GOP in health care holding pattern heading into Philly getaway

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With a virtual vacuum in place on the issue, Sen. Susan Collins, R-Maine, and Sen. Bill Cassidy, R-Louisiana, rolled out their own measure that would allow states a series of options for replacing Obamacare -- even allowing them to keep it.

WASHINGTON (CNN) – Republican lawmakers are heading to Philadelphia Wednesday for two days of intensive work on replacing Obamacare with hopes that some of the biggest questions can be answered by the often confounding President Donald Trump.

House and Senate Republicans will pack the city, not far from where Democrats nominated Hillary Clinton just six months ago, for their annual retreat — and crafting a replacement plan for Obamacare is at the top of their list.

“Look there are a whole lot of different ideas about how to replace Obamacare,” Senate Majority Leader Mitch McConnell said Tuesday, shortly before lawmakers left town. “As all of us have said repeatedly: it will be done in consultation with the new secretary of Health and Human Services, the new head of (the Centers Medicare and Medicaid Services) and active discussion among House and Senate Republicans, because we anticipate no cooperation from the other side.”

The repeal part has not been much of a question for the Republican majorities, after they started the clock ticking on stripping core items from the Affordable Care Act earlier this month. But how to craft their own version of Obamacare has Republicans in something of a holding pattern inside the Capitol, largely waiting to see what Trump and his team will do.

The concern among rank-and-file legislators has been palpable.

A small group of moderate and conservative House Republicans voted against starting the repeal process earlier this month amid a mix of worries that included not having a replacement ready. And other Republicans who supported starting the repeal have said they want more definitive answers, soon.

“I’m hopeful for a very definitive solution on what we replace the Affordable Care Act with and not just a framework,” Rep. Mark Meadows, R-North Carolina, chair of the conservative House Freedom Caucus, told reporters on Tuesday.

He said he wants to see the plan that Trump said he is preparing and discuss approaches being developed by congressional Republicans.

Thursday, in Philadelphia, they will get a chance to press the newly-minted President himself.

Trump is scheduled for a two-hour meeting with House and Senate Republicans Thursday — in between meetings with Vice President Mike Pence and British Prime Minister Theresa May. And the group will spend Thursday morning working intensively on health care.

Big questions loom about what will happen to states that expanded Medicaid (punctuated by a meeting of Republican governors in the Capitol last week, a day before the inauguration) and how Republicans can expand coverage beyond what Obamacare has accomplished. Lawmakers are also still feeling out how much of the law they can strip away through the budget “reconciliation” — a move that would avoid having to get 60 votes in the Senate to break a Democratic filibuster.

The wheels have been turning behind the scenes, perhaps best exemplified by Pence shuttling routinely between the Capitol and the White House. (On Monday, Pence left the White House, spent an hour with House Speaker Paul Ryan on the issue at the Capitol, and then jetted back to the White House to swear in the new CIA director, Mike Pompeo. Tuesday Pence held meetings with individual senators and then joined Senate Republicans for their weekly lunch meeting.)

But Trump himself has often injected confusion into the debate, with conflicting comments on what he wants — Republican lawmakers gently corrected him last week after he told The Washington Post he wanted universal health care “coverage” and not just “access.”

House and Senate Republican leaders meanwhile have said they are waiting on formal guidance from the White House before rolling out any details. And, they add, those details won’t be coming until Trump has a Health and Human Services secretary — a clear dig at Democrats, who spent Tuesday morning grilling nominee Tom Price.

With a virtual vacuum in place on the issue, Sen. Susan Collins, R-Maine, and Sen. Bill Cassidy, R-Louisiana, rolled out their own measure that would allow states a series of options for replacing Obamacare — even allowing them to keep it.

Cassidy explained Monday that he did not expect the bill to be the final measure that replaces Obamacare but wanted to start debate. He told reporters Tuesday that he thinks their idea — starting the debate before the White House has submitted its own plan — is in keeping with Trump’s style.

“You know I imagine when Donald Trump says ‘I am going to build 100-story building in New York,’ he doesn’t say, ‘I want the foundation to be this deep.’ He says, ‘I want to build a 100-story building.’ And therefore that in and of itself is establishes what the foundation is,” Cassidy said. “So sometimes just by setting your goal, you establish everything else and that is my sense of how Donald Trump does his business.”

Trump has said that their plan would come almost “simultaneously” with the confirmation of Price for HHS secretary — a prospect that is unlikely until at least a week after the retreat. And Pence told senators earlier this month that the timetable would be something close to mid-February or mid-March.

Rep. Chris Collins, a New York Republican and one of Trump’s earliest supporters, said he views the administration plan as a “starting point” and is waiting on that.

But he added that letting states decide how to handle Medicaid is something most Republicans agree on — including how to shift the program

“How we get that done, the devil is in the details. And the details have not been rolled out,” the congressman said.

The holding pattern on the toughest issues has other lawmakers holding their tongues before seeing what the Trump White House proposes. And unless Trump changes his time line for releasing a plan — based on Price’s confirmation — lawmakers could easily leave Philadelphia disappointed.

“One of the things I’ve learned is that patience is a virtue,” said Sen. Tim Scott, a South Carolina Republican.