McConnell says limited bill needed if GOP health bill dies

GLASGOW, Ky. -- A bill focused on buttressing the nation's insurance marketplaces will be needed if the full-fledged Republican effort to repeal much of President Barack Obama's health-care law fails, Senate Majority Leader Mitch McConnell said Thursday.

It was one of his most explicit acknowledgments his party's top-priority drive to erase much of Obama's landmark 2010 statutes might fall short.

The remarks by McConnell, R-Ky., also implicitly meant to show progress on health care, Republicans controlling the White House and Congress might have to negotiate with Democrats. While the current, wide-ranging GOP health-care bill -- which McConnell still is hoping to push through the Senate -- has procedural protections against a Democratic Senate filibuster, a subsequent, narrower measure wouldn't and would take 60 votes to pass.

The existing bill would fail if just three of the 52 Republicans vote no, because all Democrats oppose it.

McConnell was forced to cancel a planned vote on the measure last week after far more Republicans than that objected, and he's been spending the Independence Day recess studying possible changes that might win over GOP dissidents.

"If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health-insurance market must occur," McConnell said at a Rotary Club lunch in this deep-red rural area of southern Kentucky. He made the comment after being asked whether he envisioned needing bipartisan cooperation to replace Obama's law.

"No action is not an alternative," McConnell said. "We've got the insurance markets imploding all over the country, including in this state."

In a written statement, Senate Minority Leader Chuck Schumer, D-N.Y., called it encouraging McConnell had "opened the door to bipartisan solutions."

He said the focus should be on continuing federal payments to insurers that help them contain costs for some low-earning customers. Trump has threatened to end these payments.

Schumer repeatedly has said Democrats won't negotiate until Republicans abandon their repeal effort.

McConnell's comments came during a recess that has produced no visible evidence he's winnowed the number of unhappy Republican senators.

If anything, the list seemed to grow this week as Sen. John Hoeven, R-N.D., said he opposed the bill, but he was vague about changes he'd want.

That brought to at least a dozen the GOP senators who have opposed or criticized the legislation publicly, though many are expected to be won over by revisions McConnell is concocting.

Even as Republicans have struggled to write legislation they can pass, some have acknowledged if they encountered problems, a smaller bill with quicker help for insurers and consumers might be needed.

They've said it could include provisions continuing the federal payments to insurers, which total around $7 billion annually, and some inducements to keep healthy people buying policies -- a step that helps curb premiums.

Trump, McConnell, House Speaker Paul Ryan, R-Wis., and other Republicans have said Obama's law is failing, citing markets around the country where insurers have pulled out or sharply boosted premiums. Some areas are down to a single insurer.

Democrats acknowledge Obama's law needs changes that would help curb the growth of health-care costs. But they said the GOP is exaggerating the problem and noted several insurers have attributed their decisions to stop selling policies in unprofitable areas, in part, to Trump administration indications it may halt payments to insurers.

A federal court has ruled the payments weren't authorized by Congress but has allowed them to continue temporarily.