After an emotional public hearing, and a debate about font size, the King County Board of Health imposed a new rule on crisis pregnancy centers, many of which are faith-based, requiring them to post signs saying theyre not health care facilities.

Facilities commonly referred to as crisis pregnancy centers, many of which are faith-based, will be required to post a sign telling patients they are not health-care facilities, under a new rule approved Thursday by the King County Board of Health.

After emotional public testimony, mostly against the signs, nine of 10 board members voted for the rule saying their action was meant to bring transparency and accurate information to pregnant women. Only Metropolitan King County Councilmember Kathy Lambert dissented.

I believe women who are pregnant deserve complete, accurate and timely information about their health care and options, said board Chairman Rod Dembowski, a King County Council member. These centers are unregulated and are often staffed by volunteers and employees who lack medical training or licensure.

At least eight of the pregnancy centers operate in King County, according to the feminist group Legal Voice.

A report by Legal Voice, included in the Board of Health records for the regulation, said the centers give medically inaccurate information about abortion and some dont tell patients that they dont provide abortions or make referrals involving abortion and contraception. The groups report was based on visits to the centers by trained volunteer college and law students.

Employees and supporters of the centers strongly disagreed.

That report was an absolute lie, said Kim Triller, executive director of Care Net of Puget Sound.

They did tell me about all options available, said Jessica Johnson of Seattle, who said when she was pregnant more than a year ago, Care Net provided her an ultrasound and parenting classes at no cost. Everyone knows where you can go if you want an abortion, Johnson said.

Lambert offered similar reasoning for her dissent, saying an internet search will provide options for contraception and abortions.

Jonny Nicoli, a supporter of the centers, scoffed at the idea that the rule just required signs. Thats the same way a powerful government oppressed the Jewish population, by putting up signs, he said.

Board members Deborah Juarez and M. Lorena Gonzlez, both Seattle City Council members, said the new requirement wouldnt close the facilities down.

When a woman walks in she should know Im not in a clinic, or Im in a facility where wonderful people are offering faith-based services, Juarez said.

Gonzlez said the rule aims to ensure that women are not deceived by health care information given by people who are not qualified to dispense it.

The new rule requires that the pregnancy centers, also known as limited-service pregnancy centers, post a sign saying, This facility is not a health care facility. That sentence must be posted in 10 languages, including English, with all of the languages in 48-point type size.

Board members said they intended for the sign to be posted in entry ways or waiting areas, so that its readable to people.

The exact size of the sign led to debate and votes on amendments. Lambert proposed that signs should be 8.5 by 11 inches. Only Sally Bagshaw, a Seattle City Councilmember supported that amendment. Were fooling ourselves to think we can do it on 8-and-half by eleven, said Dr. Bill Daniell, a board member.

The board voted that the sign should be at least 11 by 17 inches.

Failure to post a sign could lead to fines of $100 per day. Violations would be complaint-based, Dembowski said. A staff report said enforcement would cost be roughly $40,000 a year.

Pro-choice groups have been pressing for more disclosure from the pregnancy centers for years. Legal Voice and Planned Parenthood Votes Washington published a report in 2011 based on volunteer visits to several local centers in 2008 and 2009. Legal Voice said it updated the report with visits in 2016 and this year.

Dembowski said the board has been dealing with the issue for more than year, mostly on the legal aspects about the government compelling speech by the centers.

He said the rule has been reviewed and refined with attorneys considering case law and similar regulations, including one in California upheld by the Ninth Circuit Court of Appeals.

Im comfortable weve narrowly tailored the regulation to achieve a legitimate public health interest, he said.

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Crisis pregnancy centers must post disclaimers stating 'Not a health care facility' under King County rule - Seattle Times

WASHINGTON (Reuters) - Republicans struggling to agree on healthcare legislation to overhaul Obamacare obeyed U.S. President Donald Trump's orders to try to swiftly reach a deal but were unable to resolve their differences in a long, late-night meeting.

Earlier on Wednesday, Trump took Senate Republicans to task for failing to agree on how to dismantle Obamacare, as a new report showed 32 million Americans would lose health insurance if senators opt to repeal the law without a replacement.

Trump gathered 49 Republican senators for a White House lunch after a bill to repeal and replace the 2010 Affordable Care Act collapsed on Monday amid dissent from a handful of the party's conservatives and moderates.

After Trump's exhortation to keep trying, party members met with Health and Human Services Secretary Tom Price behind closed doors on Wednesday night to try to finally come together on a major Republican promise of the past seven years - undoing former Democratic President Barack Obama's signature legislation, popularly known as Obamacare.

There was no immediate breakthrough.

"We still have some issues that divide us," said Senator Ted Cruz, a conservative who has proposed letting insurers offer cheaper bare-bones plans that do not comply with Obamacare regulations.

Republicans attending the late meeting sent their staff away in order to talk frankly and Senator John Kennedy said everyone was negotiating in good faith but he added he did not know if they would reach agreement.

Almost all the other senators rushed off after the meeting without comment.

As it was getting underway, the nearly two dozen Republican senators were shaken by news that their colleague, veteran Senator John McCain, had been diagnosed with brain cancer.

McCain's absence from the Senate makes the job of passing a healthcare bill more difficult because leaders need every Republican vote they can get.

"Obviously, I think more people are worried about his health than thinking about the math. You understand the math. Obviously it makes things difficult," Senator Bob Corker said as he left the meeting.

Trump had taken a hands-off approach to the healthcare debate last week and suggested on Tuesday that he was fine with letting Obamacare fail. Then on Wednesday he switched course and demanded senators stay in Washington through their planned August recess until they find common ground on healthcare.

"We can repeal, but we should repeal and replace, and we shouldn't leave town until this is complete," Trump said at the meeting.

Trump made the repeal and replacement of Obamacare, which he has called a "disaster," a central promise of his 2016 campaign.

Even with Trump's new push, Republican leaders in the Senate face a difficult task getting moderates and conservatives to agree on an overhaul that can pass.

Senate Majority Leader Mitch McConnell had planned to hold a straight repeal vote next week, but several Republican senators have already said they oppose that approach.

Thirty-two million Americans would lose their health insurance by 2026 if Obamacare is scrapped without an alternative in place, the nonpartisan Congressional Budget Office reported on Wednesday, while 17 million would become uninsured next year alone.

At the same time, premiums on individual insurance plans would rise 25 percent next year and double by 2026.

The CBO's estimates were unchanged from a previous report that assessed the impact of a 2015 bill to repeal Obamacare that passed the House of Representatives and Senate and was vetoed by Obama.

Democrats were swift to highlight the CBO's assessment, while Republicans remained silent.

"President Trump and Republicans have repeatedly promised to lower premiums and increase coverage, yet each proposal they offer would do the opposite," Senate Democratic leader Charles Schumer said in a statement.

Insurers and hospitals have lobbied against straight repeal, saying the limbo would increase uncertainty and their costs.

"CBO projects half the country would have no insurers in the individual market by 2020 under the new repeal bill. That's a true death spiral," tweeted Larry Levitt, vice president at the Kaiser Family Foundation, a healthcare research group.

Republicans say Obamacare is a costly intrusion into the healthcare system.

