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WASHINGTON Senate Republicans are still moving ahead with a vote on their health care bill next week, but barring some sudden changes of hearts, it looks like they will fall short of the votes and no one seems to have a real idea of what to do then.

Majority Leader Mitch McConnell (R-Ky.) is expected to release the text of a revised bill Thursday, along with an amendment drafted by Sen. Ted Cruz (R-Texas) that would dramatically undermine protections for people with pre-existing conditions in the name of lowering costs for healthy people. On Wednesday afternoon, Cruz suggested, but did not directly state, that he would vote against the motion to proceed on the bill if his amendment was not attached.

If there are not meaningful protections for consumer freedom that will lower premiums, then the bill will not go forward, Cruz said.

Bloomberg via Getty Images

Pressed on whether that meant he would vote against a motion to proceed, Cruz said the bill would not have the votes to go forward.The Cruz amendment would allow insurers who offer at least one health plan that complies with Obamacare regulations to offer other, cheaper plans that dont.

Regardless of whether Cruzs amendment is included, a vote on the motion to proceed may be going down anyway. Sen. Susan Collins (R-Maine) told Politico on Tuesdayshe was not optimistic that this would be a bill she could support, and Sen. Dean Heller (R-Nev.) famously expressed a number of issues with the bill in a high-profile news conferencein June issues that would largely be exacerbated or unaddressed with the addition of Cruzs amendment.

Sen. Rand Paul (R-Ky.) has also strongly suggested he would vote against a motion to proceed on the revised bill no matter the status of Cruzs amendment. He called it the same as the old bill, except worse, and, should a motion to proceed fail, he would push Senate GOP leaders to hold a vote on a straight repeal.

I ran on repealing Obamacare, Paul told reporters Wednesday. It doesnt repeal Obamacare. It creates a giant Obamacare superfund. I cant be for that.

If they lose on this vote, Im giving them an alternative, Paul said. The alternative is two bills: clean repeal, and a big government spending bill that they can work with Democrats on for big government-spending Republicans.

Republicans seem to acknowledge that they will, at some point, need to stabilize Obamacare markets. Even in their bill replacing the Affordable Care Act, there are funds that would reimburse insurers for the cost of their most expensive patients, allowing them to hold down premium increases.

But without their bill, many Republicans concede they should do something to bring more certainty to insurers offering plans in 2018.

At a minimum, Sen. Ron Johnson (R-Wis.) has suggested Republicans could fund the so-called cost-sharing reductions (CSRs), which subsidize the cost of Obamacare plans for people with incomes up to 400 percent of the poverty level. President Donald Trump has threatened to end those payments, and, in response to that uncertainty, insurers have offered more expensive plans or simply not offered plans at all.

Funding those CSR payments would be a small step that Republicans could take with Democrats to reinforce the Obamacare insurance markets. But that move would almost certainly draw the ire of conservatives, and its unclear what legislative vehicle Congress could use for CSRs.

A budget deal or debt ceiling increase with Democrats would be an obvious choice, but theres little impetus to pass one of those bills at this point, and Republicans would functionally be giving up on their repeal efforts and removing the one negotiating chip they may have to force Democrats to the table on a bipartisan health care bill.

A more likely scenario the actual bare minimum is that Republicans do nothing. The Trump administration could continue to make the CSR payments or could end them and truly throw the Obamacare exchanges into chaos. Trump has the CSR payments as leverage to extract concessions on other priorities, like his wall along the Mexican border in an omnibus spending deal, and he could make the subsidies contingent upon an item like that funding.

It would then be up to Democrats whether they would give in to Trumps demands or gamble that voters will just blame Republicans for the collapse of the insurance market and, perhaps, a government shutdown.

That potential showdown is all the more reason some Republicans are floating the idea of working with Democrats on new legislation.

