Along the center of the Republican caucus, the watchword was “concern.” A spokeswoman for Susan Collins of Maine, the closest the GOP has to a centrist in the Senate, said she had “a number of concerns” and would await the analysis of the Congressional Budget Office due early next week. Senator Dean Heller of Nevada, facing a tough reelection fight in 2018, said he had “serious concerns about the bill’s impact on Nevadans who depend on Medicaid. Ditto Senator Rob Portman of Ohio, who cited his own “real concerns” about the GOP proposal to make deep cuts to Medicaid and phase out the program’s expansion under Obamacare over four years beginning in 2020, rather than the seven he had proposed.
Any three of those Republicans would be enough to defeat the bill. With Democrats united in opposition, McConnell can lose no more than two of his 52 Republican members and have the bill pass with a tie-breaking vote from Vice President Mike Pence. The reaction from outside the Capitol was no better. Governor John Kasich of Ohio decried the GOP’s “one-party approach” and said he had “deep concerns” with the details of the bill. On the right, the conservative group FreedomWorks gave its backing to the four Senate holdouts and needled McConnell for reneging on his promise to fully repeal Obamacare. The law’s namesake, former President Barack Obama, issued a rare and lengthy statement denouncing the proposal for its “fundamental meanness.” Even President Trump withheld anything resembling an enthusiastic endorsement.
Yet just as an initial onslaught of conservative criticism didn’t ultimately doom the House’s American Health Care Act, the chilly reception won’t necessarily sink the Senate’s broadly similar plan, either. For the moment, the two most important words in the bill are the ones that adorn each page: Discussion draft. Senate budget rules require that the legislation be open to nearly unlimited amendments before a final vote, and it appears that McConnell designed the bill with future changes in mind. Republicans complaining about particular provisions or omissions will have the opportunity to make changes and then, if they vote for a revised version, claim credit for “improving” the bill.
Portman, Heller, and Senator Shelley Moore Capito of West Virginia could try to substitute their proposal for a longer transition away from Obamacare’s Medicaid expansion, as well as adding significantly to the $2 billion the current draft allocates to fight the opioid epidemic. For his part, Cruz made clear that he wanted to “get to yes” on the bill and offered a series of proposed changes.
“Don’t be fooled,” warned Senator Patty Murray of Washington state, a member of the Democratic leadership. “Senate Republican leaders are going to spend this weekend doing everything they can to cut backroom deals and get the 50 votes they need to jam Trumpcare through the Senate—and that’s why it’s so important that Democrats and patients and families across the country keep fighting back and making clear any senator who votes for this mean, heartless bill will own the consequences.”