Senate Republicans are moving full throttle to muster enough support to hold a vote next week on their last-ditch effort to replace Obamacare, but their thin majority in the chamber is, once again, proving tenuous.
Part of the battle is a race against the clock — Sept. 30, the end of the fiscal year, Republicans' last chance to pass healthcare legislation with a simple majority.
Assuming they get no support from the Democratic caucus in the Senate, Republicans can afford just two defectors, and they know of one already.
Sen. Rand Paul has been an outspoken opponent of Graham-Cassidy since the jump.
"It's a really crappy bill," Paul has said of the bill, whose main sponsors are Sens. Lindsey Graham and Bill Cassidy.
So that leaves for only one more to vote it down, and the undecideds are the usual suspects from the GOP's July attempt to pass a skinny repeal of the Affordable Care Act:
- Sen. Susan Collins
- Sen. John McCain
- Sen. Lisa Murkowski
And Collins has all but said she intends to vote no.
So Republicans need both McCain and Murkowski to vote in favor of Graham-Cassidy.
While those two mull over the bill, Senate Majority Leader Mitch McConnell's office said he intends to call a vote next week, though Politico reported McConnell will only call the vote if he knows it will pass.
"Nothing has changed. If McConnell wants to put it on the floor, that's up to McConnell. I am the same as I was before. I want the regular order," McCain told Politico.
Meanwhile, Murkowski maintains she's still doing her due diligence, especially since Republicans have zero guidance from the Congressional Budget Office; initial scoring from the group will hit next week but full-blown analysis wouldn't come until after Sept. 30.
"I have asked for nothing except the data that we're going to need to better understand the impact to a high-cost, low-density state like Alaska," Murkowski said Wednesday, The Washington Post reported.
Adding to the angst for Republicans is that a bevy of healthcare industry groups — including the insurance lobby itself — and other interest groups are vehemently against Graham-Cassidy, which kicks healthcare to the states with a block grant of federal funds to pay for it.
Those lining up against Graham-Cassidy:
The common sticking point for all of them: pre-existing conditions.
"The bill contains provisions that would allow states to waive key consumer protections, as well as undermine safeguards for those with pre-existing medical conditions," Blue Cross Blue Shield wrote in its release.
But Cassidy on Thursday said the bill requires states to get federal approval for their healthcare plans, and approval would only happen if pre-existing conditions were covered.
"The legislation says that nothing a governor asks for will be approved unless there is affordable and adequate coverage for those with pre-existing conditions," Cassidy told Fox News.