The U.S. Senate is set next week to again debate overhauling the country’s health care policies, a last-ditch effort by Republicans to dismantle the signature law championed by former Democratic President Barack Obama.  

A spokeswoman for Republican leader Mitch McConnell said Wednesday that senators would consider their party’s latest legislative proposal to overturn the Affordable Care Act, popularly known as Obamacare, just days ahead of a Sept. 30 deadline, as dictated by the Senate’s legislative rules, for completing action.

Even so, it was not clear there would be a vote because McConnell has said he will only call for a vote if he is assured of having enough votes to repeal the law. If the Senate repeals the law, the House of Representatives would then vote on it.

Republican majority unsure

A handful of Senate Republicans two months ago joined all 48 Democrats in the chamber to narrowly defeat three repeal proposals, part of Republicans’ seven-year effort to undermine the law, ever since Democrats alone, with no Republican votes, approved it in 2010.

It is not clear the majority Republicans have enough votes to pass the latest repeal effort advanced by Senators Lindsay Graham of South Carolina and Bill Cassidy of Louisiana. It would send block grants of federal money to the country’s 50 states and allow them to shape independent health care plans for the poorest people in their states, rather than having Washington officials allocate the money, as is now the case.

Numerous Democratic critics of the proposal, along with several major health care groups in the country, say that over the coming years the change in the law would cut millions of people from the insurance rolls.

Millions more Americans have been able to secure insurance to help pay their health care bills under Obamacare, but Republicans revile it, partly because almost all workers have been forced to buy insurance coverage or pay a penalty if they did not.

U.S. President Donald Trump, anxious for a major legislative victory, said in a Twitter comment, “I hope Republican Senators will vote for Graham-Cassidy and fulfill their promise to Repeal & Replace ObamaCare. Money direct to States!”

Trump targets Paul

Trump also attacked Republican Senator Rand Paul of Kentucky, who has announced his opposition to the latest repeal effort because he says it does not go far enough to upend the Obama law.

“Rand Paul is a friend of mine,” Trump said, “but he is such a negative force when it comes to fixing health care. Graham-Cassidy Bill is GREAT! Ends Ocare!”

Republican opponents are threading a narrow path to repeal, with only a 52-48 majority in the Senate. With all Democrats opposed to repealing Obamacare, Republicans can have only two defections, which would leave Vice President Mike Pence to break a 50-50 tie in favor of repeal.

With Paul and Senator Susan Collins of Maine considered as definitive “no” votes, the fate of the measure could again come down to two Republican senators who voted against a repeal effort in July, Senators Lisa Murkowski of Alaska and John McCain of Arizona.

Obama has rarely publicly engaged in the day-to-day Washington policy fights since Trump replaced him in January.

Obama aggravated

But on Wednesday, in a New York speech, Obama attacked Republicans for trying to overturn the health care law.

“The legislation that we passed was full of things that still need to be fixed; it wasn’t perfect, but it was better.” Obama said. “And so, when I see people trying to undue that hard won progress for the 50th or 60th time with bills that would raise costs or reduce coverage or roll back protections for older Americans or people with pre-existing conditions, the cancer survivor, the expecting mom, the child with autism or asthma for whom coverage, once again, would be almost unattainable.

“It is aggravating,” Obama said. “And all of this being done without any demonstrable economic or actuarial or plain common-sense rationale — it frustrates. And it certainly is frustrating to have to mobilize every couple of months to keep our leaders from inflicting real human suffering on our constituents.”

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