Sen. Lindsey Graham (R-S.C.) claims to already be working on a bipartisan health care bill a strategy endorsed by more moderate Republicans, such as Collins and Lisa Murkowski (R-Alaska) but his idea of a bipartisan measure at this point sounds less than half-baked and far short of bipartisan.

Were trying to find consensus among ourselves and at the same time reach out to some Democrats who would be open-minded to the solutions being at the state level, not necessarily in Washington, Graham said Wednesday.

If that sounds like like something Democrats might resist, it probably should. Grahams idea of Democrats jumping aboard seems more aspirational than real.

It is a concept, he said. I hope it can get bipartisanship.

Asked about the basic tenets of his health care bill, Graham declined to provide any real details until Republicans had either passed or dispensed with their current legislation. (Graham said he thought the bill coming to the floor next week would fail.)

But the GOPs best hope of getting a bill through still seems to be this weeks revised legislation. While the health care plan continued to appear short on support Wednesday, McConnell still has more than $400 billion in savings he can dole out to win over reluctant Republicans. Many of Murkowskis concerns for Alaska could be addressed with that money, as could some concerns of other Republicans over the phaseout of the Medicaid expansion and high premiums for low-income seniors, though aides and senators have indicated that the new bill will mostly preserve the current provisions on ending the Medicaid expansion.

McConnell could also get a helping hand from the Senate parliamentarian, as shell have to rule on whether Cruzs open-ended language on coverage options is actually allowable in a reconciliation bill, which requires only 50 votes to pass but limits what senators can do in order to reconcile spending with their budget. While striking down the Cruz language could be the death blow for the health care bill, it could also convince Cruz and other conservatives like Mike Lee (R-Utah) to accept a more incremental approach.

At this point, McConnell seems to need a shakeup, and a parliamentary ruling could be what shifts the current dynamics.

The idea, however, of Republicans going back to the drawing board, perhaps seeking out some Democrats to support their measure, doesnt look like a winning strategy. Republicans are already split over a health care bill for both repealing too much of Obamacare and not enough, and Democrats appear completely united in their opposition to anything resembling the Republican plan.

If the revised bill fails, GOP senators have little idea what Plan B is. Ill leave that up to the leadership to decide what to do, Sen. Richard Burr (R-N.C.) said Wednesday. Youre going to have a health care system that implodes.

As it happens, that part isnt entirely true. The markets appear to be in better shape than Burr and his allies concede or perhaps even realize. Just this week, the Henry J. Kaiser Family Foundation released a study of insurer financial performance that concluded the individual market has been stabilizing and insurers are regaining profitability.

Premiums or out-of-pocket costs remain a lot higher than many people feel they can afford, and insurer pullouts have left some areas, particularly rural ones, with few or even no choice of insurers. But some carriers are expanding their options, filling in gaps others are leaving, and many industry officials say the biggest source of uncertainty isnt the underlying market weakness that plagued the program in its first few years; its the neglect and sabotage from hostile officials, including the ones working out of the White House.

With a little more money, or at least some assurances that the existing money will continue, the worst outcomes of an Obamacare market collapse could be avoided.

But Republicans dont look all that interested in that white flag approach at least not until theyve demonstrated they cant pass a bill of their own. And even then, Republican leaders see big problems if they cant muscle through this health care legislation.

Asked on Wednesday what Republicans would do if they couldnt pass their bill, GOP Conference Chairman John Thune (R-S.D.) suggested Republicans didnt have a backup plan.

That would be highly problematic, Thune said.

Jonathan Cohn contributed to this report.

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Republicans Stare Down Failure On Health Care With No Real Plan B - HuffPost

Leadership vows to cut off recess are a staple of congressional theater, used as a ploy to force lawmakers to address an issue or face the prospect of seeing their overseas fact-finding trips canceled. But the threats usually produce some action and are very rarely acted upon. The fact that Mr. McConnell felt compelled to actually abbreviate the recess, just days after Republicans were snickering at the very idea, underscored the seriousness of his partys plight.

