Just as the House health bill had to be pulled, the Senate bill has now been delayed. Taking another couple of weeks to pass the thing certainly makes more sense than trying to jam it this week and probably losing, potentially quite badly. McConnell is pushing hard to get to a deal for 50 votes by the end of the week, then leave for the break, get a new CBO score, and vote on it when they are back.
A deal won’t be easy or simple, but it is certainly doable: a few more structural reforms in the individual market and more robust HSAs for the conservatives, more spending for the Medicaid moderates. Everyone seems to think Rand Paul and Susan Collins are “no” regardless, which means there is literally no margin for error. Is Dean Heller gettable? If not, the bill is very likely to go down. It seems to me that he’s put himself in an awkward spot with his very public posture. If he comes along, no matter what concessions he gets, it’s going to play like a climb-down.
This process is almost entirely a matter of the caucus negotiating with itself, with no meaningful input from the president. Trump was his boosterish self at the meeting with Republican senators this afternoon, but he knows and cares so little about the details that I’m told he would agree with whatever was said, even if senators were directly contradicting one another. Pence, meeting with conservative senators tonight, is playing a more hands-on role.
This is all a version of what happened in the House, when the bill seemed dead and then was resurrected with member-to-member dealmaking. You have to be less optimistic about the Senate’s chances because the caucus needs near-unanimity, but this isn’t over yet.