But the party is divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to Obamacare, which boosted the number of Americans with health insurance by 20 million through mandates on individuals and employers, and income-based subsidies.

Moderate Republican Senators Susan Collins, Lisa Murkowski and Shelley Moore Capito said they opposed McConnell's plan for a repeal that would take effect in two years. All three attended the lunch with Trump.

With Democrats united in opposition to repeal, McConnell can only lose two votes from the Republicans' 52-48 majority in the 100-seat Senate to pass healthcare legislation.

Opponents of repeal protested throughout Senate buildings on Wednesday afternoon, leading to 155 arrests, police said. Demonstrators returned in the evening to yell as senators arrived for the meeting.

Party fractures also emerged in the House of Representatives. The chamber passed a plan to repeal and replace Obamacare in May. But on Wednesday, the House Freedom Caucus, the Republican Party's conservative wing, filed a petition to vote on a straight repeal.

House Speaker Paul Ryan's spokeswoman, AshLee Strong, said: "The House passed an Obamacare repeal-and-replace bill we are proud of and we hope the Senate will take similar action."

Writing by John Whitesides and Lisa Lambert; Additional reporting by Susan Cornwell, Richard Cowan, Yasmeen Abutaleb and Susan Heavey; Editing by Leslie Adler, Peter Cooney and Richard Pullin

Link:

Republicans meet late into night as Trump demands new healthcare plan - Reuters

Republicans should abandon the process of health care reform and move on to tax reform, said Charles Krauthammer. Its going to be suicidal to go ahead with the vote next week.

Krauthammer explained why Republicans should move ahead with tax reform:

I think they have a good chance of working something out on tax reform. Thats their strength; thats what I would have recommended they start with. I think the best thing to do now, ironically, is to walk away. I think its going to be suicidal to go ahead with the vote next week; its going to be a repudiation. Its going to be a vote to proceed, meaning that the Republicans who vote against it and there will be enough, I think, to shoot it down are saying, were done with this. Well, you dont have to have it officially on the record. Just walk away and go immediately to something perhaps even radical on tax reform.

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Krauthammer's Take: It Would Be Suicidal to Proceed with the Health Care Vote - National Review

News of Sen. John McCainJohn McCainMcCain diagnosis looms over GOP healthcare talks Graham on McCain cancer diagnosis: 'This disease has never had a more worthy opponent' Lawmakers send Sen. McCain well wishes after cancer diagnosis MOREs diagnosis of brain cancer loomed over a previously scheduled meeting on healthcare negotiations on Wednesday night.

Sen. James Lankford (R-Okla.) lead more than a dozen GOP senators in prayer as they found out about the Arizona Republicans condition during the closed door talks, with senators emerging from the meeting sober faced and full of praise for their colleague.

We prayed. It was very emotional. It was almost kind of stunned disbelief for a minute, Sen. John HoevenJohn HoevenMcCain diagnosis looms over GOP healthcare talks This week: ObamaCare repeal faces latest setback in Senate Centrist Republicans push back on GOP healthcare bill MORE (R-N.D.) said after emerging from the hours-long talk.

Sen. John Kennedy (R-La.)describing senators as shocked and upsetadded that we stopped and said a prayer for John and his family.

Sen. Lindsey GrahamLindsey GrahamMcCain diagnosis looms over GOP healthcare talks Graham on McCain cancer diagnosis: 'This disease has never had a more worthy opponent' John McCain diagnosed with brain cancer MORE (R-S.C.), one of McCains best friends and closest Senate allies, appeared visibly emotional as he recounted his conversation that he had on Wednesday with McCain.

"He says I've been through worse, he told reporters. "So pray. ...This disease has never had a more worthy opponent.

McCains office announced on Wednesday night a brain tumor was discovered after the senior Arizona senator underwent a minor procedure last week to remove a blood clot from above his left eye.

The 80-year-old lawmakers diagnosis raced through Washington, sparking offers of support from members of both parties.

Sen. Ted CruzTed CruzMcCain diagnosis looms over GOP healthcare talks Lawmakers send Sen. McCain well wishes after cancer diagnosis As innovators shoot for the moon how will we regulate commerce? MORE (R-Texas) emerged from the GOP healthcare meeting recounting McCains time as a prisoner of war, calling him a man who fought and bled and served our nation.

All of us stopped. It was a sobering moment. John is someone we work with, we serve with, we respect, and it is very sad news, he said.

Sen. Mike Rounds (R-S.D.) noted McCain was as tough as they come. Meanwhile, McCains Democratic colleagues weighed in through social media praising the senatorwho is widely respected in both parties.

You are a true fighter [and] I'll be praying for you until you beat this. I know you will, Senate Minority Leader Chuck SchumerCharles SchumerMcCain diagnosis looms over GOP healthcare talks Lawmakers send Sen. McCain well wishes after cancer diagnosis OPINION | GOP's 7-year ObamaCare blood oath ends in failure MORE (D-N.Y.) tweeted.

President Obama, who defeated McCain in the 2008 election and served with him in the Senate, added cancer doesn't know what it's up against. Give it hell, John.

McCain's office, in its statement, didnt indicate when the Arizona lawmaker could return to the Senate, but said he is in good spirits and confident any treatments will be effective.

The Senator and his family are reviewing further treatment options with his Mayo Clinic care team. Treatment options may include a combination of chemotherapy and radiation, the hospital, which performed the initial surgery, said in a statement released by McCains office.

Further considerations with his doctor will determine when he returns to the Senate, according to his office.

Weve already heard from him. He sent word that he wants to get back. ...Hes a real warrior, and hes a national hero, Hoeven said.

Graham added that he spoke to McCain about healthcare and the National Defense Authorization Act (NDAA)an annual defense bill McCain shepherds through the Senateduring their phone call.

The announcement of McCain's diagnosis came as the Arizona Republican has been absent from Washington this week recovering from his surgery last Friday.

The surprise surgery forced Senate Republicans to delay a vote on their healthcare plan, which was initially expected this week, until next week.

Though GOP senators stressed their top priority is McCain's health, they also acknowledged on Wednesday night that if he remains absent it could complicate their push to pass the legislation.

Obviously I think more people are worried about his health, and not thinking about the math, but, you know, you understand the math, so obviously it makes things difficult, Sen. Bob CorkerBob CorkerMcCain diagnosis looms over GOP healthcare talks Compounds fate raised after Trump-Putin talk Tensions linger between Trump and GOP lawmakers MORE (R-Tenn.) told reporters after he left the closed-door meeting.

Sen. Pat Toomey (R-Pa.), after praising McCain, added after the meeting it does complicate things and I just don't know if he can be back next week."

McCains absence from Washington leaves GOP leadership with an even narrower path to passing their bill.

With all 100 senators voting Senate Majority Leader Mitch McConnellMitch McConnellMcCain diagnosis looms over GOP healthcare talks Lawmakers send Sen. McCain well wishes after cancer diagnosis Oil concerns hold up Russia sanctions push MORE can afford to lose two GOP senators and still let Vice President Mike PenceMike (Michael) Richard PenceMcCain diagnosis looms over GOP healthcare talks Rhode Island becomes ninth state to enact automatic voter registration After Trump scolding, Senate to try again on ObamaCare repeal and replace MORE break a tie. With McCain absent and all other 99 senators voting, he can only afford to lose one GOP senator, which would let him get a 50-49 vote.