Republicans had other motives for acting. Some anticipated that President Trump would happily whack them on Twitter if they fled as previously scheduled in a couple of weeks without first completing a health care bill. He had foreshadowed that possibility earlier this week with a tweet across the bow: I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!

The recess also made for miserable optics given the scant list of achievements Republicans have posted in what is often the most productive time for an empowered new president and his allies in Congress. Skepticism abounded in the Capitol on Tuesday as to whether the extra two weeks would be all that worthwhile, but it seemed to Republicans to be a better option than returning home or heading off on vacation.

I dont know how you go on a full-month recess without getting it done, Senator Pat Roberts, Republican of Kansas, said of the health care bill.

In addition, reducing the recess also provided Republicans a way to inflict some punishment on the Democrats they see as a significant source of their problems. In conceding their lack of achievement, Republicans sought to direct much of the blame for the shortened recess and the poor Republican showing to the opposition, led by Senator Chuck Schumer of New York.

I think it is admission of the fact that Senator Schumer has been very effective at slowing things down to a crawl and blocking the confirmation of President Trumps cabinet and other sub-cabinet level officials and making it hard to get things done, said Senator John Cornyn, Republican of Texas. I think it is important we demonstrate we are productive starting next week with the health care bill, and that is what Im focused on.

Mr. Schumer was having none of it. He said the Republicans problem wasnt the calendar, it was the substance of their health care bill.

And by the way, I have sympathy for the Republicans, Mr. Schumer said. If I were them, I wouldnt want to go home and face the voters either, because theyre not getting a very good reaction when it comes to this bill.

Mr. McConnell said the early August agenda would extend beyond health care, which Senate Republicans still hope to finish off next week. He ticked off a few other measures, including an always contentious debt limit increase, a usually bipartisan Pentagon policy bill and an important piece of legislation for the Food and Drug Administration.

Not to mention all of these confirmations that are backlogged, he said. We intend to fully utilize the first two weeks in August.

Even if they make significant progress in their additional weeks of work, which remains an open question, Republicans face continued difficulties.

For instance, House Republicans on Tuesday rolled out a Homeland Security measure that would provide $1.6 billion in physical barrier construction along the Southern border. In other words, it would fund the wall sought by Mr. Trump but vehemently opposed by Democrats in the House and Senate as well as by some Republicans.

That dispute could start a spending impasse, which could lead to a government shutdown after Sept. 30. Such a result would put many federal workers on an unwanted recess of their own, no matter how long senators stick around in August.

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A version of this article appears in print on July 13, 2017, on Page A17 of the New York edition with the headline: A Short Recess, And Long Faces.

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Republicans Reluctantly Acknowledge a Failure of Governing - The ... - New York Times

Let the record reflect that on July 12, 2017, at a few minutes after 10a.m. Eastern daylight time, the lights went out on the Republican Party.

Speaker Paul D. Ryan and fellow House Republican leaders had just finished their caucus meeting and were beginning a news conference. The House Republican Conference chair, Cathy McMorris Rodgers (Wash.), was announcing new legislation to combat human trafficking. We made a promise she said. And then the room went dark.

Whoops! Did I step on it? she asked, looking at her feet for an electrical cord. Presently, the lighting rekindled. Now, if we could pay the light bills, she resumed.

The metaphor alert level has just been raised to red.

The latest revelation in the Putin palooza that Donald Trump Jr., along with Jared Kushner and Trump campaign manager Paul Manafort, eagerly met last year with a person promising dirt on Hillary Clinton from the Russian government brings the sprawling scandal to a new level. Surely Republican leaders will move with dispatch to disavow Team Trumps behavior?

But each time President Trump hits a new low a racist outburst, a vulgar tweet, shabby treatment of women commentators invariably state that this one will be the tipping point, the time when Republicans bail on the man who is undermining their party, and conservatism, and American values. Each time, such expectations meet the same fate: Wrong!

And this time, sure enough, the Silence of the Republicans has been profound.

