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Emboldened industry lobbyists try to scale back Medicaid cuts

Hospitals, doctors and nursing homes have one last chance to shape a Republican bill to repeal and replace Obamacare they say will hurt millions of old, poor and sick Americans — and their own bottom lines.

After being on the sidelines for much of the repeal debate, the groups see an opening in the meltdown of the Senate health care bill. They’re particularly worried about the legislation’s proposed deep cuts to Medicaid, the country’s largest insurance program, which covers 74 million people.

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Medicaid “was established to prevent our country’s most vulnerable citizens from being left behind, and it’s truly become a lifeline for millions of Americans,” said Rick Pollack, CEO of the American Hospital Association, during a call with reporters on Tuesday. “Even Republican senators are sounding alarm bells over the harm these deep cuts would cause for vulnerable patients in their states.”

A coalition of the nation’s largest provider groups is airing ads across 12 states this week linking the Senate bill to worse care for millions, including children, the disabled and the elderly. Health care lobbyists are targeting shaky senators both in D.C. and in their home states, hammering home the idea that Medicaid cuts could skyrocket charity care and force hundreds of small and rural hospitals out of business. And on Monday, the trade group representing nearly 14,000 nursing homes broke its silence to deliver a scorching indictment of Senate Republicans’ bid to remake Medicaid.

“We genuinely believe that if the senators had any idea of the extent of the impact on [nursing homes] in the country that they’d never be proposing this,” American Health Care Association President Mark Parkinson said. “If they adopt this bill, the future of long-term care as we know it will be very different.”

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Insurers are taking a less combative stance, but they’re also warning that the cuts would have grave consequences. The Association for Community Affiliated Plans has released an ad criticizing the Senate plan that it says will run during MSNBC’s “Morning Joe” program. Last week, a group of 10 major Medicaid plans sent a letter to Senate leaders blasting the GOP repeal bill, arguing that it would cripple state budgets and hurt efforts to combat the opioid crisis.

“If the goal is to reform the Medicaid program and reduce costs, there are different ways of going about it than just taking a hatchet to the budget,” said John Baackes, CEO of L.A. Care Health Plan, one of the signatories to the letter.

The lobbying effort still pales in comparison to the scorched-earth tactics of the health insurance industry that derailed former President Bill Clinton’s proposed health care overhaul more than two decades ago. But the effort has been bolstered by the Congressional Budget Office's projection that the bill would leave 15 million more Medicaid-eligible Americans uninsured over a

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Senate GOP yanks Obamacare repeal bill

Republicans are delaying vote until after July 4 recess after the bill faced resistance from both moderate and conservative Republicans.

By Jennifer Haberkorn and Burgess Everett

06/27/2017 01:12 PM EDT

Updated 06/27/2017 03:31 PM EDT

2017-06-27T03:31-0400

Senate Republicans on Tuesday delayed their plans to vote on repealing Obamacare this week, amid strong resistance from moderate and conservative Republicans to even beginning debate on the GOP bill.

Republicans plan to re-write their health bill over the July 4th recess and get a new analysis from the Congressional Budget Office before bringing legislation to the floor, according to senators and aides. GOP senators said their goal is to have an agreement by Friday and vote as soon as they come back from the break.

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“Legislation of this complexity almost always takes longer than anyone would hope,” Senate Majority Leader Mitch McConnell told reporters. “But we’re pressing on.”

McConnell said he opted to delay a planned vote on the Senate bill after several members asked for more time to review the sweeping legislation.

The Kentucky Republican added that President Donald Trump will play a larger role in the discussions, calling his involvement “very important” to securing the final commitments needed to push the bill through the Senate. Republican senators will head to the White House this afternoon to meet with Trump.

Some Republicans commended McConnell for the delay.

"Sen. McConnell was wise to give it a few more days," said GOP Sen. Lamar Alexander, who chairs a key health committee. "Several members felt the bill wasn't ready to be voted on. We've been working on it for seven years and a few more days to get it right is a very sensible approach to me."

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Earlier in the day, Sen. John Cornyn (R-Texas), the GOP’s chief whip counter, had said that the vote would be held “sometime tomorrow.”

But at least five Senate Republicans — moderate Sens. Susan Collins and Dean Heller and conservative Sens. Ron Johnson, Rand Paul and Mike Lee — had said they were not ready to vote on the Obamacare repeal bill without alterations. McConnell can only afford to lose two senators.