GOP senators huddled in Sen. John BarrassoJohn BarrassoMcCain diagnosis looms over GOP healthcare talks Source: Senate leaders to offer 0 billion to win over moderates GOP takes aim at reforming Endangered Species Act MOREs office for more than two hours on Wednesday night as they try to revive their plan to move ObamaCare repeal and replacement in one bill.

The renewed effort comes after Senate Republicans attended a closed-door lunch with President Trump and emerged pledging to give their healthcare bill one last final try.

"There are going to be some meetings tonight up here with people who have issues, still have outstanding issues, I think the question will be ... can we find a way to yes," Sen. John ThuneJohn ThuneMcCain diagnosis looms over GOP healthcare talks Overnight Healthcare: Trump plays hardball on ObamaCare | Senators revive negotiations | CBO says repeal without replace would cost 32M insurance Trump plays hardball on ObamaCare repeal MORE (R-S.D.) told reporters earlier Wednesday.

A source told The Hill earlier Wednesday that Senate Republican leaders are getting ready to propose giving $200 billion in assistance to states that expanded Medicaid.

Republicans are expected to try to take up a House-passed healthcare bill, which is being used as a vehicle for any Senate action, early next week. GOP leadership will need a simple majority to get on the bill.

If that is successful they will either offer as an amendment to the legislation their 2015 repeal-only billwhich doesnt have enough support to succeedor if they can get a deal they will offer a revised version of their proposal to both repeal and replace ObamaCare.

Rachel Roubein, Alexander Bolton and Nathanial Weixel contributed to this story

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McCain diagnosis looms over GOP healthcare talks - The Hill

Americans for Prosperity, the Koch group that will be most involved in the push, says it has spent nearly $1 million so far on lobbying and advertising efforts, including more than 500 meetings with lawmakers and their staff members on Capitol Hill and ads directed at Republicans on the Senate and House committees responsible for tax policy. By the time debate begins on a tax bill, expected later this year, the group will most likely have spent several million dollars more, its strategists said.

The American Action Network, another conservative policy group, expects to invest more than $20 million in an advertising campaign promoting tax changes, more than it spent pushing for the health care bill.

The American Action Network spent $15 million on health care reform since Jan. 1, said Corry Bliss, the groups executive director. Looking ahead to the tax initiative that were all waiting for, he added, $15 million from our perspective is the starting point.

Underlying this kind of spending on a policy, no less, that was once expected to be a relatively easy lift for Republicans is a rising sense of urgency. Republicans fear they could be looking at a worst-of-two-worlds scenario in which they have a historically unpopular president dogged by persistent legal and ethical questions, at the same time they are unable to restore a semblance of functionality to Capitol Hill.

Watching efforts to repeal and replace the Affordable Care Act fall apart was more than just a setback for conservatives who disliked the law, which expanded the governments role in health care and created an expensive new entitlement program. For some, it was a demoralizing glimpse into a future in which Republicans have all the power in Washington but are powerless to do anything with it.

Anytime a party is given this kind of opportunity, youre judged by the product you produce, said Josh Holmes, a Republican strategist and former aide to Mitch McConnell, the Senate majority leader.

The inability to produce is especially problematic for the Republican Party, which portrays itself as more capable and efficient when it comes to running an unwieldy federal bureaucracy. Where Republicans have their biggest problem, Mr. Holmes said, is when all of a sudden they look like they dont have their hand on the wheel.

In that sense, it is competence and not the accusations of corruption or collusion that have led to various investigations into the Trump campaigns ties to Russia that most worries many Republicans.

A perception of ineptitude could be especially damaging for President Trump, who portrays himself as a master problem-solver and deal maker and promised voters that the country under his leadership would be run so competently, youre going to be so sick and tired of winning.

Many conservatives brushed aside doubts about Mr. Trumps readiness to be president, and his true commitment to conservatism, and voted for him because he represented their best shot at pursuing an agenda that would begin rolling back what they saw as an egregious expansion of government under President Barack Obama.

And while conservatives have much to cheer under Mr. Trumps presidency so far a decidedly conservative new Supreme Court justice, a rollback of regulations on business, and plans to withdraw from the Paris climate pact he has yet to fulfill some of his biggest campaign promises.

Planned Parenthood has retained its federal funding, despite Mr. Trumps repeated vows to cut the group off, a promise that has died, for now, with the health care bill. Just this week, Mr. Trump recertified the international agreement with Iran that curtails its nuclear program, despite having repeatedly said that it was the worst deal ever and that he would renegotiate it. And construction of the wall he promised along the countrys southern border has not begun.

The governing party has to govern, said John Shadegg, a Republican former congressman from Arizona. And especially when you make the case for eight years that you can do it: Give us the House; we can fix this. Give us the Senate; we can fix this. Give us the White House and we can fix this.

You cannot make a promise for eight years, he continued, and simply say, Eh, when push came to shove, our promises turned out to be wrong or too difficult.

Mr. Trumps supporters have demonstrated a tendency to forgive. But Republican lawmakers may find voters far less sympathetic. And as conservatives digested news on Tuesday of the failed health care effort, their disgust was evident.

We may well be witnessing one of the greatest political whiffs of our time, said Rich Lowry, editor of National Review.

In an editorial on Wednesday, The Wall Street Journal described the weeks events as one of the great political failures in recent U.S. history, going as far as endorsing efforts to unseat the disloyal senators. If the Obamacare Republicans now get primary opponents, they have earned them, the paper said.

As the radio host Hugh Hewitt took calls from irate listeners, he predicted political ruin for Republican senators, like Dean Heller of Nevada, who had opposed the bill. Boy, are people mad, he said. They are mad as hell.

But banking on a tax overhaul as a springboard for a dispirited Republican Party may not be a sure thing. The issue does not have the potency and emotion of the Affordable Care Act, which also had an easily demonized antagonist in Mr. Obama. Democrats will be waiting to pounce with criticism that the Republican plan is a big giveaway to the rich. And the conservative grass roots may find the policy lacking in populist appeal.

Either way, said Levi Russell, director of public affairs for Americans for Prosperity, Republicans need to move in unison on this issue.

Clearly, thats what we lacked during the health care debate, he added. Republicans were not unified around a solution.

Get politics and Washington news updates via Facebook, Twitter and in the Morning Briefing newsletter.

A version of this article appears in print on July 20, 2017, on Page A16 of the New York edition with the headline: Health Care Has G.O.P. Down. Tax Cuts May Be Cure.

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Health Care Has G.O.P. Down. Tax Cuts May Be the Cure. - The ... - New York Times

Fox News's Meghan McCain said Wednesday that Republicans shouldn't expect any "participation trophies" for their unsuccessful efforts to repeal and replace the Affordable Care Act.

"I think people collectively are very angry, because they elected President Trump on repeal-and-replace, one of the major issues," McCain, thedaughterof Sen. John McCainJohn McCainMcCain diagnosis looms over GOP healthcare talks Graham on McCain cancer diagnosis: 'This disease has never had a more worthy opponent' Lawmakers send Sen. McCain well wishes after cancer diagnosis MORE (R-Ariz.), said. "And yesterday, I thought the messaging was very strange, just sort of saying, 'We're gonna let it fail, this isn't on me, we almost got it."

