Senate now aiming for ‘skinny’ Obamacare repeal

WASHINGTON - Republican Senate leaders, struggling to keep their seven-year vow to end the Affordable Care Act, turned their focus Wednesday to passing a slimmed-down 'skinny” repeal that would throw the issue into negotiations with the House.

The last-ditch effort came as senators voted 45-55 against a straight repeal of the health law, which provided for a two-year delay to give Congress time to find a replacement. Seven Republicans opposed that.

The vote marked the Senate's second failure in 24 hours to repeal the 2010 law popularly known as Obamacare, which expanded health insurance to about 20 million people.

Late Tuesday, senators handily rejected the repeal-and-replace plan Republicans had been working on since May.

The failures underscored the party's deep divisions on the role of government in helping provide access to health care as the Senate conducted its second day of a debate that could stretch through the week.

Republicans said they were still trying to work out what would be in a skinny repeal, which could simply eliminate mandates requiring individuals and employers to obtain or provide health insurance, and abolish a tax on medical device manufacturers.

Sen. John Thune, the No. 3 Senate Republican, said the party was trying to 'figure out what the traffic will bear, in terms of getting 50 of our members to vote for things that will repeal as much of Obamacare as possible.”

Republicans hold a 52-48 majority in the Senate.

Most versions of skinny repeal plans being circulated leave most Obamacare provisions intact. Untouched are insurance protections, including the ban on insurers turning away sick people; the prohibition of annual and lifetime limits on coverage; and the requirement that insurers cover a basic set of benefits, including prescription drugs, maternity care and mental health services.

Also preserved are taxes on wealthy individuals used to help provide hundreds of billions of dollars in government aid for low- and moderate-income Americans.

Money for Medicaid, which 31 states including Iowa have expanded for poor adults, would stay.

But any Senate legislation would be enough to kick the issue to a negotiating committee with the House, which passed its own version in May.

If that panel can agree on a new bill, the House and Senate would again have to approve the legislation - a process that could last months.

'I think people would look at it not necessarily based on its content, but as a forcing mechanism to cause the two sides of the building to try to solve it together,” Republican Sen. Bob Corker said. 'That's going to be the last chance.”

President Donald Trump, who has been in office for six months, has come down hard on his fellow Republicans for failing to act on Obamacare, something that he had promised repeatedly in his election campaign last year. Some Senate Republicans were growing uncomfortable with the chaotic debate.

'We've got to have a more organized process,” Republican Sen. Ron Johnson said, noting the skinny repeal would simply delay acting on the core issue. 'We just don't have the courage and really the intestinal fortitude to suck it up and ... do this right.”

Trump attacked members of his own party who opposed repeal, targeting Lisa Murkowski of Alaska by name in a tweet early Wednesday.

Murkowski, a moderate Republican who was one of two party members to have voted against opening debate on a bill to end Obamacare, told MSNBC she was not worried.

'Every day shouldn't be about winning elections,” she said. 'How about just doing a little bit of governing around here?”

Reuters and the Tribune Washington Bureau contributed.