Rival Senate factions push competing agendas as healthcare measure hangs in balance

Heading into a week of intense jockeying and arm-twisting over the Senate’s polarizing healthcare plan, the rift appeared to widen Sunday between moderates who consider the measure too punitive and conservatives who want to see the sweeping bill toughened up before agreeing to back it.

President Trump, who made the repeal of his predecessor’s signature Affordable Care Act a campaign centerpiece, expressed optimism about chances for Senate passage, but declared again that he wanted to see a plan with “heart” — suggesting he might undercut Republican efforts to bring recalcitrant conservatives on board.

With Senate Majority Leader Mitch McConnell (R-Ky.) seeking to push ahead with a vote this week, the bill’s prospects hung in the balance. Five GOP senators have said publicly they oppose the measure as written; the defection of only three Republicans would be enough to sink it.

Democrats, who have said they would be willing to work with the GOP to fix but not scrap the act known as Obamacare, declared that the Senate measure would inflict far-reaching harm on poor and middle-income Americans, as well as the elderly.

Senate Minority Leader Charles E. Schumer (D-N.Y.) said in an interview on ABC’s “This Week” that he thought chances for Senate approval were “50-50” at best.

Failure to pass the bill would represent a high-profile setback for Trump at a time when his White House is increasingly beleaguered over the widening probe of Russian meddling in the 2016 presidential campaign.

There, too, Trump made life more difficult for those seeking to advance his policy agenda. A day after heaping blame on President Obama for failing to act forcefully against Russian interference — an accusation that critics pointed out was actually Trump’s most explicit admission to date that the Kremlin had sought to influence the vote’s outcome — Trump took fresh aim Sunday at Hillary Clinton, his vanquished opponent.

Amid the growing investigation of possible links between his campaign and Russia, Trump went on Twitter to accuse Clinton of “collusion” with Democratic officials, simultaneously defending and deriding “Crazy Bernie Sanders,” who had been her principal rival for the party’s presidential nomination. It was a complaint Trump has made repeatedly in the past, based on revelations contained in emails hacked by the Russians that appear to show Clinton’s campaign working with the Democratic National Committee during the primary.

On the healthcare front, conservatives voiced concerns about the Senate plan and floated two amendments for revisions this weekend at the influential Koch network’s gathering of wealthy donors in Colorado Springs, Colo.

The Koch network had similarly rejected the original House GOP bill this spring until party leaders tacked on stringent amendments meant to appease the party’s hard-liners.

One key lawmaker attending the weekend summit, Rep. Mark Meadows (R-N.C.), the chairman of the House Freedom Caucus and a chief negotiator on the House bill that was passed earlier, outlined key changes to the bill that he said could likely win enough conservative support for passage.

One idea from Sen. Ted Cruz (R-Texas) would allow companies that offer insurance policies on the Obamacare marketplace to also offer plans that do not meet the Affordable Care Act’s strict requirements.

Such a change would in essence allow insurers to offer cheaper, though skimpier, policies that may help achieve the GOP’s goal of lowering premium prices for consumers.

Another change would broaden the ability of those who buy insurance on the marketplace to sock away more money in tax-free Health Savings Accounts to help them pay for their premiums.

Cruz is one of four Senate conservatives who have said they would not support the bill unless changes are made, positioning them for negotiations in the days ahead.

Another of the conservative holdouts, Sen. Mike Lee (R-Utah), was among those feted Saturday night at a reception with Charles Koch, the billionaire industrialist who funds the conservative network. Hundreds of donors pay $100,000 annual dues to be members and attend the Koch summits.

Even as McConnell continued to push for a speedy vote, one key GOP centrist, Sen. Susan Collins of Maine, said she doubted there would be a swift resolution.

“It’s hard for me to see the bill passing this week,” she said on ABC’s “This Week.” Collins, who has expressed particular concern over funding for Planned Parenthood, said she wanted to see the Congressional Budget Office’s “score” of the measure, which would outline its projected effects.

“I’m very concerned about the cost of insurance for older people with serious chronic illnesses, and the impact of the Medicaid cuts on our state governments, the most vulnerable people in our society, and healthcare providers such as our rural hospitals and nursing homes, most of whom are very dependent on the Medicaid program,” Collins said.

Another holdout, Sen. Bill Cassidy (R-La.), a physician who had offered his own proposal, also criticized the rush.

“I frankly would like a few more days to consider this,” Cassidy said on CBS’ “Face the Nation.”

Similar reservations were voiced by Sen. Ron Johnson of Wisconsin.

“We don’t have enough information,” he said on NBC’s “Meet the Press.” “I don’t have the feedback from constituencies who will not have had enough time to view the Senate bill. We should not be voting on this” in the coming week.

But Republicans are anxious to resolve the healthcare debate, which has created a fresh logjam in an already stalled legislative agenda. Meadows told reporters if the Senate passes the bill this week, the House could quickly follow with a weekend session — ahead of an envisioned Fourth of July bill signing by the president.

Senate GOP Whip John Cornyn said the Senate remains on track to start Wednesday’s procedural votes.

“But it’s going to be close,” the No. 2 Republican told reporters Sunday at the Koch summit.

Cornyn, of Texas, said Trump is “important in the process” but acknowledged that the hopes for a Fourth of July bill signing expressed by one Republican lawmaker were “optimistic.”

Trump, who spent part of the weekend at his Virginia golf club, said he thought the bill’s prospects were good.

“Healthcare is a very, very tough thing to get, but I think we’re going to get it,” he said in an interview aired Sunday on “Fox and Friends.”

But Trump, who had celebrated the passage of the House version of the measure with a triumphal Rose Garden gathering of GOP lawmakers, essentially confirmed previous news reports that he had called the House bill — which is highly unpopular, according to public opinion polls — “mean.”

“That was my term, ‘mean,’” he said in the Fox interview. “I speak from the heart, that’s what I want to see — I want to see a bill with heart.”

Trump’s Health and Human Services secretary, Tom Price, appearing on “Fox News Sunday,” pledged that under the GOP measure, “nobody will fall through the cracks, nobody will have the rug pulled out from under them.”

But Sen. Rand Paul of Kentucky, another of the five holdout Republicans, said that that was exactly the sort of over-promising that could scuttle the measure. Paul said he might “get to yes if they change their approach,” but expressed broad reservations about unrealistic claims.

“They’ve promised too much,” he said on ABC. “They say they’re going to fix healthcare and premiums are going to go down. There’s no way the Republican bill brings down premiums.”

Read the GOP’s plan to replace Obamacare »

King reported from Washington and Mascaro from Colorado Springs, Colo.

laura.king@latimes.com | @laurakingLAT

lisa.mascaro@latimes.com | @lisamascaro

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