"There are no ... participation trophies for this," she added.

Trump said Tuesday he and congressional Republicans would "let ObamaCare fail" and that the GOP would not take responsibility for the current healthcare law. Trump made the comments following the collapse of GOP efforts in the Senate to advance a repeal-and-replace bill.

"We're not going to own it. I'm not going to own it," Trump told reporters. "I can tell you the Republicans are not going to own it. We'll let ObamaCare fail and then the Democrats are going to come to us."

Trump has since called for the Senate to continue work on a healthcare reform plan, though his comments Tuesday cast doubt on Republicans' ability to fulfill their seven-year promise to repeal and replace the Affordable Care Act.

Despite holding the White House and majorities in the House and the Senate, Republicans have struggled in their efforts to overhaul the country's healthcare system.

House Republicans narrowly passed their version of a healthcare reform measure in May. But in the Senate, GOP lawmakers have faced even stronger infighting over how to tackle healthcare.

Opposition from key moderates and conservatives effectively killed the Senate's bill on Monday, leaving uncertain the future of Republicans' healthcare reform efforts.

Updated at 3:12 p.m.

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Meghan McCain: No 'participation trophies' for GOP on healthcare - The Hill

In remarks prepared for a meeting with Senators at the White House, President Donald Trump told Republicans: "We can repeal, but we should repeal and replace, and shouldn't leave town" until the bill is complete. (July 19) AP

President Trump(Photo: Alex Brandon, Alex Brandon, AP)

WASHINGTON One day after President Trump declared he wanted to let the current health care law fail, he pressed Republican senators to agree to an alternative plan to replace Obamacare before taking any August recess.

"I don't think we should leave town unless we have a health insurance plan," Trump said during a White House lunch attended by 49 of the 52 Republican senators. "We shouldn't leave town until this is complete, until this bill is on my desk."

ButSenate Majority Leader Mitch McConnell, R-Ky., was already hedging about whether that's possible.

He promised to hold a vote next week to debate a bill to simplyrepeal Obamacare without a replacement but it's not clear whether he even has the votes to do that.

"It's pretty obvious we've had difficulty in getting 50 votes," McConnell said.

Related:

Trump's latest health care strategy: Let Obamacare fail

Analysis: What can Republicans do if they can't repeal Obamacare?

Senate plan to repeal Obamacare appears doomed as moderates balk

The president also issued a warningto Republicans who want to delay taking action. "Any senator who votes against debate says you are fine with Obamacare," he said.

Trump made his demands while seated next to Sen. Dean Heller, R-Nev., who is considered vulnerable in next year's congressional elections and has opposed Republicans'health care plans. Trump backers have also threatened a primary challenge of Heller over his recalcitrance.

In an apparent reference to thepolitical minefield Heller is facing on health care, Trump said:"Look, he wants to remain a senator, doesn't he?"

Two of the three GOP senators not in attendance John McCain of Arizona and Johnny Isakson of Georgia are recovering from surgery.The third missing senator, Richard Burr of North Carolina, said he couldn't attend because he was presiding over the Senate at lunch.

The less-than-perfect attendance at the White House underscoresthe difficulties for Trump and Republicans, even though they control both chambers of Congress. McConnellhas been unable to secure enough support to repeal and replace Obamacare. He is willing to repeal the law and hold a vote on it next week but there are already three Republican senators who say they wont vote to bring it to the floor.

In making his plea toRepublicans, Trump also tore into his critics, singling out Senate Democratic leader Charles Schumer of New York, who has said the GOP health care plan is a matter of life and death for Americans who might lose coverage. "He was saying death, everyone's going to die Death! Death!Death!" Trump said. "That's the only thing they're good at."

The president also denounced predecessor Barack Obama as well as the health care law that bears his name, telling senators Obamacare was a big lie," and "it was a lie directly from the president."

Trump is making an aggressive push to achieve some kind of victory on health care, after several days of mixed messages.

After GOP leaders announced Monday night they would pull a bill to "repeal and replace" the 2010 health care law signed by Obama, Trump said he was inclined to simply leave the current law in place, predicting it would "fail" and force Democrats to cooperate on a new plan.

"Were not going to own it Im not going to own it I can tell you, the Republicans are not going to own it," Trump told reporters at the White House on Tuesday, "Well let Obamacare fail and then the Democrats are going to come to us, and theyre going to say, 'How do we fix it?'"

Yet by Wednesday morning, Trump who has sent conflicting signals throughout the health care debate over the course ofthe year changed his tune, telling senators: "We can repeal, but we should repeal and replace ... I'll sign it."

Still, as he announced Wednesday's lunch meeting, Trump already appeared to be distancing himself from his party or the fate of the repeal and replace efforts,repeatedly referring to Republicans as "they" and the health care plan as "their" bill.

Tweeting ahead of his lunch with the Senate Republicans, Trump said "they MUST keep their promise to America!"

"The Republicans never discuss how good their healthcare bill is, & it will get even better at lunchtime," Trump said in another post. "The Dems scream death as OCare dies!"

Trump campaigned on a pledgeon a campaign to repeal and replace Obamacarewith a plan that does not cut Medicaid, covers "everybody," and provides people with preexisting conditions similar coverageas current law.

He cheered passage of a House plan which passed by a narrow217to 213 margin and even hosted a party in the White Houseto celebrate its passage in early May.

The Congressional Budget Office said the House billwould lead to 23 million fewer people having health insurance by 2026 ascompared toObamacare. Andthe health care issued moved to the Senate, Trump declared the House bill too "mean," and urged GOP senators to make changes.

Now,Democrats are saying the Republicans should work with them,instead of Trump, given the president's recent comments. "Dothey want to take the path of President Trump, who yesterday said he wanted our healthcare system to fail, or do they want to work with Democrats on legislation to improve the law?" said Democratic leader Charles Schumer of New York.

Trump held a similar White House meeting with the Senate Republican caucus last month.At that confab, the president sat between GOP senators Susan Collins of Maine and Lisa Murkowski of Alaska both of whom were in opposition to the Republican alternative to Obamacare.

Republicans have had a variety of objections to a health care plan that had been pushed by McConnell.

Some, including Collins and Murkowski, protested rollbacks in the Medicaid program. Some of the more conservative Republicans, such as Sen. Mike Lee of Utah, said the GOP plan did not go far enough in repealing Obamacare, particularly its tax provisions.

It was a Monday night announcement by Lee and Republican Sen. Jerry Moran of Kansas that forced McConnell to shelve the Republican repeal and replace plan

As Republican senators planned to head to the White House, Moran told reporters: "I dont know what the next step is."

Contributing: Eliza Collins

Read more:

3 promises Trump made about health care that repeal plans haven't kept

Analysis: At the six-month milestone, can Trump turn around his struggling presidency?

The Bubble: Health care fail has conservatives calling for McConnell's head

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Trump demands Republicans replace Obamacare before August recess, but McConnell is wary - USA TODAY

Capitol Police on Wednesday arrested approximately 155 people protesting an effort by Senate Republican leaders to repeal the Affordable Care Act.

