Sen. Susan Collins (R-ME) confirmed on ABC’s This Week that the Senate version of the healthcare bill makes even deeper cuts to Medicaid than the bill that passed the House.
— ABC News Politics (@ABCPolitics) June 25, 2017
Sen. Collins said, “Based on what I’ve seen given the inflation rate that would be applied in the outer years to the Medicaid program, the Senate bill is going to have more impact on the Medicaid program than even the House bill.”
By using a smaller inflation rate to calculate Medicaid spending, the Urban Institute estimates that the Senate bill cuts Medicaid by $373.6 billion more than the House bill. This is what Sen. Collins was referring to when she said the Senate legislation would have more impact on Medicaid than the bill that passed the House.
Forget the group of four far-right Republicans who are trying to cut a deal to make the Senate bill more extreme. Sens. Cruz, Paul, Lee, and Johnson will all most likely end up voting for the bill. The fate of the legislation hangs with a group of moderates. Sen. Dean Heller of Nevada has already come out as a no vote. Susan Collins sounds like a no vote, although, she is waiting to see the CBO numbers before she makes up her mind. Sen. Lisa Murkowski of Alaska has been very critical of the bill. Sen. Rob Portman of Ohio is undecided and under pressure due to the Medicaid cuts. Sen. Ben Sasse of Nebraska is undecided, but will probably vote for the bill. Sen. Shelly Moore Capito of West Virginia could be another swing vote as she has expressed serious concerns about the Medicaid cuts.
The three Senators who are likely to sink the bill if it fails are Heller, Collins, and Murkowski. Mitch McConnell has put himself in a no-win situation. If he moves to the right to capture the support of the Cruz/Paul wing, he will lose the moderates. If he moves to the middle to keep the moderates, he risks losing a combination of Heller, who is a no vote no matter what, and two of the far right Senators.
There are a lot of ways for this bill to fail, and no clear path to passage.
When even a Republican Senator is admitting that the bill is bad for Medicaid, the outlook for Republican success is murky at best.