maternity care that Obama's law requires. The Cruz amendment was alienating senators like Collins amid concerns it would lead to unaffordable prices for people with pre-existing medical conditions because younger, healthier customers wouldn't be sharing their costs.

But Pence endorsed Cruz's plan on Limbaugh's show, saying: "Rush, that's what freedom looks like, isn't it?"

Also Monday, a study found the number of uninsured adults has grown by 2 million this year, underscoring recent coverage gains have begun to erode.

The Gallup-Sharecare Well-Being Index found the uninsured rate among adults was 11.7 percent in the second three months of this year, compared with a record low of 10.9 percent at the end of last year. The reduction could reflect rising premiums and dwindling choices in the insurance markets created under Obama and could also flow from Trump administration actions and comments about withholding support for the law.