Police responded to reports of demonstrations in the Senate office buildings, warning protesters to cease and desist. Those that didn't, Capitol Police said in a statement, were arrested and charged with "Crowding, Obstructing, or Incommoding."

Four protesters were also charged with resisting arrest, according to Capitol Police.

Protesters targeted the offices of GOP senators, as Republican leaders in the chamber push for a vote on a measure that would simply repeal ObamaCare.

That measure is unlikely to pass a vote in the Senate. It is unanimously opposed by Democrats, and some Republicans have voiced deep misgivings about repealing the law without immediately replacing it.

A proposalto repeal and immediately replace the ACA was effectively killed on Monday, after key Republicans announced that they would not support the measure.

The Congressional Budget Office released its assessment of the repeal bill on Monday, estimating that it would increase the number of uninsured by some 32 million people by 2026.

That prompted President Trump to call on GOP lawmakers to simply repeal the existing law and pass a replacement plan down at some point in the future.

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Capitol Police arrest 155 people at healthcare demonstrations - The Hill (blog)

Former Vice President Al GoreAl GoreAl Gore warns Democrats about accusing Trump of treason Overnight Energy: GOP moves to reform Endangered Species Act Budowsky: Dems need council of war MORE called for a single-payer healthcare system this week amidthe collapse of the Senate GOP's plan to repeal and replace ObamaCare.

The private sector has not shown any ability to provide good, affordable healthcare for all, Gore said Tuesday at an event atBorough of Manhattan Community College in New York,The Huffington Postreported.

I believe we ought to have single-payer healthcare.

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Gore, a Democrat, didn't include single-payer healthcare in the platform for his unsuccessful 2000 presidential bid against George W. Bush.

Gore has spoken about such a system before. In 2002, he said he"reluctantly" had come to the conclusion that an effort to "begin drafting" a national single-payer healthcare plan was necessary.

I think weve reached a point where the entire healthcare system is in impending crisis, Gore said at the time. I have reluctantly come to the conclusion that we should begin drafting a single-payer national health insurance plan.

Republicans are looking to plot a path forward after opposition from GOP senatorssunk a plan to repeal and replace former President Barack ObamaBarack ObamaObama sends well wishes to McCain: 'Cancer doesn't know what it's up against' John McCain diagnosed with brain cancer House votes to streamline pipeline reviews MORE's signature healthcare law this week.

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Gore calls for single-payer healthcare - The Hill

Counselor to the President Kellyanne Conway told Fox News' "Hannity" Wednesday night that Republican senators "would be held accountable" if they voted against repealing ObamaCare.

"Any Republican Senator who votes against a motion to proceed [on repeal] is basically saying, 'were proceeding with ObamaCare,'" Conway told host Sean Hannity. "If you dont like the bill, do what [Texas Sen.] Ted Cruz did ... He offered an amendment. If you dont like it ... go to the Senate floor and say how to improve it."

Conway spoke to Fox News hours after President Trump told senators to stay in session until an ObamaCare repeal bill is sent to his desk.

"The presidents done his job. He ran successfully on repealing and replacing ObamaCare," she said. "The House bill got passed and he is waiting right behind me, in his office, pen in hand, ready to sign it."

Conway also addressed the controversy over a previously undisclosed conversation between Trump and Russian President Vladimir Putin at the G-20 summit in Germany earlier this month, calling the reaction "over the top."

"Any description of this as an undisclosed, secret, second, furtive meeting is complete nonsense." she said. "This is what leaders do. They talk to each other. They talk to each other in sit downs for two hours and 15 minutes ... And they also talk to each other when their spouses are seated next to the world leaders [at dinner]. So this is just another attempt to bring Russia into the conversation."

Continue reading here:

Conway: GOP senators 'will be held accountable' for health care votes - Fox News

Video Trump on G.O.P.s Failed Health Care Bill

The president spoke today about the collapse of the Republicans plan to repeal and replace the Affordable Care Act.

WASHINGTON President Trump said early Tuesday that Democrats and a few Republicans were at fault for the collapse of health care legislation in the Senate, and he restated his strategy to let the Affordable Care Act fail.

In a pair of morning tweets, Mr. Trump said, We will return, but he provided no specifics.

Senate Republicans hopes for a health care bill died Monday night when two Republican senators said they would oppose their partys bill to repeal the Affordable Care Act, leaving the Senate at least two votes short of what would be needed to start the debate on the proposed law.

On Monday night, Senator Mitch McConnell, the Republican leader, said that the effort to repeal and immediately replace the failure of Obamacare will not be successful.

He described a plan to vote now on a measure to repeal President Barack Obamas signature law. But that is unlikely to pass, because it could leave millions without insurance and is likely push insurance markets into turmoil.

Continue reading here:

Trump, Tweeting About Health Care, Says, 'We Will Return' - New York Times

In announcing his opposition to the bill, Mr. Moran said it fails to repeal the Affordable Care Act or address health cares rising costs.

Vice President Mike Pence, Speaker Paul D. Ryan and Senator Mitch McConnell, the majority leader, discuss the next steps.

There are serious problems with Obamacare, and my goal remains what it has been for a long time: to repeal and replace it, he said in a statement.

In his own statement, Mr. Lee said of the bill, In addition to not repealing all of the Obamacare taxes, it doesnt go far enough in lowering premiums for middle-class families; nor does it create enough free space from the most costly Obamacare regulations.

By defecting together, Mr. Moran and Mr. Lee ensured that no one senator would be the definitive no vote.

House Republicans, after their own fits and starts, passed a bill to repeal the Affordable Care Act in May, a difficult vote that was supposed to set the stage for Senate action. But with conservative and moderate Republicans so far apart in the Senate, the gulf proved impossible to bridge. Conservatives wanted the Affordable Care Act eradicated, but moderates worried intensely about the effects that would have on their most vulnerable citizens.

The Senate Democratic leader, Chuck Schumer of New York, responded to the announcement on Monday by urging his Republican colleagues to begin anew and, this time, undertake a bipartisan effort.

This second failure of Trumpcare is proof positive that the core of this bill is unworkable, Mr. Schumer said. Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health care system.

A comparison of public meetings on Obamacare and the Republican bills to repeal it.

Roughly 20 million people have gained coverage through the Affordable Care Act. Repealing the law was a top priority for Mr. Trump and Republicans in Congress, who say it has driven up premiums and forced consumers to buy insurance they do not want and cannot afford.

The opposition from Mr. Paul and Ms. Collins to the latest version of the Senate bill was expected, so Mr. McConnell had no margin for error as he unveiled it. But he managed to survive through the weekend and until Monday night without losing another of his members though some expressed misgivings or, at the very least, uncertainty.

Mr. McConnell had wanted to hold a vote this week, but he was forced to abandon that plan after Senator John McCain, Republican of Arizona, had surgery last week to remove a blood clot from above his left eye. That unexpected setback gave the forces that opposed the bill more time to pressure undecided senators.

Already, Mr. McConnell was trying to sell legislation that was being assailed from many directions. On Friday, the health insurance lobby, which had been largely silent during the fight, came off the sidelines to blast as unworkable a key provision allowing the sale of low-cost, stripped-down health plans, saying it would increase premiums and undermine protections for people with pre-existing medical conditions.