Sen. Lisa Murkowski (R-Alaska), one of the swing votes on the bill, said not voting on the procedural motion Tuesday “is good, because I don’t think we’re ready to proceed today. This person is not ready to proceed today.”

Sen. Rob Portman of Ohio also would not commit to supporting a vote to advance the bill, and said he had "serious concerns about the Medicaid and opioids issues."

Both McConnell and Vice President Mike Pence met with reluctant Republicans Tuesday as the GOP hunted for the votes together to fulfill their seven-year pledge to dismantle the Affordable Care Act.

Republicans have some money to play with. The CBO score left

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Senate GOP yanks Obamacare repeal bill

Republicans are delaying vote until after July 4 recess after the bill faced resistance from both moderate and conservative Republicans.

By Jennifer Haberkorn and Burgess Everett

06/27/2017 01:12 PM EDT

Updated 06/27/2017 03:31 PM EDT

2017-06-27T03:31-0400

Senate Republicans on Tuesday delayed their plans to vote on repealing Obamacare this week, amid strong resistance from moderate and conservative Republicans to even beginning debate on the GOP bill.

Republicans plan to re-write their health bill over the July 4th recess and get a new analysis from the Congressional Budget Office before bringing legislation to the floor, according to senators and aides. GOP senators said their goal is to have an agreement by Friday and vote as soon as they come back from the break.

Story Continued Below

“Legislation of this complexity almost always takes longer than anyone would hope,” Senate Majority Leader Mitch McConnell told reporters. “But we’re pressing on.”

McConnell said he opted to delay a planned vote on the Senate bill after several members asked for more time to review the sweeping legislation.

The Kentucky Republican added that President Donald Trump will play a larger role in the discussions, calling his involvement “very important” to securing the final commitments needed to push the bill through the Senate. Republican senators will head to the White House this afternoon to meet with Trump.

Some Republicans commended McConnell for the delay.

"Sen. McConnell was wise to give it a few more days," said GOP Sen. Lamar Alexander, who chairs a key health committee. "Several members felt the bill wasn't ready to be voted on. We've been working on it for seven years and a few more days to get it right is a very sensible approach to me."

Get the latest on the health care fight, every weekday morning — in your inbox.

By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time.

Earlier in the day, Sen. John Cornyn (R-Texas), the GOP’s chief whip counter, had said that the vote would be held “sometime tomorrow.”

But at least five Senate Republicans — moderate Sens. Susan Collins and Dean Heller and conservative Sens. Ron Johnson, Rand Paul and Mike Lee — had said they were not ready to vote on the Obamacare repeal bill without alterations. McConnell can only afford to lose two senators.

Sen. Lisa Murkowski (R-Alaska), one of the swing votes on the bill, said not voting on the procedural motion Tuesday “is good, because I don’t think we’re ready to proceed today. This person is not ready to proceed today.”

Sen. Rob Portman of Ohio also would not commit to supporting a vote to advance the bill, and said he had "serious concerns about the Medicaid and opioids issues."

Both McConnell and Vice President Mike Pence met with reluctant Republicans Tuesday as the GOP hunted for the votes together to fulfill their seven-year pledge to dismantle the Affordable Care Act.

Republicans have some money to play with. The CBO score left

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Senate Republicans delay Obamacare repeal vote until after recess

John Cornyn is pictured. | Getty

Sen. John Cornyn, the GOP’s chief whip counter, said Tuesday that the vote would be held “sometime tomorrow.” He previously said the vote could be held Tuesday or Wednesday. | Getty

The bill lacked sufficient support to even begin debate amid resistance from moderate and conservative Republicans.

By Jennifer Haberkorn and Burgess Everett

06/27/2017 01:12 PM EDT

Updated 06/27/2017 02:44 PM EDT

2017-06-27T02:44-0400

Senate Republicans on Tuesday delayed their plans to vote on repealing Obamacare this week, amid strong resistance from moderate and conservative Republicans to even beginning debate on the GOP bill.

Republicans plan to re-write their health bill over the July 4th recess and get a new analysis from the Congressional Budget Office before bringing legislation to the floor. GOP senators said their goal is to have an agreement by Friday and vote as soon as they come back from the break.

