Nation/World

McConnell delays August recess so Senate can complete work on health bill and other issues

WASHINGTON – Senate Majority Leader Mitch McConnell, R-Ky., announced Tuesday that he will delay the August recess by two weeks to complete work on health-care and other issues.

"In order to provide more time to complete action on important legislative items and process nominees that have been stalled by a lack of cooperation from our friends across the aisle, the Senate will delay the start of the August recess until the third week of August," McConnell said.

In addition to health care and appointments, the Senate will also devote time to passing a defense authorization bill "and other important issues."

Work on the Senate's health-care bill, meanwhile, remained uncertain Tuesday.

Sen. Ted Cruz, R-Texas, planned to make the case to fellow Republicans that they should embrace a radical change to the Affordable Care Act that would allow companies to offer minimalist plans on the private insurance market that don't meet current coverage requirements.

The presentation, which Senate GOP aides said Cruz planned to make behind closed doors at the caucus' weekly luncheon Tuesday, highlights the party's ongoing struggle to devise a health care plan that can satisfy a broad enough swath of lawmakers.

Cruz and other conservatives are trying to steer the bill to the right even as GOP leaders are eyeing changes – such as preserving a tax on wealthy Americans' investment income for several years – aimed at enlisting the support of centrists.

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The Cruz proposal would let insurers offer plans that don't meet current market requirements under the Affordable Care Act, such as providing benefits ranging from preventative care to mental health and substance abuse treatment. While this would lower premiums for some Americans, health experts say it would also siphon off younger, healthier consumers and could destabilize the market for more generous plans.

Tuesday's lunch will offer Senate Republicans the first chance to convene as a group since they left for a week-long holiday recess, where many constituents and industry groups attacked their leaders' plan to rewrite the 2010 law known as Obamacare.

In an interview with Rush Limbaugh on Monday, Vice President Mike Pence endorsed both the Cruz amendment and the idea that lawmakers should repeal the ACA outright if they cannot devise an immediate substitute. However, Senate GOP leaders are trying to narrow the number of options among from which their members can choose.

One person familiar with leadership strategy said Tuesday that McConnell is expected to present GOP senators with a "binary choice" in Tuesday's lunch between getting a deal done among them or having to work with Democrats, which is a less palatable option.

The person, who spoke on the condition of anonymity, said another main purpose of the meeting will be for Cruz to have the chance to pitch his controversial amendment, particularly to skeptical moderates.

Asked about his plans, Cruz spokeswoman Catherine Frazier said the senator has made his case "numerous times" and stands ready to do so again.

McConnell did not immediately respond to a request for comment.

Senate leaders have serious concerns that the Cruz amendment might violate a set of budget rules that the health-care measure must meet in order to pass with 51 votes rather than the 60 votes needed for most other legislation. The overall bill needs to save at least $133 billion to comply with those rules.

Leaders are still waiting for the Congressional Budget Office to produce an analysis determining the budgetary and coverage impact of the Cruz amendment, but some aides said they worry the outcome could be devastating to the overall savings in the bill.

Douglas Holtz-Eakin, a former CBO director, said it appears that Cruz's amendment would send all of the young, healthy people who are cheaper to cover into one insurance pool – and leave sicker, older people "in a glorified high-risk pool."

"It would be expensive and possibly not particularly stable," Holtz-Eakin said in an interview. "If the public-policy goal is to give people access to affordable insurance options, there's a set of people who would just not have access to that."

Holtz-Eakin said he would expect insurers to flee the exchanges even faster than they are under current policy, driving up premiums and forcing the federal government to increase subsidies to keep up with the skyrocketing rates.

The concern over how the change could create two separate pools of consumers, paying very different insurance rates, has prompted a group of more moderate rank-and-file senators to pitch a plan that they say would curb the risk of that sort of segmentation. Sen. Mike Rounds, R-S.D., said he spoke with McConnell and Senate Majority Whip John Cornyn, R-Texas, Monday night in a private conversation on the Senate floor.

Rounds said he wants to create a fixed ratio between the least expensive plan and the most expensive plan that each company offers in a given state, though he did not offer details on how this goal would be achieved.

"Once you establish that, based on an actuarial determination, that ratio wouldn't change," Rounds said.

Rounds said he also asked McConnell to consider keeping a 3.8 percent tax on investment income for individuals earning more than $200,000 annually and couples earning more than $250,000 for six more years. Several individuals familiar with GOP leaders' thinking, who asked for anonymity because no final decision has been made, said this idea is under active consideration.

The tax is among several proposed for elimination in the current Senate proposal.

By keeping it in place for anywhere between five and seven years, Rounds and others said, the federal government could steer more money to a stabilization fund that could to help offset consumers' health care costs while the new GOP plan goes into effect. Some conservatives have said they could support that plan, provided that Cruz's amendment is also included in the GOP's base bill.

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