Mr. McConnell has now failed twice in recent weeks to roll out a repeal bill and keep his conference together for it. He first wanted to hold a vote in late June, only to reverse course after running into opposition.

House Republicans in competitive districts who supported their version of the bill will now have to explain themselves and Democrats are eager to pounce.

Make no mistake, Paul Ryan cant turn back time and undo the damaging vote he imposed on his conference, said Meredith Kelly, a spokeswoman for the Democratic Congressional Campaign Committee. House Republicans all own a bill that would strip health care from 23 million Americans and raise costs for millions more, and it will haunt them in 2018.

Mr. Lee, one of the most conservative members of the Senate, was part of a group of four conservative senators who came out against the initial version of Mr. McConnells bill after it was unveiled last month. He then championed the proposal to allow insurers to offer cheap, bare-bones plans, which was pushed by another of those opponents, Senator Ted Cruz of Texas. But the language ultimately added was not quite what Mr. Lee had been advocating, a spokesman said last week.

Mr. Moran, a reliable Republican vote and a past chairman of the Senate Republicans campaign arm, had announced his opposition to the bill as drafted after Mr. McConnell scrapped plans to hold a vote in late June. He expressed concerns about how it would affect Kansas, including whether it would limit access to health care in rural communities and effectively penalize states, like his, that did not expand Medicaid under the Affordable Care Act.

The pressure on Mr. Moran at home showed no sign of relenting. The Kansas Hospital Association said last week that the revised Senate bill comes up short, particularly for our most vulnerable patients.

Robert Pear contributed reporting.

Get politics and Washington news updates via Facebook, Twitter and in the Morning Briefing newsletter.

A version of this article appears in print on July 18, 2017, on Page A1 of the New York edition with the headline: 2 More Defections Lead To Collapse of Health Effort.

Read more here:

Health Care Overhaul Collapses as Two Republican Senators Defect - New York Times

Senators were just wrapping up dinner at the White House an upbeat chat with President Trump about next steps for healthcareonce they passed the long-promised Republican Obamacare overhaul.

And then the news broke with barely a heads-up to GOP leadership -- that two more Republicans had announced their opposition to the Senate legislation, effectively killing the bill.

Republican senators struggled Tuesday to make sense of what happened and what comes next now that their long promise to repeal and replace the Affordable Care Act appears to have hit the end of the road.

Its unfortunate, Sen. Marco Rubio (R-Fla.) told reporters. I still think it will happen --just not this week or this month.

Republicans did not necessarily blame Trump, who failed to roll up his sleeves to become involved in the process until just this week. Nor did they openly criticize Senate Majority Leader Mitch McConnell for pushing a hodgepodge bill that had scant support.

Ultimately, senators said, they have come to realize that their campaign promise may be easier said than done, and impossible to accomplish with their 52-seat majority.

At the end of the day, just being so close in number and having a few people having different views thats just part of being a senator, said veteran Sen. Orrin Hatch of Utah.

The bottom line was there were plenty of members here who understood the presidents preference and were willing to vote against it anyway, Rubio said. This is the Senate. In the Senate leadership sets agendas, but senators by and large vote for the interests of their states.

Stillsome Republicans were unable to admit defeat.

Sen. Ted Cruz (R-Texas), a key architect of the failed strategy, vowed to press on, even though there appears to be no viable path to repealing the Affordable Care Act or replacing it any time soon with an agreed-upon alternative.

I continue to believe we can get this done, Cruz told reporters. We can honor our promise and repeal Obamcare.

Senators were blindsided late Monday when two colleagues, Sen. Mike Lee (R-Utah), a longtime ally of Cruz, and Sen. Jerry Moran, a more low-key colleague from Kansas, jointly announced they would oppose the bill.

With two other Republicans, Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine), already withholding support, leaders had lost the votes needed to advance the bill.

McConnell quickly produced a back-up plan a vote in coming days on simply repealing ACA now, and replacing it later. That had been McConnells original ideamonths ago, but he abandoned it when Trump and others sought repeal and replace at the same time.

But by early Tuesday McConnells new plan soon fizzled amid opposition.

Sen. Tim Scott (R-S.C.) called the episode a very painful process, Scott said. We are watching the thing unfold on the screens of our TV and the papers you guys write for.

He added, The fact of the matter is we need to find a way to get traction among enough senators to get something accomplished. We dont seem to be there yet.

Sen. James Lankford (R-Okla.), who attended the dinner with a handful of other Republican senators, said the evening had been very positive as they discussed healthcare and other topics with the president.

Thats what was interesting. It was the assumption: Were going to finish this bill. We were talking about the next step.'

Continue reading here:

A nice dinner at the White House, then suddenly Republican healthcare bill was dead - Los Angeles Times

"The Senate should vote to repeal now and replace later or return to the legislation carefully created in the House and the Senate. But either way, inaction is not an option," Pence said. "Congress needs to step up, Congress needs to do their job and Congress needs to do their job now."

Pence used his speech at the National Retail Federation meeting in Washington to deliver a direct message to the Republican senators who bucked their party and came out against the repeal and replace effort on Monday night, all but sinking the Republican's preferred plan.

Most Republicans "were loyal, terrific and worked really hard," Pence said, but some rebelled against the White House and their leadership and signaled that "the Senate still doesn't have consensus to repeal and replace Obamacare at the same time."

After the defeat, Senate Majority Leader Mitch McConnell announced that the Senate would take up the House bill to repeal and replace Obamacare, and then vote on a bill to repeal former President Barack Obama's signature legislative accomplishment.

"President Trump and I fully support the majority leaders' position to move forward with a bill that just repeals Obamacare and gives Congress time, as the President said, to work on a new health care plan that will start with a clean slate," Pence said.

Multiple Republican senators have already signaled that they are either against or skeptical of the McConnell plan, meaning the prospect of that plan working is already fraught.

Pence said that Trump's "inexhaustible optimism and determination" means the fight to repeal Obamacare is not over.

"Stay tuned, we will return," he said, echoing the President. "We will rescue the American people from the disastrous consequences of Obamacare."

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Pence on health care: 'Inaction is not an option' - CNN

In the uncertainty created by the Senate plans collapse, Congress should guard against a hasty next step. Just taking up the fatally flawed House plan is not an answer, and this idea should be immediately rejected for the same reasons senators rejected the Senates own proposal. Also, simply repealing Obamacare without having a workable replacement is just as bad. Both would simply yank health coverage out from under millions of Americans who have no other alternative.

After two failed attempts at reform, the next step is clear: Congress should first focus on fixing the Obamacare exchanges before it takes on Medicaid. If we want to move Americans off Medicaid, there must be somewhere stable for them to go. For all its faults, at least Medicaid is currently a stable system for those who need it. The exchanges are anything but, and need immediate improvements.

One vital improvement would be to provide adequate tax credits, which would help keep health plans in the individual market and encourage not undermine robust competition. Companies should also be required to continue following reasonable guardrails like ensuring minimum coverage that is genuinely useful and covers pre-existing conditions. Once we see these repairs taking hold, Congress should then take up needed improvements to Medicaid as part of comprehensive entitlement reform.

