New hurdles as Republicans rush to reverse Obama health law

Momentum for repealing and replacing the Affordable Care Act — a primary Trump pledge as a candidate — swelled in the past week, after a group of Republican senators unveiled a bill that would effectively replace Obamacare with block grants to the US states.

Senators returned to Washington with Republicans hoping to ram the bill through in the next 12 days, before a change in procedural rules that currently allow a health care overhaul to pass with a simple 51-vote majority in the 100-member chamber.

But if the bill were to move forward before September 30, it would have to do so without a comprehensive review by the Congressional Budget Office (CBO).

"That's problematic," moderate Republican Senator Susan Collins told reporters.

"I'm concerned about what the effect would be on coverage, on Medicaid spending in my state, on the fundamental changes in Medicaid that would be made without the Senate holding a single hearing to evaluate them."

Collins is one of the three Republicans who voted against the previous Obamacare repeal effort, which dramatically collapsed July 28 when Senator John McCaingave his thumbs down on the plan. In recent days, the senator from Arizona said he would rely on his state's governor for guidance on whether the new plan, known as the Graham-Cassidy bill, was viable. As Arizona Governor Doug Ducey endorsed the new plan, its co-author Senator Lindsey Graham insisted the effort was "gaining the momentum we need to repeal and replace Obamacare."

But McCain's hesitation was clear. He expressed frustration with the lack of public hearings or a CBO score of the legislation. "I am going to continue to look at this as the process goes on," McCain told reporters. "But I want regular order."