A look at the senators crucial to action on health care


WASHINGTON (AP) — Senate Republicans get their shot at crafting a bill to repeal the Affordable Care Act.

The version that narrowly passed the House on Thursday didn't win over many in the Senate, where lawmakers insist they'll come up with their own version. Majority Leader Mitch McConnell, R-Ky., spoke to President Donald Trump after the House vote and is now working with roughly a dozen other senators — all male — to write a new bill.

There is no effort to include Democrats in the process as Republicans are intent on ramming any legislation through on a simple majority vote.

A look at some of the players:



Finance Committee Chairman Orrin Hatch, R-Utah, and Health, Education, Labor and Pensions Chairman Lamar Alexander, R-Tenn., head the committees that oversee the law. Hatch said Thursday that the Senate must "manage expectations and remain focused on the art of the doable," while Alexander said the Senate "will take the time to get it right."

Hatch, the longest-serving Republican in the Senate, is a longtime friend of Trump's. Alexander is a seasoned dealmaker who has often reached across the aisle, but will have difficulty doing so on the thorny issue of health care.

Alexander, Hatch and Budget Committee Chairman Mike Enzi, R-Wyo., are all in McConnell's working group.



McConnell has remained characteristically quiet about the details of a Senate health care proposal as the House has worked through the process. He indicated in March that a previous version of the House health care bill could move straight to the floor, but it's unclear how he will handle the latest version, which passed in the House 217-213 on Thursday.

Another member of GOP leadership, South Dakota Sen. John Thune has worked on language that would redirect some of the tax credits in the House bill to better help low-income and elderly people. Two other Republican leaders, No. 2 Senate Republican John Cornyn and Wyoming Sen. John Barrasso, are joining McConnell and Thune in the working group.

Though they have occasionally broken with him on policy — and his use of Twitter — Senate GOP leaders will be eager to get a deal with Trump on health care, a major issue for GOP base voters.



Republican Sens. Susan Collins of Maine and Bill Cassidy of Louisiana, a doctor, proposed legislation in January that would let states keep the current law or opt for a new program providing trimmed-down coverage. In recent days, Cassidy has discussed ways his proposal could improve upon the House bill.

Collins could be a difficult vote to win for Republican leaders, who can only lose two votes to pass the bill. She has been critical of the House bill and is opposed to cutting federal money for Planned Parenthood, which the House legislation would do. The moderate also has no problem opposing Trump, whom she didn't vote for in the presidential election.

Neither Collins nor Cassidy are part of the GOP working group.



The Senate bill will have to take into account the concerns of several Republicans who represent states that expanded Medicaid coverage for low-income residents through the current law. Many of the same senators represent states ravaged by deaths caused by opioid abuse, and the House bill could reduce coverage for anti-drug services.

Republican Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Lisa Murkowski of Alaska and Cory Gardner of Colorado sent a letter to McConnell in March opposing Medicaid cuts. Portman and Gardner will represent those interests in the working group.

All but Gardner represent states handily won by Trump, so they will want to work with him on a deal.



On the other side of the GOP spectrum, some senators want a full repeal. Kentucky Sen. Rand Paul said Thursday that he believes the House bill would pay too much taxpayer money to insurance companies.

Sens. Mike Lee of Utah, Tom Cotton of Arkansas and Ted Cruz of Texas have been vocal repeal supporters and could hold their support unless the Senate bill comes close enough. All three men are in the GOP working group.

Paul and Cruz, along with Florida Sen. Marco Rubio, all ran against Trump and have been mocked by the president.



The two most vulnerable GOP senators in next year's midterm elections, Dean Heller of Nevada and Jeff Flake of Arizona, represent states with large populations of older voters. McConnell will want to ensure that they are both on board before making them vote on a bill.


Associated Press writer Richard Lardner contributed to this report.


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