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Senate ACA repeal bill closer to unveiling, Republican leader says

Senate Republican leaders June 6 were given the all-clear from the chamber's parliamentarians that a bill adopted by the House in May to repeal the Affordable Care Act can proceed under reconciliation rules, which would allow for the legislation to pass with only 51 votes rather than the usual 60.

"We are getting closer to having a proposal that we will be bringing up in the near future," Senate Majority Leader Mitch McConnell, R-Ky., told reporters at the Capitol. He declined, however, to provide details of the components the Senate was considering for its yet-to-be-written bill.

"We've had plenty of time to discuss this issue," McConnell said. "We've had seven years to talk about healthcare."

"We'll let you know when we are going to go to the floor with it," he said.

Earlier in the day, Republican senators met behind closed doors to hear options that have been mulled over by a 13-member all-male panel of senators from the party, which was tasked with drafting the bill.

But McConnell said he would not describe the meeting as "pivotal."

"It was one of an ongoing series of meetings we've had that will continue throughout the week," he said, shortly before leaving for a meeting at the White House, where House and Senate Republican leaders met with President Donald Trump to discuss his legislative agenda.

The White House wants the healthcare bill on the president's desk before the summer is over so that Trump's tax reform proposal can proceed.

While some Republican leaders have been optimistic about bringing the legislation to the floor before the end of June, Cowen & Co. analyst Rick Weissenstein said that could slip, although not much past that timeline.

Even though the Senate parliamentarian said the House bill could advance under reconciliation rules, Sen. Bernie Sanders, I-Vt., was skeptical, declaring in a June 6 statement emailed to reporters tha it remains to be seen whether the legislation will meet the $2 billion total deficit reduction target for the Senate Health, Education, Labor and Pensions and the Finance Committees.

Getting to 51 votes

In deciding what to include in the bill, McConnell faces the challenge of ensuring he can get to the 51 votes needed to pass the legislation under reconciliation. Republicans hold a slim majority of 52 seats in the Senate.

One key lawmaker, Sen. Bill Cassidy, R-La., who has voiced opposition to the House bill, whose popularity with the public has increasingly diminished, signaled that he liked what he heard during the June 6 Republican gathering, telling reporters it would protect Americans with pre-existing conditions.

But getting Cassidy's colleague Sen. Susan Collins, R-Maine, who coauthored an ACA repeal and replace bill with the Louisiana senator, on board likely will be more difficult.

Collins is among a handful of Republicans that have vowed to reject any legislation that does not ensure Americans can afford their coverage. She already said she would not support measures in the House bill.

Republicans Rob Portman of Ohio, Dean Heller of Nevada, Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska also have said they would not go along with the House's measures to drop the ACA's expansion of Medicaid, the government's insurance program for the poor.

Sen. Lindsey Graham, R-S.C., noted that Sen. Rand Paul, R-Ky., also is another likely no vote, given that he wants all of the ACA repealed, which lawmakers would not be able to do under reconciliation rules.

Paul also has said he would not vote for any bill that has refundable tax credits to help low-income people buy healthcare, Graham pointed out.

Therefore, he said, the Senate was "stuck" and had no way of getting to 51 votes.

Even if the Senate managed to pass a bill, Graham said it was highly unlikely for the House to agree to it, given the difficulty that chamber had with its own legislation, which narrowly passed in a 217-213 vote May 4.