Health care state of play: The last lunch, and no agreement

PHOTO: Senate Majority leader Mitch McConnell smiles as he leaves the chamber after announcing the release of the Republicans healthcare bill, June 22, 2017. PlayJ. Scott Applewhite/AP Photo
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Senate Republicans’ Thursday all-member lunch was the last opportunity for the conference to discuss health care together before the July recess, and they don’t seem anywhere near an agreement.

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Led by Senate Majority Leader Mitch McConnell, Republicans have zeroed in on a few new proposals intended to get holdouts on board with the health care bill, but none of the options appear to be enough to get anyone from a no to a yes vote, and in fact some of the provisions could turn off members who currently support the bill.

"It's hard to predict exactly where this thing is going to end up,” Sen. Susan Collins, who remains opposed to the bill, said. There are a few new items that are in the mix as possible additions to the original bill: An extra $45 billion or more in additional funding for opioid treatments as well as a proposal to keep some of the Obamacare taxes including one on the investments of wealthy individuals and couples.

Some conservatives are also advocating for a proposal from Sen. Ted Cruz that would allow insurance companies to offer cheaper health care plans that don’t include essential health benefits required by the Affordable Care Act.

But some senators interviewed by ABC News before and after the lunch expressed skepticism that any of these items individually could get holdouts on board, and others expressed outright hostility to some of the ideas.

One Republican senator said the additional opioid funding was the only new proposal that members agree on. But Sen. Rob Portman, whose home state of Ohio has been especially hard hit by the opioid crisis and who does want more funding for treatment, said earlier through a spokesperson that this provision alone wouldn’t be enough to get him to support the bill.

“This is just one of several asks,” a Portman spokesperson said.

Some moderate Republicans are amenable to keeping some Obamacare taxes on wealthier Americans in order to avoid passing new laws that appear to be tax cuts for the rich. But Sen. John Thune, a member of Senate leadership, acknowledged that “there are probably a few” senators who would drop their support of the bill if those taxes stayed in place.

And while Cruz’s amendment on insurance plans is picking up steam with the conservative wing of the conference, some moderates fear it could mar insurance coverage pools which depend on healthy people buying comprehensive plans in order to help lower costs for all who buy in.

“Until somebody endorses the Patient Freedom Act, I don’t think it’s really serious,” said Sen. Bill Cassidy, referring to Cruz’s proposal. He also noted that it might not meet some of the procedural requirements needed to pass bills under the rules of budget reconciliation, which only require a 51-vote threshold.

McConnell had said he wanted to submit changes to the Congressional Budget Office by Friday in order to allow the office time to analyze the bill’s updated budgetary impact. But as they were walking into their lunch, where Vice President Mike Pence stopped by, Republicans were speaking in such esoteric terms that it seemed they were less narrowing the terms of a deal and more engaging in an intellectual exercise.

“I hope [Cruz] and others keep coming up with interesting ideas. I’ve got a lot of them myself,” Sen. Orrin Hatch told reporters.

“A lot of moving parts,” added Portman.

Pence also continued his one-on-one shuttle diplomacy, meeting with skeptics including Collins, Sen. Shelley Moore Capito and Sen. Ted Cruz, but at least one of the members he met with today was still a no by this afternoon.

“I did not,” Collins said when asked if she heard anything in the lunch today that would persuade her to vote in favor of the bill.

ABC News’ John Parkinson contributed to this report.