Story Continued Below

President Donald Trump has also invited all Senate Republicans to the White House for a meeting Tuesday afternoon to discuss GOP plans. Senate Majority Leader Mitch McConnell (R-Ky.) made the announcement about a White House trip during a closed-door party lunch on Tuesday.

"Sen. McConnell was wise to give it a few more days," said GOP Sen. Lamar Alexander, who chairs a key health committee. "Several members felt the bill wasn't ready to be voted on. We've been working on it for seven years and a few more days to get it right is a very sensible approach to me."

At least five Senate Republicans — moderate Sens. Susan Collins and Dean Heller and conservative Sens. Ron Johnson, Rand Paul and Mike Lee — have said they’re not ready to vote on the Obamacare repeal bill without alterations. McConnell can only afford to lose two senators, and a significant bloc of other senators are undecided.

Sen. Lisa Murkowski (R-Alaska), one of the swing votes on the bill, said not voting on the procedural motion Tuesday “is good, because I don’t think we’re ready to proceed today. This person is not ready to proceed today.”

Sen. Rob Portman of Ohio also would not commit to supporting a vote to advance the bill, and said he has "serious concerns about the Medicaid and opioids issues."

Both McConnell and Vice President Mike Pence were expected to meet with reluctant Republicans Tuesday as the GOP hunts for the votes together to fulfil their seven-year campaign pledge to dismantle the Affordable Care Act.

They have some money to play with. The CBO score left the GOP with about $188 billion more revenue than they need, meaning Republicans can put that savings in programs to shore up premium reduction efforts, anti-opioid spending or, as some conservative Republicans want, deficit reduction.

Get the latest on the health care fight, every weekday morning — in your inbox.

By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time.

"We've been talking about Medicaid, seeing if we can get it right for the states,"

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New Orleans Mayor Attacks Trump’s ‘Narrow, Myopic View’

MIAMI BEACH, Fla.—Mitch Landrieu thinks Donald Trump “is wrong most of the time, because he takes a myopic, narrow view.”

As he tells it, that’s not Landrieu the Democratic mayor of New Orleans talking, or Landrieu the heir to one of the most famous names in Southern Democratic politics, or Landrieu who gets chattered about as a dark horse Cajun entry into the 2020 presidential field. It’s the Landrieu who just took over as the president of the Conference of Mayors, reflecting what he says is the consensus view of the 1,400 Republicans and Democrats looking at Washington and judging it from their seats at city halls around the country—as Mayor John Giles, the Republican mayor of staunchly conservative Mesa, Ariz., put it, “is there any sanity in government anymore?”

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Thanks to Trump and to lots of others in the federal government, Landrieu said, actually governing has gotten more difficult for the people who have to think about it each day.

“We want you here, we need you here. But if you’re not coming, we’ve got to do two things: contain you, or get you off of us,” Landrieu told me in an interview for POLITICO’s Off Message podcast.

He’s blown away, for example, by how Congress has approached repealing the Affordable Care Act, Barack Obama’s signature health-care law. Take it beyond politics, or morality, or even the hot-off-the-presses Congressional Budget Office score showing that the new Senate proposal would leave 22 million fewer people insured. Mayors like him, he says, have to deal with the consequences.

“When all those people in the cities don’t have health care, where are they supposed to go? And how do we provide enough drug treatment centers and emergency rooms,” Landrieu said. “And if you don’t have an answer for that, why are we doing this again?”

These are strange times for mayors. They like to style themselves as beyond the partisan fray, focused on results and solutions instead of politics, and are wary of taking on the president directly. Even former New York City mayor Mike Bloomberg, a sometime Republican who called Trump a con man at the Democratic convention last year and arrived here to announce $200 million in innovation grants for cities in response to Trump’s politics, quickly shot down a reporter who suggested as he arrived that he was saying people should look past the state and federal government.

Likewise, Landrieu said that the line he delivered in his speech that “America’s greatness is alive and well in cities and towns across this country—from urban to rural to suburban, from coast to coast,” purposefully didn’t mention Trump’s name because he’s trying to avoid a battle, though he obviously took a shot at the president’s famous slogan.

“What I’m doing is directly challenging what the word great means,” Landrieu said, explaining the parsing he’s attempting.

Yet the agenda that the Mayors’ Conference has been putting together for two years, and has now officially adopted, puts mayors in direct

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