Returning from their one week recess, Senate Republicans continued with their attempts to pass their Better Care Reconciliation Act (BCRA), hoping to have votes towards the end of the week. But much like the legislative hurdles in the weeks leading up to the recess, many Republicans have said they would vote "no" because they felt the bill wasn't good enough for the people in their state or that it was still too much like the Affordable Care Act (ACA), otherwise known as Obamacare.

Repeal or sabotage Obamacare

While the future of the bill itself has been in doubt, President Trump and his aides have made their demands that if the Senate was not able to pass their bill, that they should simply repeal Obamacare and replace it with the BCRA later.

Senate Majority Leader Mitch McConnell has essentially dismissed the suggestion. And yet, it's unknown if he would accept some effort by other senators to help speed up the process of repealing the ACA.

It's been reported that with the support of Sen. Mike Lee (R-Utah), Sen. Ted Cruz (R-TX) wants to pass an amendment called: "Consumer Freedom Option" that offered insurance providers the chance to not have to be held to the restrictions and regulations of the ACA in exchange for something "better." It was already reported that many insurers were leaving the market under the ACA and with rising premiums, people are less reluctant to sign up.

Trump's demands over constituents

President Trump's legislative director Marc Short gave his support for Sen. Cruz's plan on Fox News last Sunday. Republicans have said in interviews over the years that Obamacare was failing which was not necessarily the case.

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Over that span of time, Republicans have said that the law was in a death spiral and that it would end up collapsing on itself, which many Republicans have said they would like to see. If Senator Cruz's plan were to stand a chance in Congress, a death spiral would certainly become more fact than fiction.

However, according to a report by Politico titled: "Conservatives bet on risky plan that could tank Obamacare markets," the Congressional Budget Office (CBO) scores would already make it more unpopular than moderate Republicans are willing to accept. There is no doubt moderates would be under pressure to their constituents to go by the score as they've already been doing every time they return to their districts and held town halls. Also, parliamentary rules would cause a lot of problems along the way.

Needless to say, Trump surrogates who want a win for replacing and/or repealing the ACA -- as well as President Trump himself -- have already expressed that they feel the process Congress goes through to pass bills already gets in the way.

First signs of this were when House Republicans passed their American Health Care Act (AHCA) without a CBO score or even the willingness to write a bill that made legislative sense. As a result, the Senate rewrote their own which is still having problems getting passed.

CBO, parliamentary issues and backlash from insurance providers

Even during the creation of the BCRA, it was reported that Mitch McConnell checked with the CBO regularly in order to make adjustments along the way. Issues with parliamentary rules had also been reported, such as with abortion related amendments over the Byrd Rule with the Hyde Amendment. Seeing the issues that threaten the bill quite clearly, another point of concern might be with Republicans who are more supportive of Trump's style of legislating, could decide to somehow override those requirements.

As for Sen. Cruz, it was reported that his amendment had made it into the recent version of the bill but that America’s Health Insurance Plans and the BlueCross BlueShield Association united and sent a letter to the Senate demanding that Cruz's amendment be removed from the bill. They said that it was unworkable and that it would undermine protections for pre-existing conditions for millions of patients. It's already been reported that many medical organizations tried to meet with McConnell to provide input into the Senate's BCRA. However, McConnell refused to meet with them, therefore, rejecting their suggestions. It's likely that a scathing letter will also be just as easily ignored.