Senate Republicans are trying to keep their ObamaCare repeal bill alive this week after a surprise setback is casting doubt on a timeline for the legislation. 
 
 
McCain's absence left Republicans officially unable to get the 50 votes needed to advance the healthcare bill, which was already facing an uncertain future and no room for error. 
 
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"While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act," McConnell said in a statement over the weekend. 
 
The move is expected to delay the legislation for at least a week as McCain recovers in Arizona. The Mayo Clinic, which removed a blood clot from above the senator's left eye, noted it was waiting for the results from a pathology report to determine next steps in his treatment. 
 
But it's unclear if McConnell will have the support for his ObamaCare repeal-and-replace proposal even after McCain returns to Washington. 
 

“At the end of the day, I don’t know whether it will pass,” Collins told CNN. 

With a slim 52-seat majority, leaders need at least 50 GOP senators to support the bill, allowing Vice President Mike Pence to break a tie.

McConnell scored a small victory late last week when he managed to keep enough of his caucus on the sidelines that the ObamaCare repeal bill didn’t die immediately after it was released on Thursday

His next test is expected to be the Congressional Budget Office's analysis of the updated bill, setting up a potential make-or-break moment for the GOP effort. The score was set to be released on Monday, but on Sunday the office signaled that it was delayed and would be released at the earliest on Tuesday

A politically disastrous CBO score of the initial bill found that an additional 22 million Americans would become uninsured over a decade under the proposal, and that some low-income individuals would be priced out of being able to afford health insurance. 

The White House is trying to get ahead of the CBO score, arguing the analysis is flawed and inaccurate. 
 
"Although the media and the political left will certainly seize on it, the CBO’s estimates will be little more than fake news," White House legislative affairs director Marc Short and Brian Blase, a special assistant to the president for healthcare policy at the National Economic Council, wrote in a Washington Post op-ed. 

The surprise delay will give leadership more time to try to secure enough support to get the bill over an initial motion to proceed vote, but it will also give opponents more time to target key GOP swing votes. 

Several key moderate GOP senators — including Sens. Dean Heller (Nev.), Lisa Murkowski (Alaska) and Rob Portman (Ohio) — largely held their fire late last week, saying they wanted to wait to see the CBO score. 

They also huddled in McConnell’s office with Seema Verma, Trump’s Medicaid chief, on Thursday afternoon to discuss the Senate bill, which fundamentally overhauls the program. 

Murkowski and Collins have been particularly vocal about the Medicaid cuts, arguing GOP leadership is trying to include drastic entitlement reform in what is supposed to be an ObamaCare repeal bill. 

"The only change that the Affordable Care Act made in the Medicaid program was to give states the ability to expand coverage with an increased federal match. It did not re-write the entitlement program,” Collins told reporters. 

Portman and Heller are also stuck between McConnell — who needs to them to vote for this bill — and their state’s GOP governors, who have been deeply critical of it. 

Ohio Gov. John Kasich (R) said on Friday that the Senate bill is “still unacceptable” and the Medicaid cuts are “too deep.” Meanwhile, Nevada Gov. Brian Sandoval (R) huddled with top administration officials over the weekend but signaled after the meeting that he was still unconvinced. 

“I am struggling to validate the numbers that are being presented to me by the administration, versus what I'm hearing from independent [experts], what I'll likely hear from the CBO, what I'm hearing from back home,” Sandoval told reporters

Other undecided GOP lawmakers include Sens. Bill Cassidy (La.), Shelley Moore Capito (W.Va.) and John Hoeven (N.D.), who were critical of the initial proposal. Cassidy is sponsoring an amendment with Sen. Lindsey Graham (R-S.C.) to shift more control of the insurance market back to individual states. 

McConnell will need to run the board and win over every hesitant moderate senator if he wants to get his healthcare bill through the upper chamber. 

He’ll also need the support of Sen. Mike Lee (R-Utah), a close ally of Sen. Ted Cruz, who remains undecided. GOP senators are hopeful the Texas Republican will be able to bring him on board. 

A modified version of an amendment originally hashed out by Cruz and Lee is included in the Senate bill, though it could be stripped out either in response to the CBO analysis or opposition from moderate senators. 

The language gives insurance companies more flexibility in selling plans that do not meet ObamaCare’s coverage mandates, but centrist senators, including Cassidy, signaled late last week that they weren’t sold. They are worried the provision will lead premiums to rise on sick people and those with pre-existing conditions.

GOP leadership is expected to move forward with a vote even if they don’t have 50 votes locked in. The healthcare debate has loomed over the agenda for months, and senators are increasingly signaling they want to move on to other delayed priorities like tax reform and figuring out how to fund the government. 

