Last week, a Republican-only effort to scrap key portions of the Affordable Care Act died by one vote in the U.S. Senate, opening the door a crack for a bipartisan effort to patch up the nation's ailing health care system. But getting a bill that can garner a filibuster-proof 60 votes may prove easier said than done – and the clock is ticking.
When senators return from their August break, a bipartisan hearing is planned to question insurance commissioners, patients, insurance companies, governors and healthcare experts. Members of both parties say the emerging effort is already getting off to a better start than Majority Leader Mitch McConnell's aborted attempt, crafted behind closed doors with input from only a small handful of his male, Republican colleagues.
"I hope that we have a common ground of understanding of what is creating the increase costs and premiums," Sen. Patty Murray, the top Democrat on the health committee, tells Rolling Stone.
Lawmakers are short on time though. The insurance industry signs new contracts with the federal government on September 27th that will dictate what they sell on the Obamacare exchanges, and there's a lot lawmakers hope to accomplish in that brief window.
"I hope to get a consensus on how to stabilize the individual market, get premiums down, keep insurance companies in the individual market so people can buy affordable insurance during the year 2018," Sen. Lamar Alexander, the Republican chair of the health committee, tells Rolling Stone. "It needs to be limited. Bipartisan. And it needs to be able to go into effect before the end of September so the insurance companies can see it. And then I would expect them to lower their prices as a result of the certainty that Congress has provided."
In the House of Representatives, a bipartisan group of 40 lawmakers are floating a plan to immediately plug some of the most glaring holes in the current system, like creating a stability fund so states can help drive down the costs of premiums, along with providing about $7 billion to insurance companies – called cost sharing – to subsidize the poorest Americans who are on Obamacare.
But President Trump seems to be against that effort. Over the weekend he tweeted out that he opposes "bailouts" for the insurance industry.
If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!— Donald J. Trump (@realDonaldTrump) July 29, 2017
That language is now resonating with some members of the GOP's conservative wing.
"I think it would be a serious mistake to bail out the insurance companies instead of honoring our promise to repeal Obamacare and provide real relief for the millions of Americans who have been hurt by Obamacare," Republican Sen. Ted Cruz told reporters at the Capitol.
Cruz and other conservatives are beating their drums in party leader's ears and saying: the GOP promised voters a full repeal of Obamacare, and that's what the party needs to deliver. They're already pointing fingers at the three Republican senators who they blame for derailing the last effort.
"The failure on the health care bill I blame more on, frankly, those who used to be for repeal and are no longer for repeal," Republican Sen. Rand Paul told reporters. "In the health care debate I think we got too big – we bit off too big a bite of the apple and sort of in the end everyone was like, 'That bill doesn't fix everything so I'm not for it."
Other rank-and-file Republicans aren't giving up on the repeal-and-replace effort, either. They say two Republican amendments were so rushed that they were never given an official score by the nonpartisan Congressional Budget Office, which they said made some lawmakers oppose them.
"We still haven't seen the two scores – this is a dynamic fluid situation," Republican Sen. Purdue told reporters. "We can't afford to give up this up just yet if there's a glimmer of hope, and I think there is."
But more moderate Republicans are calling on the president not to take steps to undermine the Affordable Care Act by cutting off those federal subsidies that help insurance companies cover poorer Americans.
"I think just thinking about those families that would be hurt were they not [continued], I think it would be better to continue them," Republican Sen. Bill Cassidy told reporters. He's working with governors across the nation to try and revive his effort with fellow Republican Sen. Lindsey Graham to keep Obamacare taxes in place but to send that money back to states as a block grant.
With senators preparing to leave Washington for their summer break, there's uncertainty over what the Senate – let alone the House – will be able to craft that can pass the chamber. But after the GOP-only attempt failed in a dramatic late night vote last week, there are glimmers of hope from centrists in both parties that the Senate can buck its recent tradition of being mired in gridlock, even if the president is still prodding his party to just pass an outright repeal.
"However the White House is functioning – super or not so super – we ought to be at our best," Democratic Sen. Tim Kaine told reporters. "I think that the activity of last week kind of opens that door, and there's sort of a good feeling about that prospect around here this week."