On the Houses first morning back from the July 4 recess, five GOP leaders took turns making statements before the microphones, and there wasnt a single mention of Trump, or of the Russian monster devouring their legislative agenda. Ryan (Wis.) waited to be asked the question, by CNNs Deirdre Walsh, and provided a prepared non-answer.

Ryan, omitting mention of Trump Jr.s Russia meeting, said he would leave it to the professionals investigating the matter to do their jobs.

NBCs Kasie Hunt asked Ryan if he would accept a meeting with a representative of a foreign adversary offering dirt on an opponent.

Im not going to go into hypotheticals, the speaker replied, repeating his mantra about professionals doing their jobs.

But Ryan is a professional hes the most senior Republican in Congress and he isnt doing his job. At least he isnt if his job is to protect his party (hurt by association with Trump), his policy agenda (bottled up because of Trumps troubles) or the institutions of the government he represents.

No doubt Republican leaders and backbenchers alike are afraid not of Trump but of the 25percent or so of Americans who support Trump strongly and who also happen to be many of the people who dominate Republican primaries and show up to vote in midterm election. By the time these voters peel away from Trump, it may be too late to rescue the party, or the country.

Senate Majority Leader Mitch McConnell was no braver. On Tuesday, McConnell (R-Ky.) was pressed four times about his confidence in Trump and his thoughts on Trump Jr. Four times, he responded with a variation of the same answer: What I have a lot of confidence in is the Intelligence Committee handling this whole investigation.

In the Senate, only a few Republicans have criticized Trump, among them Sen. John McCain (Ariz.), who observed to the Weekly Standard that another shoe drops from the centipede every few days. In the House, there have been even fewer (although Rep. Lee Zeldin of New York labeled Trump Jr.s meeting with the Russian a big no-no).

Republicans abandoning Trump tend to be those who dont answer to voters. Congressman-cum-MSNBC host Joe Scarborough told Stephen Colbert on Tuesday that he was quitting the GOP over officials refusal to disown Trump. What have you heard from Republican leaders today? Scarborough asked. Nothing. Theres always silence.

Alas, Scarborough didnt object to Trump when it could have done the most good, in the early months of the campaign. His show, Morning Joe, boosted Trumps candidacy with chummy coverage and free airtime in the form of friendly call-in interviews. My colleague Erik Wemple wrote at the time that the show veered from journalism into the friendly confines of a morning social club. After Trump won the New Hampshire primary, the candidate thanked Scarborough and his colleagues, calling them supporters, then believers.

Democratic leaders remarked Wednesday on the silent majority. If the situation were reversed, Rep. Linda T. Snchez (Calif.) said, theyd be screaming to the rafters about the need for prosecutions.

Firing squads, added Rep. Joseph Crowley, the House Democratic Caucus chairman from New York. All were hearing right now is crickets.

Crickets and a centipede that keeps dropping shoes.

Twitter: @Milbank

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The lights go out on the Republican Party - Washington Post

"Morning Joe" co-hosts Joe Scarborough and Mika Brzezinski joined Stephen Colbert on "The Late Show." Scarborough announced that he could no longer support the Republican Party because of its allegiance to President Trump. (Erin Patrick O'Connor/The Washington Post)

Roughlytwo hours before CBS aired Stephen Colbert's interview with Joe Scarborough and Mika Brzezinski on Tuesday's episode of The Late Show, Fox News host Sean Hannity complained to his viewers about Liberal Joe.

Hannity has been using the moniker for a while in an apparent attempt to weaken the former Republican congressman's GOP bona fides. The weight of Scarborough's criticism of President Trump is rooted in the idea that it comes from a member of Trump's own party. Hannity has been trying to destroy that premise by arguing that Scarborough is really just another liberal on MSNBC and that Republicans should not think of him as one of their own.

Scarborough made Hannity's job easier when he told Colbert that he is officially leaving the GOP.

