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Budget office puts off scoring of health bill

WASHINGTON -- Adding to uncertainty over the fate of the Senate health care bill, the Congressional Budget Office indicated Sunday that it no longer expects to release its analysis today on the estimated cost and scope of insurance coverage under the latest GOP bill.

Senate Majority Leader Mitch McConnell late Saturday put off plans to hold a vote on the bill this week, after Republican Sen. John McCain said he would be at home in Arizona recovering from a surgery to remove a blood clot from above his left eye. McCain's absence will leave Republicans without the votes necessary to advance the legislation.

The No. 2 Senate GOP leader, John Cornyn of Texas, said he still expected the Senate to move quickly, holding a vote as soon as McCain returns. But amid growing public unease over the bill, some Republicans suggested the delay will make McConnell's task of winning enough support even harder.

Conservative critics will now have more time to mobilize, said Sen. Rand Paul, R-Ky., one of the measure's most outspoken opponents.

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"The longer the bill is out there, the more conservative Republicans are going to discover it is not repeal," Paul said Sunday in an interview with CBS.

"I think it's absolutely wrong," Paul said of the bill. "It's not at all consistent with Republican principles. ... We promised repeal."

Paul and Sen. Susan Collins, R-Maine, for different reasons, have said they will not vote even to proceed to the legislation on the Senate floor. Along with all 48 senators in the Democratic Caucus -- and without McCain -- their opposition would be enough to block the bill from advancing.

Trump did not mention the health care bill or McCain's surgery in a series of tweets Sunday morning in which he mentioned Hillary Clinton and the Russia investigations now engulfing the administration, among other topics.

The White House said Sunday that Trump was "monitoring what's going on with health care" but did not otherwise weigh in on the growing uncertainty. "We wish Sen. McCain a speedy recovery," said Helen Aguirre Ferre, director of media affairs.

Vice President Mike Pence has sought to rally support for the health bill and recently called on governors to embrace the new bill in a speech at the summer meeting of the National Governors Association.

Collins said she disagreed with Pence's comment to governors that the bill "strengthens and secures Medicaid for the neediest in our society."

"You can't take more than $700 billion out of the Medicaid program and not think that it's going to have some kind of effect," Collins said in an interview Sunday with CNN.

"This bill imposes fundamental, sweeping changes in the Medicaid program, and those include very deep cuts that would affect some of the most vulnerable people in our society, including disabled children and poor seniors. It would affect our rural hospitals and our nursing homes, and they would have a very hard time even staying in existence."

Paul criticized the Republican bill for keeping the same "fundamental flaw" that he said has caused premiums to surge under the Patient Protection and Affordable Care Act.

"They are subsidizing the death spiral of Obamacare," Paul said. "They don't fix it -- they just subsidize it with taxpayer moneys."

Both senators raised doubts about wider Republican support for the bill.

"There are about 8 to 10 Republican senators who have serious concerns about this bill, so at the end of the day, I don't know whether it will pass," Collins said.

Asked if McConnell has the votes for passage, Paul was blunt.

"I don't think right now he does," he said in an interview with Fox News.

McConnell last week had refashioned the legislation to attract additional GOP votes. The new package added language letting insurers sell discount-priced policies with minimal coverage aimed at winning over conservatives, and revised funding formulas that would mean federal money for states including Louisiana and Alaska -- home to four GOP senators who are uncommitted on the measure.

But the health care legislation was already hanging by a thread. McCain's absence meant it would become impossible for the majority leader to round up the votes needed this week to proceed on the bill.

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It was the second time that McConnell was forced to call off a planned vote, even with heavy lobbying by Trump administration officials. A vote was postponed last month, also due to limited support. Democrats are unanimously opposed to the bill, as are the nation's major medical groups and insurers.

"While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act," McConnell said Saturday. He has already said the Senate will work through the first two weeks of the August recess, citing a need to finish a slate of unfinished business.

McConnell did not indicate when he would aim to return to the health care bill, but Cornyn made clear Sunday that moving quickly is important.

"I believe as soon as we have a full contingent of senators, that we'll have that vote," he said on NBC's Meet the Press.

Cornyn acknowledged that if the Senate is unable to attract enough GOP votes that it will "keep trying" but will eventually have to come up with a different plan.

"We're willing to do what we can to shore up the system now, to stabilize it to make health care available to people now, but we want reforms to go along with it," he said.

The Senate bill, like legislation the House passed earlier, repeals mandates requiring individuals to carry insurance and businesses to offer it, and it unravels an expansion of the Medicaid program enacted under President Barack Obama's law. Analyses of the earlier version of the Senate bill found it would result in more than 20 million additional uninsured Americans over a decade, compared with current law.

The newest version attempts to attract conservative support by allowing insurers to offer skimpy coverage plans alongside more robust ones, but also reaches out to moderates by adding billions of dollars in help for the opioid crisis and to defray high costs for consumers.

In Phoenix, Mayo Clinic Hospital doctors said McCain underwent a "minimally invasive" procedure to remove the nearly 2-inch clot and that the surgery went "very well," a hospital statement said. McCain was reported to be resting comfortably at his home.

Pathology reports on the clot were expected in the next several days.

McCain, 80, is a three-time survivor of melanoma. Records of his medical exams released in 2008 when he was the GOP candidate for president showed that he has had removed precancerous skin lesions, as well as an early stage squamous cell carcinoma, an easily cured skin cancer.

Information for this article was contributed by Elise Viebeck and Sean Sullivan of The Washington Post and by Hope Yen and Erica Werner of The Associated Press.

A Section on 07/17/2017

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