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Missouri, Illinois senators call for compromise after latest effort to repeal health care law fails

On Thursday, U.S. Sens. Tammy Duckworth, D-Ill., Roy Blunt, R-Mo., Claire McCaskill, D-Mo., and Dick Durbin, D-Ill., cast late night votes for and against the most recent health care bill making rounds on Capitol Hill.
Ryan Delaney, Gage Skidmore, Center for American Progress

After another Republican Senate loss early Friday, Missouri and Illinois senators are calling for a return to bipartisan talks to overhaul the nation’s health care law.

They include U.S. Sen. Roy Blunt, a Missouri Republican, who had tried to help his party’s leaders come up with the votes needed for a trimmed-back version of a bill that would have repealed key provisions of the Affordable Care Act, the signature achievement of former President Barack Obama.

The GOP fell one vote short when three Republicans joined all 48 Democrats to block the repeal bill early Friday morning.

In a statement, Blunt said he was disappointed by the vote, and that Republicans and Democrats need to work on a solution to the political impasse over health care.

“Doing nothing is not an option,’ Blunt wrote. “In the coming months, it is imperative that Senate Democrats, who put this failed system in place, work with us to advance bipartisan solutions that will provide relief for American families and create a more reliable, affordable health care system.”

U.S. Sen. Claire McCaskill, a Missouri Democrat, joined her Illinois colleagues – Democratic Sens. Dick Durbin and Tammy Duckworth – in lauding the repeal bill’s defeat.  All three said the loss saved health insurance for millions of Americans. They also called for the two parties to work together on any plan to change the Affordable Care Act.

McCaskill responded to the vote on Twitter, writing “No celebration. Time for hard bipartisan work to fix problems in ACA. We've already begun meetings, now please let's schedule hearings.”

Durbin and Duckworth offered similar sentiments.

“Now is the time to start anew in the Senate with a bipartisan effort to strengthen our health care system and give more Americans the peace of mind of quality, affordable health insurance,” said Durbin, who holds the second-highest position in the Senate Democratic Caucus.

House Republicans were taken aback by the latest setback. Among Missouri’s six GOP members, only U.S. Rep. Blaine Luetkemeyer of St. Elizabeth said anything after the Senate vote.  He attacked Senate Democrats, claiming that their votes several years ago helped produced deep divisions in the country. But Luetkemeyer said Republicans in the House will likely wait to see if the Senate can cobble together some sort of bipartisan alternative.

Public keenly interested in consequences of vote

Many of the senators' constituents stayed up late to watch the vote on C-SPAN and Twitter, expressing frustration that a bill to cut the health policies of 15 million Americans over the course of a year would be introduced and brought up for a vote just three and a half hours later.

The latest Republican plan would have eliminated the penalty for people who don’t buy health insurance and the penalty for employers who do not offer it. It also would have made it easier for states to opt out of federal rules that define baseline coverage.

That proposal is popular among conservatives, who say it would make insurance plans cheaper. Patients with complex conditions, however, worry that states could allow insurance companies to no longer cover certain therapies, mental health treatment or expensive drugs.

“The ‘skinny repeal’ evokes the image of trimming the fat, making it a leaner bill … but it’s dismembering vital organs to kill it,” said David Mueller of St. Louis, whose 3-year-old daughter lives with a rare form of cystic fibrosis that requires specialized care and physical therapy to keep her healthy. “I’m relieved.”

The Congressional Budget Office estimated that the “skinny repeal” would have increased premiums for individual insurance plans by 20 percent each year for the next decade, relative to current law.

Of the people losing insurance in the first year of the repeal bill, 6 million would have had to forgo individual coverage, 6 million would have lost coverage through their employer, and 3 million would have lost their eligibility for state Medicaid programs.

The latest Republican plan would have made a less drastic cut to Medicaid than in previous ones. But a proposal for deep cuts likely will resurface in the coming months.

About 70 million people across the country – largely senior citizens, people with disabilities, low-income people and children – rely on coverage through Medicaid and the related Children’s Health Insurance Program, commonly known as CHIP.

In Missouri, about 990,000 are covered by Medicaid, a federal- and state-funded health insurance program.

More than 200,000 additional people would have been covered if the state had participated in the Affordable Care Act’s voluntary Medicaid expansion. Illinois, which does participate in the expansion, has about 3 million people on Medicaid.

In addition, about 290,000 in Missouri and more than 300,000 in Illinois purchase private insurance through the Affordable Care Act’s marketplace. Most qualify for federal subsidies or cost sharing to help cover their premiums and other expenses.

President Donald Trump has threatened to cut the amount of money the federal government gives some consumers to help pay health care costs as well as the federal payments to health insurance companies that offer policies on the marketplace.

In a Twitter post early Friday, the president said, “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!”

The continued health insurance battle is expected to be an issue in 2018’s congressional elections, especially in Missouri, where McCaskill’s re-election bid is seen as one of the marquee Senate contests in the country. 

At town hall meetings across the state, McCaskill has highlighted her support for the Affordable Care Act in recent months.

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Jo Mannies is a freelance journalist and former political reporter at St. Louis Public Radio.