Im not going to be a Republican anymore, the Morning Joe co-host said. Ive got to become an independent.

Scarborough isn't ready to call himself a liberal. I want lower taxes; I want less regulation, he told Colbert, highlighting traditional Republican principles that he maintains.

['Morning Joe' co-host Joe Scarborough is leaving the Republican Party]

Scarborough is, however, forfeiting his status as a top dissenting voice within the president's party. That's a big deal.

Here's an example that illustrates the significance:

On an episode of Morning Joe last August, Scarborough interrupted Brzezinski as she slammed congressional Republicans for refusing to reject their presidential nominee.

Mika, youre a Democrat, he said. Let me say this. Let me say this because it means nothing coming from you. Youre a Democrat.

Excuse me? Brzezinski replied.

It means nothing coming from a Democrat to these Republicans, Scarborough continued. Let me say this to my Republican Party: You are letting Donald Trump destroy the party.

Scarborough won't be able tosay things like that anymore.

His decision seems to cede that theRepublican Party is now the party of Trump. Only a short time ago, Republicanism and Trumpism seemed like different canons. At the Conservative Political Action Conference in February, Trump said that he skipped last year's gathering because I was worried that I would be, at that time, too controversial.

Now, however, Republicanism is Trumpism for many voters and politicians, anyway.

On a surface level, Scarborough's exit from the GOP would appear to upend the fundamental conceit of Morning Joe two strong-willed hosts, one Republican and one Democrat, bantering about the news. But in practical terms, it probably won't altermuch. Scarborough and Brzezinski have been in sync on Trump, and his views on other issues appear unchanged.

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Joexit: Why Scarborough's departure from the Republican Party is significant - Washington Post

Senator Mitch McConnell and fellow Republicans. Photo: Alex Wong/Getty Images

With the latest, and probably final, version of the Republican plan to repeal and replace Obamacare due to emerge Thursday, the party leadership is in the astonishing position of desperately trying to design a workable plan to meet their deadline. I hate to break this one to you guys, but I dont think they have any idea yet how theyre going to do this, a senior Republican aide tells HuffPost.

As the deadline approaches, the endpoint of a coherent bill seems to be moving further out of reach. Senator Ted Cruz has been selling his colleagues on an amendment that would allow insurers to sell unregulated plans with minimal coverage, as long as they also sell regulated plans. That would split the market into two completely different risk pools, one cheap and healthy, and the other sick and expensive, an arrangement insurers call unworkable. Another Republican senator, Mike Rounds of South Dakota, is trying to undo the damage Cruzs plan would do by creating some kind of ratio between the costs of the expensive insurance and the cheap insurance. Such an approach has never been tried, and no health-care experts have emerged to suggest it might work even in theory.

If youre going to rush a secret plan into law, you really need to be working with an off-the-shelf policy. The health-care debate started eight years ago. Republicans have had a long time to whiteboard some ideas. They are trying to reconceptualize the problem almost from scratch over a few days. This is like the Airplane! flight attendant announcing, By the way, is there anyone onboard who knows how to fly a plane?

The attempt to hastily devise a fix for a problem the Republican bill itself creates is symptomatic of the degree to which their plan has lost all touch with its rationale. The putative reason Republicans have given for repealing and replacing Obamacare is that the law is a train wreck, collapsing, and so on. The individual health-care exchanges are supposedly heading into a death spiral of sicker customers, higher premiums, and fleeing insurers. GOP leaders have insisted they are on a rescue mission.

Even if the exchanges were collapsing into a death spiral, it would not justify their plans to slash Medicaid, a program that does not require actuarial balance and is not even theoretically susceptible to a death spiral. And in any case, a mounting body of evidence has found that the exchanges are stable. Financial analysts have said this, insurance actuaries have said it, even the federal government has said it.