States are willing to assume greater financial risk by transitioning to a block grant or per-capita cap, but will also need new flexibilities, such as tools to manage the rising cost of pharmaceuticals the fastest growing component of Medicaid. And states cannot expect the federal government to continue paying 90 percent of Medicaid expansion costs given our nations historic debt; they must accept a gradual return to traditional cost-sharing levels.

Finally, we can never truly fix the rising cost of health care unless we start paying for value rather than volume. We are making this transition in Ohio by paying physicians for providing better care, not simply more care, in order to pursue better health outcomes.

In resetting health care reform in these ways and I dont rule out that other, balanced approaches bear consideration also Congress can surmount the fatal flaws of both Obamacare and the current approaches: the reflection of a single partisan point of view. Health care policy is only partisan in the abstract. When you or your loved one is sick and needs care, ideology is irrelevant; getting well is all that matters. That same common sense must be reflected in the way we fix Obamacare. Another one-sided plan, driven hard by one party against the wishes of another, can never succeed because it will essentially maintain the status quo: partisan opposition and no real solutions.

The best next step is for members of both parties to ignore the fear of criticism that can come from reaching across the aisle and put pencil to pad on these and other ideas that repair health care in real, sustainable ways. America needs it, and I know that a bipartisan group of governors, including myself, stands ready to help in any way we can to provide an affordable, sustainable and responsible system of health care for the American people.

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John Kasich: The Way Forward on Health Care - New York Times

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'The Daily': A Fatal Blow to the Health Care Bill? - New York Times

Two-year-old Robbie Klein has hemophilia, a medical condition that interferes with his blood's ability to clot normally. Without insurance, the daily medications he needs to stay healthy could cost hundreds of thousands of dollars or more each year. Jesse Costa/WBUR hide caption

Two-year-old Robbie Klein has hemophilia, a medical condition that interferes with his blood's ability to clot normally. Without insurance, the daily medications he needs to stay healthy could cost hundreds of thousands of dollars or more each year.

The U.S Senate's plan to replace Obamacare would cut funding for Medicaid and other health insurance subsidies by more than $1 billion a year within five years. That has many lawmakers, doctors, hospitals and patients across Massachusetts in a state of alarm.

"Where in this bill is the protection for children," asks Dr. Jonathan Davis, the chief of newborn medicine at Tufts Medical Center, as he stands in the hospital's NICU among babies who weigh as little as 1 pound. Roughly 60 percent of babies in the Tufts NICU are covered by Medicaid.

Davis pauses in front of an incubator that holds a tiny girl, just a few days old, who weighs 2.5 pounds. Her little lungs pump several times a second.

"The fact is, she's in room air, so she's breathing entirely on her own which is great," Davis says.

Doctors and nurses will work round-the-clock to give this baby and her roommates the best possible start. But it's unclear whether Tufts could provide this care for free if the baby or her mom didn't qualify for Medicaid. Davis says they also need good insurance after they leave the hospital.

"Because if those children don't go home to get great primary care, follow-up, early intervention and support, all those gains that could potentially have been made are going to be lost," Davis says.

That threat seems real under the Senate health care bill, says Audrey Shelto, president of the Blue Cross Blue Shield Foundation.

"It is even more devastating than the House bill for low-income and vulnerable populations," Shelto says.

That's because as of 2025, the Senate would tie spending for each person on Medicaid to a standard inflation rate, instead of the rate of medical inflation, which is usually higher. In Massachusetts, lots of lawmakers Democrats and Republicans are frustrated, if not angry.

State Rep. Jeff Snchez, House chair of the Joint Committee on Health Care Financing, reviewed the details on his way to a health care conference.

"They talked about repeal and replace," he says. "This is more like search and destroy because fewer people are going to get coverage that they need, and people will pay more out of pocket."

Snchez says Massachusetts has a longstanding practice of making kids a priority and has enhanced MassHealth to make sure kids in low-income families get the care they need.

"Nobody's clear on what's the future of that program," he says. "Everything is up in the air."

Snchez's co-chair, state Sen. James Welch, has called the U.S. Senate bill "class warfare" because it would take money from poor kids and their moms and give it to wealthy adults in the form of tax cuts. But Welch says the state won't have any good options if Massachusetts has to make up $1.4 billion in federal health care cuts in the future.

"Do you raise taxes somewhere? Do you cut back on eligibilities? Do you cut back on benefits? Tough decisions are going to have to be made," Welch says. "But health coverage that children are currently receiving we'll fight tooth and nail to make sure that continues."

Eileen McAnneny, president of the Massachusetts Taxpayers Foundation, says the state should cut health care spending before any talk of raising taxes or moving people off Medicaid. But McAnneny says MassHealth, the state's Medicaid program, is growing faster than the state can manage. About 60 cents of every new tax dollar goes to MassHealth.

"So we have to reduce the cost of the MassHealth program, or the state will deliver MassHealth services and few others because it will consume a lot of our resources," McAnneny says.

For kids, there is one bright spot in the Senate health plan that is not in the House Obamacare replacement bill: About 20 percent of children who qualify for Medicaid because they are severely disabled would be exempt from the cuts.

Kayla Klein, of West Roxbury, is watching what Congress is doing closely. She tugs at the appliqud dog on the front of her 2-year-old son Robbie's T-shirt.

"Right Robs? Where's your port?" she asks, playfully,

Robbie's T-shirt hides a central line port through which he gets medicine every day that he needs to stay healthy; he has the blood-clotting disorder hemophilia.

Robbie makes his mom and dad, Joel Klein, laugh a lot. But they're also very worried. Hemophilia medications can be terribly expensive, and the Kleins are both school teachers, without hefty salaries. Robbie has private insurance through his parents to cover most of the cost, and Medicaid is a backup plan, for now.

The Kleins want to make sure members of Congress understand the decisions they're making are really important.

"Our futures and our livelihood are hanging in the balance," Joel Klein says.

"It makes you feel very fragile. It makes you feel like you aren't empowered when your child's life is at stake," Kayla Klein adds.

Senate leaders say they expect to vote on their health care bill before their August recess. It's not clear whether the bill has the votes to pass.

This story is part of NPR's reporting partnership with WBUR and Kaiser Health News.

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GOP's Cuts To Medicaid Could Threaten Kids' Health Care, Doctors ... - NPR

Majority Leader Mitch McConnell needs the support of 50 of 52 GOP senators to proceed to a floor debate on the bill, and two senators have already said they will not support that motion. That means just one more GOP senator coming out against the motion to proceed would stop the bill, as written, in its tracks.

Increasing the pressure: GOP leaders have restarted the clock by publicly stating that they'd like a vote (or at least to take the procedural steps toward a vote) next week. The White House is also making its push -- on Twitter, by phone and behind closed doors -- in an effort to net President Donald Trump a major legislative achievement ahead of lawmakers' August recess.

The White House legislative affairs team held meetings on the legislation with Senate leadership "all afternoon" on Friday, a senior White House official said. Trump and Vice President Mike Pence will be making calls throughout the weekend on health care as well, the official said.

McConnell recently announced that the recess would be delayed by at least two weeks, but it still wasn't clear going into the weekend whether the additional time would help the GOP leadership get this legislation through the chamber.

Here's what we know after this week:

The revised legislation also has $45 billion in opioid-treatment funding -- a top request from senators like Rob Portman of Ohio and Shelley Moore Capito of West Virginia -- and money for states meant to lower premiums for high-cost enrollees.

