GOP considers scaled-back health plan as voting continues 07:33 CBS News' Rebecca Shabad, Emily Tillett, John Nolen and Kathryn Watson have contributed to this developing story. The Senate is set for a midnight vote on the "skinny repeal" bill, only two hours after the text of the legislation -- called the Health Care Freedom Act -- was released. The bill repeals the individual and employer mandates, among a few other key Republican objectives. On Wednesday, a vote to simply repeal Obamacare failed to attract enough votes, with seven Republican senators voting against the measure.
President Trump has made it clear that he believes this is Republican's final chance to repeal and replace President Obama's signature legislation, as he pledged to do on the campaign trail. Mr. Trump urged senators not to leave Washington, D.C., for August recess before they do.
Sen. John McCain, Sen. Lisa Murkowski and Sen. Susan Collins voted no on the "skinny repeal" bill, dooming its fate.
Vice President Mike Pence and Sen. John McCain (R-Arizona) are having a long discussion ahead of the much-anticipated health care vote, ostensibly so Pence can persuade McCain to vote for the bill. Earlier in the day, McCain had said he wouldn't vote for the "skinny repeal" without an assurance from Speaker of the House Paul Ryan that the bill would go to conference.
Sen. Susan Collins (R-Maine), Sen. Lisa Murkowski (R-Alaska), and Sen. Dan Sullivan (R-Alaska) eventually joined the conversation.
The proposal from Sen. Patty Murray (D-Washington) to send the "skinny repeal" bill or Health Care Freedom Act back to committee failed, as expected.
The next vote should be the main one, although senators are stalling.
Vice President Mike Pence arrived at the U.S. Capitol around 11:30 p.m. Thursday, ahead of a health care vote series expected around midnight. As the vice president, he reserves the power to cast a tie-breaking vote, if necessary.
President Trump urged Republican senators to do something about Obamacare late Thursday night, although it's unclear specifically what he is advocating.
Go Republican Senators, Go! Get there after waiting for 7 years. Give America great healthcare!
— Donald J. Trump (@realDonaldTrump) July 28, 2017
The Congressional Budget Office late Thursday released an estimate on the Health Care Freedom Act, which shows 16 million more people would be uninsured by 2026. It would also increase premiums by 20 percent compared to current law between 2018 and 2026.
The American Medical Association released this statement from its president, David Barbe, opposing the "skinny repeal" proposal:
"Action is needed to address problems in the individual insurance market, but the so-called 'skinny' bill is a toxic prescription that would make matters worse," Barbe said. "Eliminating the individual mandate will lead to adverse selection, triggering higher premiums and further destabilizing the individual market. The stated goal was to advance policies to lower premiums, but the 'skinny' bill would do the exact opposite, harming patients across the country.
Senators are expected to begin voting shortly after midnight, although other votes will come before any vote on the main bill.
Here is the text. The bill would do the following:
Senate Majority Leader Mitch McConnell said the legislation restores freedom to aspects of health care that Obamacare took away.
"I would urge everyone to support it," McConnell said.
This bill apparently requires a simple majority to pass, not 60 votes.
Sen. Lindsey Graham (R-South Carolina), one of the handful of Republican who said he would not vote for the "skinny repeal" bill unless he received absolute assurances from Speaker of the House Paul Ryan that the bill would go to conference instead of becoming law as-is, said he is satisfied with Ryan's approach. Ryan earlier in the evening said he would permit the skinny repeal bill to go to conference in the House, but only after it first went to conference in the Senate.
Sen. John McCain (R-Arizona), one of the other key senators who opposed passing skinny repeal without assurances from Ryan earlier in the day, said Ryan's statement wasn't sufficient to persuade him to vote for the bill as it stands.
The Senate is an amendment to the bill proposed by Sen. Dean Heller (R-Nevada) to repeal Obamacare's so-called "Cadillac" tax, 52-48.
The Obamacare measure imposed a 40 percent tax on the cost of employer-sponsored health care coverage for individuals whose annual premiums are higher than $10,800, and families whose annual premiums exceed $29,050. The tax was intended to curb health care spending by penalizing wealthy people who have the most robust health care plans.
An attempt from Senate Minority Leader Chuck Schumer (D-New York) to send the bill back to a Senate committee for further study failed, 43-57.
Speaker of the House Paul Ryan released a statement saying the "burden remains on the Senate" to prove it can come up with a passable bill, saying the House will go to conference -- but not before the Senate does.
The Senate, Ryan said in a statement, must pass a conference bill first.
Sen. John McCain (R-Arizona) said Ryan's statement was not enough for him to move forward with "skinny repeal."
Obamacare is collapsing and hurting American families. We have to keep working at this until we get the job done. https://t.co/ypv3TV2eZ0 pic.twitter.com/7JlFgb1z4S
— Paul Ryan (@SpeakerRyan) July 27, 2017
Republican members of the House will convene on Capitol Hill at 9 a.m. to determine a path forward on health care. It's unclear if there will be any more direction from House leaders Thursday night, after key Republican senators said they will not vote to pass the "skinny repeal" bill unless they are guaranteed the House will conference on it so it isn't standalone legislation.
