Senate Republicans have been trying to thread the needle on health care reform for weeks, but they've come up empty so far in their search for the perfect compromise.
Why can't they find agreement? Each senator has a different reason to oppose the legislation -- from ideology to re-election concerns to the demographics and health nuances of individual states.
With all Democrats opposed to repealing Obamacare and only 52 members in the chamber's slim majority, Kentucky Sen. Mitch McConnell can afford to lose only two GOP defectors in his quest to push a bill through his chamber. But it won't be easy: the members he needs to convince sit
Ten Republicans said they would oppose a previous version of the Senate Republicans' plan and many others had expressed reservations, so the majority leader spent weeks rewriting it and wants to hold a vote in August.
To explain why the Senate's Obamacare repeal plan is in so much trouble, let's focus on the 10 Republicans who opposed McConnell's earlier bill and four of those who had real problems with it.
An analysis from the Urban Institute and Robert Wood Johnson Foundation finds nearly one-in-six
Paul lashed out against McConnell's original plan, saying "they're not going to fix the death spiral of Obamacare." The new Senate plan released Thursday isn't likely to change those projections.
More than three in 10 residents of Louisiana are enrolled in Medicaid, drawing attention from Sen. Bill Cassidy. The most recent Senate plan was slated to cut Medicaid spending by 35 percent over the next two decades, according to the non-partisan Congressional Budget Office.
Cassidy partnered with South Carolina Sen. Lindsey Graham on Thursday to propose a plan B: keeping some of Obamacare's
Voting for the Senate bill is a particularly hard lift for senators in states that expanded Medicaid under Obamacare. One-in-10 residents in West Virginia are insured through the Medicaid expansion program -- one of the highest rates in the nation.
West Virginia Sen. Shelley Moore Capito represents the state with the highest proportion of drug overdose deaths in the nation -- 42 per 100,000 deaths -- almost three times the national average, according to the Center for Disease Control and Prevention. She said in late June that the plan "does not do enough to combat the
With one of the highest rates in the nation, Ohio Sen. Rob Portman als
The proportion of uninsured Americans has dropped 6 percentage points since 2009, according to data from the US Census Bureau. But the boost nationwide has helped residents represented by Sen. Ted Cruz, Sen. Rand Paul and Sen. Shelley Moore Capito more than most. The uninsured rate in Texas has dropped 9 percentage points since 2009, and the uninsured rate has dropped 8 percentage points -- more than cut in half -- in both Kentucky and West Virginia.
The most real and immediate re-
In addition to Nevada Sen. Dean Heller, Texas Sen. Ted Cruz and Tennessee Sen. Bob Corker are both up for re-election in just a year and a half.
Cruz has been successful in lobbying for a change to give insurers more flexibility to offer plans that don't comply with
Arizona Sen. Jeff Flake, who has also been playing the fence
Ideology marks one of the major hurdles for both the right and the left wings of the GOP caucus.
Kentucky Sen. Rand Paul, Texas Sen. Ted Cruz and Utah Sen. Mike Lee -- the three most conservative members -- released a joint statement on the original Senate plan, saying "it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs."
Elements of a proposal by Cruz were included in the new version, drawing his
Meanwhile, in the moderate wing of the party, possible defections include Maine Sen. Susan Collins and Alaska Sen. Lisa Murkowski -- both of whom have already united to oppose the nomination of Betsy DeVos and a bill allowing states to block Planned Parenthood funding.
Collins has been more vocal in her opposition to the bill so far, saying she needs a "complete overhaul" in order to back the bill. Ratings in the chart above come from DW-NOMINATE, a scoring system developed by political scientists based on Congressional voting records.
While Maine Sen. Susan Collins has enjoyed a re-election margin nearly double the average member of the U.S. Senate, her state narrowly voted for Hillary Clinton in November. And with some pundits wondering if she has her eye on the governor's mansion in 2018, the views of her constituents are also not far from her mind.
While Trump won the Buckeye State by a wider-than-expected 8 points, Ohio Sen. Rob Portman still represents a purple state. He's just kicking off his new term and won't face re-election until 2022, but Medicaid expansion and drug crisis are keeping him on the fence.