Senate Republican leaders seem increasingly focused on reviving their effort to undo the Affordable Care Act before the end of the month, asking Congress's nonpartisan budget analysts to fast-track consideration of a plan that would devolve federal health-care spending to states.
The Congressional Budget Office is in the process of estimating the cost and coverage impact of the so-called Graham-Cassidy bill, according to a senior Senate Republican aide. The measure from Sens. Lindsey O. Graham (R-S.C.), Bill Cassidy (R-La.), Ron Johnson (R-Wis.) and Dean Heller (R-Nev.) would provide states with funding to establish health insurance programs outside ACA protections and mandates, an approach that could force millions off insurance rolls.
Republicans are facing pressure to undercut the Affordable Care Act, also known as Obamacare, with legislation as soon as possible, partially because the Senate's ability to pass budgetary legislation with a simple majority expires Sept. 30. After that date, health-care legislation will require 60 votes to pass, making it much harder for Republicans to approve legislation that would restructure Obamacare.
Democrats are taking the latest chatter seriously, and liberal lawmakers spent the weekend slamming the bill on social media.
"The Graham-Cassidy @SenateGOP 'health care' bill IS Trumpcare, & it will rip health care away from millions of Americans," Sen. Elizabeth Warren (Mass.) wrote as part of a series of tweets.
Progressive groups also spent the weekend on the warpath. Ben Wikler, the Washington director of MoveOn, told followers to be ready for a possible vote as early as Sept. 27.
Republican leaders are now trying to determine whether they have enough votes to begin debate on the bill, according to Senate aides. They are also trying to get Sen. John McCain (R-Ariz.), whose "no" vote sank the most recent Republican health-care bill in July, fully on board.
McCain has said he supports the bill in theory but wants to assess its impact on Arizona. Without prompting, he cautioned Republicans on Sunday against the instinct to "ram through our proposal" with a party-line vote.
"Why did Obamacare fail? Obamacare was rammed through with Democrats' votes only. . . . That's not the way to do it. We've got to go back. If I could just say again, the way to do this is have a bill, put it through committee," he said on CBS's "Face the Nation."
Senate Republicans have a very slim path to victory on Graham-Cassidy: If more than two Republicans vote no, the bill won't pass. The math became even harder once Sen. Rand Paul (R-Ky.) announced his opposition Friday.
"I can't support a bill that keeps 90% of Obamacare in place," Paul tweeted.
Cassidy replied to say the measure "repeals entire architecture of Obamacare & gives Kentucky control over its own health care."
Compared with Paul, conservative groups have been fairly quiet on the bill. Americans for Prosperity, the Koch-funded tea party group, has said nothing about it since the group's pivot to tax reform in August.
Heritage Action for America, which organized years of repeal rallies, echoed Paul's worry that the bill would leave the ACA's basic structure in place.
But senators' all-or-nothing pitch for the bill has worked on some organizations.
The Family Research Council has backed the measure as the last good chance to "stop taxpayer funding of abortion and redirect tax dollars away from the nation's largest abortion business, Planned Parenthood."
FreedomWorks also gave the bill a partial endorsement.
"It's not the repeal of Obamacare that was promised," wrote FreedomWorks' legislative affairs vice president Jason Pye on Saturday. "Nevertheless, FreedomWorks is treating it as what is likely to be the last serious attempt to reform Obamacare."
Kelsey Snell, Mike DeBonis and Sean Sullivan contributed to this report.