Rep. Mark Meadows, R-North Carolina, spoke to reporters before the Graham/McCain press conference and said he personally opposes the skinny repeal because it could increase premiums and doesn't fulfill their promise to repeal Obamacare.
He said he doesn't think that the skinny repeal has the votes in the House, and leadership in the House and Senate know this.
Key Republican senators Sen. Lindsey Graham (R-South Carolina), Sen. John McCain (R-Arizona), Sen. Ron Johnson (R-Wisconsin) and Sen. Bill Cassidy (R-Louisiana) said they will not vote for the skinny plan alone without a guarantee from Speaker of the House Paul Ryan that it will go to conference and not become law.
Without their support -- Republicans can only afford to lose two votes -- the skinny plan cannot pass.
"The skinny bill as policy is a disaster," said Graham, flanked by his Republican colleagues and calling the skinny bill alone a "fraud." Graham said the skinny bill is not a repeal of Obamacare, and if Republicans pass that plan alone, they will be responsible for the collapse of health care.
"I'd rather get out of the way and let it collapse than have a half-ass approach that is not our problem," Graham said.
McCain said the "status quo" of Obamacare is not satisfactory, but he also can't support the skinny plan as it stands.
Johnson said he has a very simple request: Guarantee a conference immediately after skinny repeal. The skinny bill alone, he said, doesn't come close to keeping Republicans' promise to repeal Obamacare.
Graham said passing the skinny plan alone would be the "dumbest thing" in political history.
Rep. Mark Meadows (R-North Carolina), who chairs the conservative House Freedom Caucus has said the skinny plan alone will be dead on arrival in the House.
America's Health Insurance Plans (AHIP) addressed a letter to Senate leaders, calling for short-term stability and longer-term improvements in the individual health insurance market and emphasizing that the deadline is rapidly approaching for insurers to make final decisions about their premiums and participation for 2018.
The letter read, "This continued uncertainty – combined with targeted proposals that would eliminate key elements of current law without new stabilizing solutions – will not solve the problems in the individual market, and in fact will result in higher premiums, fewer choices for consumers, and fewer people covered next year."
It went on to say, "We would oppose an approach that eliminates the individual coverage requirement, does not offer alternative continuous coverage solutions, and does not include measures to immediately stabilize the individual market."
The CEO of AHIP previously sent leadership a letter slamming the Cruz amendment as "simply unworkable."
Speaking on the floor, Ron Wyden of Oregon slammed the skinny repeal plan, saying "who knows what was done at the GOP lunch today between the salad course and the entree."
House Majority Leader Kevin McCarthy, R-California, advised members that while last votes are currently scheduled for Friday before their scheduled recess, the "House schedule is subject to change" depending on what the Senate produces on health care.
Sen. Rob Portman of Ohio told reporters on Thursday, "The leadership team said the intention was if we vote on a final bill we would get it to the House. With that understanding I'm going to support it, I don't know the final product, you'd have to ask them."
He added, "I don't think it's a replacement, want to be sure we're going into conference."
The single payer system amendment offered by Sen. Daines fails in the Senate after failing to secure a single "yes" vote in its favor.
Graham says skinny repeal a "trust but verify situation"
Sen. Lindsey Graham told reporters he still needs confirmation that his amendment being put forth is "conferenceable" but that the House will also agree to having a conference in the first place before moving forward on a vote to support the skinny repeal plan.
Graham said he has faith that Republican leadership would assure him either way.
"My guess is we're very close to the votes and well have the votes," Sen. Blunt of Missouri told reporters of the progress on the skinny repeal plan.
He added, "I think we'll get it done tonight," noting that the plan is a "significant step in right direction to go to conference."
"Fat or skinny or anorexic or bulimic, I don't know yet, I know it's kind of messy, but it's pretty in a way because this is how democracy works," the Louisiana Senator says of the skinny repeal plan.
Kennedy says that everyone will be able to offer their amendment, saying "there will be hundreds, maybe thousands" offered.
The Senate comes to session to vote on a on the single payer amendment plan offered by Republican Sen. Steve Daines of Montana who opposes the single-payer system. The effort is largely seen by Democrats as a "political trick" by Republicans to force Democrats to be on the record where they stand on Single payer system. Daines is not expected to vote for his own amendment.
"This is a political stunt in the midst of the unprecedented and disastrous process Republicans have undertaken to repeal the Affordable Care Act," wrote Sen. Bernie Sanders in a statement.
"I truly don't know when it's gonna be released, its still a work in progress," Collins of Maine told reporters on Thursday
Sen. Ron Johnson of Wisconsin echoes his colleagues calls for a skinny repeal plan to usher in a move toward conference.
