With Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.) said to be definite noes on the Graham-Cassidy legislation, Senate Republicans have zero margin for error in their latest bid to repeal and replace Obamacare before the fiscal year ends on Sept. 30.
This makes the vote of Sen. Lisa Murkowski (R-Alaska) critical once again. Murkowski had voted no both on the Senate’s version of the American Health Care Act as well as the so-called “skinny” repeal of Obamacare.
Can she be persuaded this time?
The new legislation mirrors House legislation passed earlier this year, eliminating the individual and employer mandates, the medical device tax, block grants Medicaid and other federal funding and allows states to apply for waivers from Obamacare regulations.
Unlike last time, however, Murkowski has not yet staked out her position. On Sept. 20, she told reporters, “If it can be shown that Alaska is not going to be disadvantaged, you gain additional flexibility. Then I can go back to Alaskans, and I can say, ‘Okay, let’s walk through this together… That’s where it could be different.”
So, put Murkowski down for maybe.
The other Republican senators who opposed similar legislation when it came up last time include the aforementioned Sen. Paul, as well as Sens. Jerry Moran (R-Kan.), Mike Lee (R-Utah), Dean Heller (R-Nev.), Lindsey Graham (R-S.C.), Tom Cotton (R-Ark.), Bob Corker (R-Tenn.) and Susan Collins (R-Maine).
Obviously, now Graham, one of the bill’s lead sponsors, is in favor, but without Paul and Collins on board once again, he will have to run the table, picking up not just Murkowski, but Moran, Lee, Heller, Cotton and Corker. Of those, Heller and Cotton have already said they are supporting it. Lee and Corker are leaning towards yes. Moran, like Murkowski, is evaluating the impact on their states.
Sen. John McCain (R-Ariz.), who opposed the “skinny” repeal, actually supported the other, similar Senate version of the American Health Care Act the last time it came up and may be easier to get on this bill.
One thing to watch from these senators on the fence is the Congressional Budget Office score and other analyses of the legislation that could prove critical to securing passage, particularly those looking at state impacts with the new block grant formula being proposed.
These considerations will in turn impact what concessions senators may seek in order to help get the bill across the finish line, send it to the House and get it to President Donald Trump’s desk for his signature.
It’s not over yet, but at the end, Murkowski may hold the key to final passage, which could be the last, best chance to repeal and replace Obamacare.
Robert Romano is the Vice President of Public Policy at Americans for Limited Government.