In several key areas, though, the new bill remains unchanged.

The new version does not address moderates' concerns about cuts to Medicaid, which the original bill would slash by $772 billion by 2026. That would leave an estimated 15 million fewer people insured by the program.

The Congressional Budget Office is expected to release its score of the revised bill early next week, when the White House will continue its lobbying effort, the senior White House official said.

Sen. Rand Paul of Kentucky: "The new bill is the same as the old bill -- except for worse," he said Wednesday. Paul, who reiterated his opposition Thursday, is facing pressure from the White House to support the bill. While on an official trip to Paris, Trump called Paul urging him to vote yes, an aid to Paul told CNN.

The revised Senate bill left Medicaid virtually untouched, meaning the serious concerns of moderates (particularly those in Medicaid-expansion states) were not addressed. And with the Cruz amendment in the bill, all eyes are now on moderates.

Heller is another one to watch. In the past, he has sharply criticized the Senate's version of the bill, and he's recently indicated that he's in lockstep with his state's Republican governor, Brian Sandoval. The state's chief executive this week did not sound enthused with the bill, particularly as it relates to residents in his state covered under the Obamacare-era expansion of Medicaid.

"I'm greatly concerned and very protective of the expansion population," Sandoval told CNN Thursday at the National Governors Association meeting in Rhode Island. "They are living healthier and happier lives as a result of their receiving coverage, and for them to lose that at this point would be very hurtful for them. And it's about people -- this is about people. And 210,000 people in my state."

In addition to these senators, a number of others have remained noncommittal. They include: Murkowski; Jeff Flake of Arizona; Mike Lee of Utah; John Hoeven of North Dakota; Bill Cassidy of Louisiana; Thom Tillis of North Carolina; Ben Sasse of Nebraska; Thad Cochran of Mississippi; Cory Gardner of Colorado; and Todd Young of Indiana.

The President tweeted four times about health care on Friday from France. He said Vice President Mike Pence is "working hard" on it and that he'll have his "pen in hand" to sign a bill into law.

Pence touted the Senate bill -- and stressed his view that the Affordable Care Act is collapsing -- during remarks Friday to a group of about 30 governors at their group's summer meeting.

"Let me be clear: President Trump and I believe the Senate health care bill strengthens and secures Medicaid for the neediest in our society, and this bill puts this vital American program on a path to long-term sustainability," he said, without noting that the bill also cuts Medicaid spending from current projections.

"I understand and appreciate, as the President does, the concerns that many of you have as we talk about Medicaid in the future going forward. Our administration's paid very close attention to this issue," he said.

The President remains focused on getting a deal on health care that's better for the American people, a senior administration adviser told CNN on Friday.

"If they don't get this done now, I don't know when it'll happen," the adviser said. "We've had seven years to create an alternative plan."

CNN's MJ Lee, Lauren Fox, Tami Luhby, Eric Bradner, Liz Landers, Ryan Nobles and Ted Barrett contributed to this report.

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Highlights: Crucial week for Republican health care plan ...

A leading business coalition has warned that employers could pick up the tab if millions of people lose their coverage under the Republican plan to repeal the Affordable Care Act.

David Lansky, president and chief executive of the Pacific Business Group on Health, a nonprofit organization whose members include Boeing, Chevron, Hewlett-Packard Enterprise, Intel, Walmart and the Walt Disney Company, told The Washington Post that the Senate proposal to repeal the Affordable Care Act could push the costs of providing health care to uninsured people onto employers and their workers.

There are a couple of specific reasons continuing to support an effective Medicaid program and an individual market is important, and one of those is its importance to business, Lansky said .

Approximately177 million Americans receive insurance through employers. Until now those plans have been largely left out of the debateover the future of the Senate health bill, which would make long-term cuts to Medicaid, the government health program for the poor, and reshape the individual market where people buy their own coverage.

But if the bill is passed and more people are uninsured, or public sector programs facing federal funding cuts decrease their reimbursements, Lansky said hospitals will simply shift those costs onto commercially insured patients namely employers and employees.

He added that if Medicaid is cut and the individual market doesnt provide affordable, comprehensive coverage, new workers may delay care until they get a job which could make workers less productive and also create an initial surge in health-care costs that could increase premiums.

Any additional cuts to public programs are likely to make additional increases [on costs] to the employer and the employee at a time that most of us are worried about what were spending on health care, Lansky said.

[Health insurers have been strangely quiet about undoing Obamacare. Until now.]

Until now, big employers have praised elements of the health-care bill that would benefit them and been restrained in any criticism. The U.S. Chamber of Commerce has been one of the few major industry groups to come out in support of the bill. The National Business Group on Health has praised the delay of theCadillac tax that would have been leveled on generous health-care plans and thegreater flexibility in howhealth savings accounts could be used.

The biggest impact on employers are the taxes and the added administrative requirements that have been imposed by the Affordable Care Act. We see the changes in those provisions, since they alleviate our concerns, as a good thing, saidSteve Wojcik, vice president of public policy at the National Business Group on Health.

But Lansky said despite those benefits, employers are becoming aware that insurance markets arent as siloed as it was once thought.

Commercially insured patients generally pay higher rates for health care in part to compensate for shortfalls created by public health-care programs and the uninsured. Lansky argued the cost-shifting would likely increase if millions more Americans were to lose coverage, as has been predicted. That could push health-care costs higher in the employer market.

(The most recent version of the Senate health bill has not yet been scored by the Congressional Budget Office, but a previous iteration was predicted to result in 22 million people becoming uninsured within a decade.)

Employers have a natural interest in a healthy workforce. If people delay health care while they are unemployed, they could be less productive or need more health services once they do start a new job.

Most large employers have been reluctant to be vocal about any health-care concerns. Its not their primary business or expertise and many have other, industry-specific issues pending before lawmakers or the White House that are bigger priorities, so they do not want to use up their political capital by taking a side.

Theyre alittle uncomfortable to be in this space; its very politically charged. And these companies have no desire to get in the midst of a partisan debate that isnt their primary issue, Lansky said. I think the stakes are very high, and they realize with this issue, its at least important to share our perspective to educate policymakers there are some effects of these bills that may have a larger effect.

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How the Republican health-care bill could raise premiums for 177 million Americans - Washington Post

Health care was cited by 35% of Americans as the most important challenge facing the nation.

It is the first time in the Bloomberg poll's history that respondents have said health care is the most pressing issue. Since it was first included in July 2010 as a response to the question of which issue is most important, health care has never been cited by more than 20% of Americans as most pressing and has never outranked all other issues.

Unemployment and jobs, terrorism or government spending have typically been mentioned as the most important issue.

Unemployment and jobs ranked as the second most cited issue in the poll, with 13% of Americans rating it most important. Eleven percent said terrorism was most important, while immigration and climate change were both rated most important by 10% of respondents.

The poll was conducted in English from July 8 to 12, based on interviews with 1,001 US adults ages 18 and older and has a +/- 3.1 percentage point margin of error. The pollsters dialed numbers from random samples of both landlines and cell phones.

Read more from the original source:

Poll: Americans say health care is most important issue - CNN International