Senate health care bill on life support as Trump presses for progress

Even as President Donald Trump celebrated Bastille Day in France with President Emmanuel Macron Friday, he had health care on his mind, urging Republican senators via Twitter to get on board with Senate Majority Leader Mitch McConnell’s (R-Ky.) newly released proposal to repeal and replace the Affordable Care Act.

However, the bill, introduced Thursday, was breathing on life support by Friday after 2 GOP senators – Rand Paul (R-Ky.) and Susan Collins (R-Maine) – immediately rejected it. Complicating the effort, Ohio GOP Gov. John Kasich called the revised measure "still unacceptable," largely because of its cuts to Medicaid, the same concern that's been voiced by Ohio Republican Sen. Rob Portman, one of the other holdouts.

McConnell released the measure Thursday, a plan that caps seven years of his party's promises to obliterate Obama's 2010 law.

Also under pressure, indirectly, was Sen. Dean Heller (R-Nev.) who opposed McConnell's initial bill last month, also citing its Medicaid reductions. Heller, who faces a tough re-election next year, has stood arm-in-arm with his state's popular GOP Gov. Brian Sandoval in opposing cuts to that program for the poor, disabled and nursing home patients.

In an interview Friday, Sandoval said his initial understanding of the new bill was that it "really doesn't change the dynamic" about the Medicaid cuts, and "that's a big concern for me."

Sandoval said he expected to meet privately with Vice President Mike Pence and Health Secretary Tom Price at governors' meetings he is attending in Providence, Rhode Island, and had already heard from both men. Republicans consider winning over Sandoval a key to gaining Heller's vote.

The nation's largest doctors' group dealt another blow Friday, saying the plan falls short on coverage and access, particularly for low-income people on Medicaid. The American Medical Association said Medicaid cuts and "inadequate subsidies" will lead to "millions of Americans losing health insurance coverage."

The AMA said GOP leaders took a "positive step" by adding $45 billion for treatment to help victims of the opioid epidemic. But it pointed out that people dealing with addiction also need regular health insurance, and that many would lose it if Republicans succeed in rolling back Medicaid financing.

McConnell's reworked bill aims to win conservatives' support by letting insurers sell low-cost, skimpy policies. At the same time, he seeks to placate hesitant moderates by adding billions to combat opioid abuse and help consumers with skyrocketing insurance costs.

Moderate Republican Sen. Susan Collins of Maine told reporters she had informed McConnell she would be voting against beginning debate on the bill, citing in part cuts in the Medicaid health program for the poor and disabled. Sen. Rand Paul of Kentucky, who has repeatedly complained that McConnell's efforts don't amount to a full-blown repeal of Obama's law, also announced he was a "no."

McConnell could cancel next week's vote if he's short of support, something he did last month when his original legislation was headed toward defeat. He and other GOP leaders are urging senators to at least vote in favor of opening debate, which would open the measure up to amendments.

The Associated Press contributed to this report.