Senate Scraps Health Care Bill, Skilled Nursing Operators Exhale

Senate Republicans scuttled their most recent attempt to pass health care reform legislation after several members announced their opposition to the bill, putting proposed Obamacare replacement on hold — and prompting skilled nursing operators and advocates to breathe a temporary sigh of relief.

“We appreciate the Senators that hit the pause button on this debate,” American Health Care Association president and CEO Mark Parkinson said in a statement released Tuesday. “The past few months have demonstrated the complicated nature of health care policy.”

“On behalf of the nation’s long-term care providers, caregivers, patients, and families, we look forward to a collaborative dialogue with policymakers on providing quality care that meets the needs of the most vulnerable citizens,” Parkinson continued.


LeadingAge, a group that represents non-profit care providers around the country, similarly applauded the demise of the Senate’s Better Care Reconciliation Act (BCRA).

“LeadingAge is pleased that the BCRA will not be considered in the Senate,” the group said in a statement e-mailed to Skilled Nursing News. “It’s clear that our collective voices have been heard through our extensive grassroots efforts. We will continue to oppose any efforts to cut or cap Medicaid.”

The Senate’s bill had raised alarm among skilled nursing and other long-term care (LTC) providers with its $772 billion in promised cuts to Medicaid — the single largest payer for skilled nursing care, covering about 62% of residents nationally. The American Health Care Association predicted that the plan could end up costing individual SNFs $600,000 a year by the 2030s, far more than many make in a year.


But in the end, majority leader Sen. Mitch McConnell, a Kentucky Republican, couldn’t corral defectors from the liberal and conservative wings of his party. Moderate Sen. Susan Collins of Maine objected to the bill due to its deep Medicaid cuts, while Sens. Rand Paul of Kentucky and Mike Lee of Utah attacked the legislation from the right, claiming it didn’t fully repeal the Affordable Care Act (ACA) and its associated taxes.

A fourth rogue Republican, Sen. Jerry Moran of Kansas, abandoned the bill out of concern that it would hurt his rural constituents, especially since his state opted out of Medicaid expansion under the ACA, according to the New York Times.

After the bill’s death, both McConnell and President Trump expressed interest in a two-pronged approach that would see the Senate repeal Obamacare without an immediate replacement, then develop a new plan during a two-year sunset period.

“Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate,” the president wrote in a Tweet Monday evening. “Dems will join in!”

But that approach fell apart almost immediately, with Sens. Collins, Shelley Moore Capito of West Virginia, and Lisa Murkowski of Alaska quickly expressing opposition to the plan Tuesday, the Times reported.

“I did not come to Washington to hurt people,” Moore Capito said in a statement, according to the Times. “I cannot vote to repeal Obamacare without a replacement that addresses my concerns and the needs of West Virginians.”

With the GOP claiming a slim 52-48 advantage in the Senate, the party could only afford to lose two defectors on any health legislation; as the president of the Senate, Vice President Pence would serve as a tiebreaker in the event of a 50-50 split. Three public rejections would effectively kill the plan, and the road ahead remains unclear despite Republican control of Congress and the White House.

Written by Alex Spanko

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