Sen. Bob Corker would not get into details of the skinny repeal plan, but told reporters that, "the substance of this is not revelenat, what's relevant is getting to conference."
He added, that Senators "want to be assured" that this is a "lifeline to the conference."
Sen. Steve Daines told reporters, "We need to do a repeal and replace of Obamacare and the skinny bill, in my opinion, is only like a motion to proceed, it's a vehicle to move forward.
Sen. Lindsey Graham said he is a "no" on the skinny repeal plan if the Graham-Cassidy amendment cannot be included in a conference agreement.
Graham told reporters on Thursday that he is set to meet with the Senate parliamentarian and Sen. McCain this afternoon to see if his amendment would be able to be included in conference, giving it a "chance to build it out."
If it is, Graham said, "I'll move forward with the skinny bill, but I told everybody this cannot be the final product."
He added, "About half the conference would not tolerate having the skinny bill be our final answer on health care. "
"If they send it back over and say this is the best we can do, no way, because if you passed it as a standalone, it will destroy the insurance markets and we would own the failure of Obamcare.
When asked if he knew of any details of what was currently included in the skinny plan, he responded, "the skinny bill is getting bigger."
Asked by a reporter on Capitol Hill if he was "not a definite yes at this point" on the skinny repeal approach to the health care bill, Sen. McCain responded, "no certainly not."
He added, "I'll have to look at it, but it depends on how my governor feels as far as the provisions and what those concerns are."
Sen. Bob Corker of Tennessee joined the chorus of his Republican colleagues in saying many Senators have no idea what the "skinny repeal" plan entails exactly.
Corker told reporters, however, "What I have in my pocket is very different than what was being discussed on the floor yesterday."
Alabama Republican Sen. Richard Shelby told reporters on Thursday that while Senators "don't know what is going to happen today, I'm hopeful we can pass the skinny bill."
He added, "While I'm straight out repeal and replace later, I think we got to get what we can get, and do what we can do. That's part of the legislative process, I hope it'll work today, but we'll see."
As Shelby explained to reporters that politicians have to "keep their word" to their constituents, a protester with Epilespy approached Shelby in his gaggle with reporters, explaining to the Senator, "I would never be covered under what your proposing."
Shelby responded to the protester's pleas, "Any group that's underserved, for medical, we ought to protect."
Sen. Orrin Hatch, R-Utah, says that while he'd prefer the Senate's final health care plan to be a "fuller bill", the skinny repeal approach is a step in the right direction toward reform.
"I suspect we'll find that this is going to be a continuing, bubbling up situation until we really go through the hole situation," Hatch added.
Hatch conceded that while much of the debate over what Senators were actually voting for on Thursday was up in the air, he said Republicans are "hopeful that we'll have a little better cooperation on tax reform."
Senate Budget Committee Ranking Member Sen. Bernie Sanders of Vermont says that state waivers largely violate the Senate's rules according to the Senate Parliamentarian, requiring a majority of 60-votes to pass.
The issues of waivers is just another section of original BCRA, the repeal and replace plan, that violates the Senate's Byrd Rule.
Under the Byrd rule, according to the the Senate is "prohibited from considering extraneous matter as part of a reconciliation bill or resolution or conference report thereon." The definition of what constitutes 'extraneous matter' is set in the Budget Act; however, the term remains subject to considerable interpretation by the presiding officer.
Under current law, 1332 waivers allow states to waive certain Affordable Care Act provisions as long as they can ensure that they cover the same number of people, same level of services and same protections against high out of pocket costs.
"The function of reconciliation is to adjust federal spending and revenue, not to enact major changes in social policy. The parliamentarian's latest decision reveals once again that Republicans have abused the reconciliation process in an attempt to radically change one-sixth of the American economy by repealing the Affordable Care Act," said Sanders in a statement.
Ranking member of the Senate Finance Committee Sen. Ron Wyden of Oregon echoed Sanders comments, saying in a statement, "Today's decision confirms that Senate Republicans cannot use their partisan, go-it-alone reconciliation process to water down key consumer safeguards like protection for people with pre-existing conditions and essential health benefits that Americans count on today."
The Senate majority leader said in remarks on the Senate floor Thursday morning that, "Senators will have the opportunity to consider many, many more amendments tonight. I know that colleagues in both parties are eager to do so. I encourage Senators with health-care ideas — whether Republicans, Democrats, or Independents — to bring their amendments to the floor."
He added, "I urge everyone to keep working hard so we can get this over the finish line — it's what our constituents, and our country, deserve."
The Senate GOP Conference is expected to meet behind closed doors Thursday for lunch to discuss the next steps forward on health care.
Senate Minority Leader Chuck Schumer, D-New York, said Democrats would not continue offering amendments to the bill until they see the Republican plan.
The upper chamber is scheduled to vote after Senate lunches Thursday on an amendment proposed by Sen. Steve Daines, R-Montana, that will ask senators whether they support a single-payer health care system.
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