Recently, another piece of evidence has underscored the conclusion in even more detail. Cynthia Cox and Larry Levitt have a detailed report on the state of the markets. They conclude that insurers on the whole have found a stable price point. The medical loss ratio, which means the share of premium payments paid out in claims, dropped significantly in the beginning of this year:

Not surprisingly, insurers profit margin shot up:

Facing a brand-new market, insurers initially set their premiums far too low (and much lower than the Congressional Budget Office forecast). It has taken a few years, but they have corrected the error and settled in at a stable level. Republicans have cherry-picked horror stories of skyrocketing premiums, and it is true that 2017 saw premiums rise as part of this price correction. But there is zero reason to expect premiums to need to rise more.

Except, of course, for the fact that the government is run by people who are trying to kill Obamacare. Because of that fact, insurers in many states have fled the market due to political uncertainty. The Trump administration has followed a strategy of threatening to destroy the exchanges through sabotage, and then using the response by insurers to these threats as evidence that the law is collapsing on its own. Trumps Department of Health and Human Services has put out press releases celebrating insurer exits from the marketplaces.

Health-care policy analyst Adrianna McIntyre noticed an interesting fact about these insurer departures. They are disproportionately concentrated in states where the exchange is run by the federal government rather than by the state. The National Academy for State Health Policy finds that state-based exchanges are not seeing their insurers flee the markets.

With federally-facilitated exchanges that use healthcare.gov, the federal government is responsible for most exchange activities, McIntyre tells me. This includes consumer outreach, a function that is hugely important to insurers if the Trump administration decides not to allocate resources toward outreach for the next enrollment period, insurers might reasonably expect that the people who do sign up will be sicker, on average. If your business is dependent on cooperation from people who publicly celebrate every time a firm quits the market, you may have some reservations about staying in the market.

This policy makes perfect sense if your goal is to roll back the welfare state by any means necessary, or to undo as many Obama-era policies as you can. But that isnt what Republicans have promised, and it isnt what the public wants. (What the public wants, by nearly a three-to-one margin, is not to repeal and replace Obamacare but to work with Democrats and fix the law.) So the Republican Congress has to destroy a law that people like, and then replace it with something that replicates its current functions. They are scrambling to solve a problem that has no real answer.

White House aide Stephen Miller is reportedly working with GOP senators on a bill that would drastically reduce the number of legal immigrants.

In the age of Trump, its impossible to say.

The presidents lawyers dont want him taking advice about the Russia investigation from a son-in-law whos already deeply ensnared by it.

It will target three areas, and include some new trash cans.

He apparently doesnt have the funds or flexibility to get to 50 votes.

One version of Trumps (vague) plan would deliver 76 percent of its benefits to the top one percent while raising taxes on some in the middle class.

A photograph of the event is getting some buzz today.

Christopher Wray was pressed on FBI independence and the Russia probe at his Senate confirmation hearing.

They have till Thursday late morning. No pressure!

[Most] accusations fall into the category of we were both drunk, we broke up, and six months later I found myself under a Title IX investigation.

A respected human-rights group says hes been killed. But ISIS calls it fake news. Whos right?

Dana White told reporters that even though Trump is hyped for the fight, hes not coming because it would be a huge hassle.

The progress weve had over the last centuries, more people having a higher standard of living thats going to go in the other direction.

David Wildstein, who was the star witness for the prosecution of former Christie aides, is sentenced to three years probation for the traffic scheme.

The former Goldman Sachs president could soon lead one of the most powerful regulators of Wall Street.

Trump Jr.s emails may or may not be the smoking gun. But what seems clear is that this is only the beginning of what investigators could uncover.

With his upset of Andy Murray, American Sam Querrey has reached the first Grand Slam semifinal of his career.

The belief that the GOP Congress absolutely has to repeal Obamacare or face the wrath of angry base voters is an exaggeration at best.

The development suggests that the entire ice shelf may eventually collapse, leaving glaciers free to drift off of land and raise sea levels.

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Republicans Still Can't Design a Workable Health-Care Plan - New York Magazine