US Republicans left scrambling after health bill sinks again

Aaron P. Bernstein / Reuters

The collapse of Republicans' push to repeal and replace Obamacare in the US Senate set up a possible repeal-only vote and clouded the path forward for President Donald Trump's other domestic policy goals, rattling financial markets on Tuesday.

After two Republicans said they would not back the latest Obamacare rollback bill, Senate Republican Leader Mitch McConnell threw in the towel and was weighing a vote on simply repealing the 2010 healthcare law with no replacement.

After almost six months office, Trump still has no major legislative achievements. As the Obamacare rollback collapsed in the Senate, his counterparts in the House of Representatives unveiled a budget plan putting a proposed tax code overhaul on the same partisan procedural path that led to the anti-Obamacare initiative’s chaotic downfall late on Monday.

Republican senators Mike Lee and Jerry Moran joined colleagues Susan Collins and Rand Paul in opposing the legislation to dismantle the Affordable Care Act, passed under Democratic former president Barack Obama. McConnell said in a statement, "Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful."

Trump urged an outright repeal, even as other Republicans sought a shift toward bipartisanship with Democrats. The setback sent the US dollar to a 10-month low against a basket of major currencies as investors worried about the impact on other administration reform efforts.

In an early morning Twitter message, Trump said, "We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!"

In the face of full opposition from Democrats, Monday's defections left Senate Majority Leader Mitch McConnell without enough votes to pass the bill in the 100-member Senate.

Trump late Monday said Congress should "start from a clean slate" on a new plan that he said Democrats would join. On Tuesday morning, he put the blame on "all of the Democrats and a few Republicans."

McConnell said he would try to bring repeal legislation to the Senate floor in coming days, but with a two-year delay in implementation to assure a smooth transition.

Democrats have remained united against Republican efforts to undo Obama's signature domestic achievement that aimed to reduce the number of people without health insurance and help lower costs, even as they acknowledged changes were needed.

Late Monday, Senate Democratic Leader Chuck Schumer urged Republicans to start over and work with Democrats.

'MORE UNCERTAINTY'

Some Republican and Democratic US governors, who help oversee the joint federal-state Medicaid program for the poor as well as private health insurers, have balked at Republican lawmakers' efforts to undo a law that expanded Medicaid in some states and reduced the number of uninsured people.

Virginia's Terry McAuliffe, a Democrat who heads the National Governors Association, on Tuesday told CNN that a repeal-only measure "will only bring more uncertainty. Uncertainty is crushing this market because the insurance companies don't know what to do."

Shelving the current bill means that insurers once again face uncertainty about whether the administration will cut off funding for the subsidies used to make Obamacare individual plans affordable, putting 2018 coverage and long-term planning at risk.

For hospitals, the move relieves the near-term pressure of massive Medicaid reform, but the long-term plan for federal spending for states' Medicaid expansion is now murky.

"The hospitals remain at the whim of the fluid efforts in Washington," Oppenheimer analyst Michael Wiederhorn said in a research note.

Republicans in Congress had hoped to finish with healthcare before an upcoming August recess so they could tackle a wide-ranging rewrite of the US tax code in September. Separate talks on taxes appear unlikely to reach Trump's pledged 15 percent corporate rate.

But their failure exposed the sharp divide within their own ranks between moderates concerned about Medicaid cuts and conservatives who back them and want even more dramatic changes.

A similar version of the Senate bill passed the House in May but legislation must pass both chambers for Trump to sign into law. As of late Monday, House of Representatives Speaker Paul Ryan had no immediate comment on his next steps on healthcare.