McConnell has acknowledged that his current effort could fall short, warning that would force Republicans to work with Democrats who want ObamaCare to stay in place. 

Using bipartisanship as a “Plan B” has split GOP senators. Conservatives argue it is a waste of time, but that hasn’t stopped other rank-and-file members from trying to work with Democrats. 

Sen. Joe Manchin (D-W.Va.) told reporters late last week that he had talked briefly with Graham about trying to hash out a plan. Meanwhile, Collins said the failure of the GOP ObamaCare repeal bill could be “the beginning” of moving a bipartisan bill through the Senate committees. 

“This is not over if this bill does not succeed,” she told reporters late last week. "I believe that the Democrats are going to be forced to come to the table despite the very conflicting signals that [Senate Minority Leader Charles] Schumer [D-N.Y.] has given."

Russia sanctions

Lawmakers are trying to reach agreement on bipartisan legislation to impose new sanctions on Russia and establish congressional oversight of the Trump administration’s implementation.

The bill also slaps sanctions on Iran for its ballistic missile development, and lawmakers are now considering whether to include North Korea in the mix.

House Majority Leader Kevin McCarthy (R-Calif.) called for adding North Korea sanctions into the bill after its intercontinental ballistic missile launch in early July.

The House overwhelmingly passed legislation in May to establish harsher North Korea sanctions in a 419-1 vote.

“I believe Iran, the work that Russia has done, and what North Korea has done, it would be a very strong statement for all of America to get that sanction bill completed and done and to the president’s desk,” McCarthy said on the House floor.

Senate Foreign Relations Committee Chairman Bob CorkerBob CorkerThe Hill's 12:30 Report Iran nuclear deal still under threat — US must keep its end of the bargain Senate heads to new healthcare vote with no clear plan MORE (R-Tenn.) said he has discussed the idea with his House counterpart, Rep. Ed Royce (R-Calif.), and appeared open to it.

“There is no question that we need to apply more pressure to North Korea," Corker said in an email.

The bill originally passed in the Senate by a 98-2 vote. But it stalled after lawmakers said it violated the constitutional requirement that all revenue-raising measures originate in the House.

Senators then approved changes by unanimous consent to address the issue. But yet another procedural sticking point emerged over the last several days after House Democrats objected to a provision that they say weakens their oversight over the Trump administration.

House GOP leadership had requested the language, which allows only the majority party to force votes to block the Trump administration from lifting the sanctions.

House Minority Leader Nancy Pelosi (D-Calif.) suggested Friday that she was willing to let the issue go in order to move the bill forward.

“I want to protect the prerogatives of the minority in the House, but weighing the equities, what was more important was passing the Russian-Iran sanctions bill. So we are on board to just proceed,” Pelosi said.

Budget

House Republicans are weighing whether to move a trillion-dollar spending package to keep the federal government funded in the next two weeks before the August recess.

The House GOP whip team is expected to survey members on Monday to gauge support after announcing the move at a party conference meeting on Friday.

The House Appropriations Committee is expected to finish approving all 12 of its annual spending bills for 2018 by the end of the week. In addition, the House Budget Committee is expected to unveil a 2018 budget resolution after weeks of delays.

Conservatives have been pushing for more spending cuts, but have met resistance from centrists who think the idea has no real shot at passing in the Senate. Whatever Congress has to pass to avoid a government shutdown at the end of September will need support from Senate Democrats, who can filibuster spending bills they don’t like.

Republicans are hoping that moving a spending package would at least establish a marker ahead of negotiations to avoid a shutdown when Congress returns from the August break.

Adopting a budget doesn’t just have consequences for keeping the government funded. The GOP will need to get a 2018 budget rolling in order to use the procedural route for tax reform that won’t require votes from Democrats.

Congress is far behind in the annual budget and appropriations process this year. The House has typically passed multiple spending bills on the floor by this point in the summer, but so far not a single one for 2018 has made it for a vote.

In the meantime, the House is expected to consider multiple energy infrastructure measures this week to create a uniform process for constructing electric transmission facilities and cross-border pipelines, establish state and federal agency coordination for approving natural gas pipeline projects and set up how states can implement the Environmental Protection Agency’s ozone standards.

Nominations

Senators will take up President Trump’s pick to fill the No. 2 spot at the Defense Department this week before turning to healthcare.

The Senate will have a procedural vote on Patrick Shanahan’s nomination to be deputy secretary on Monday evening, setting up a final vote for Tuesday night or Wednesday morning if Democrats drag out debate time.

Sen. John McCain (R-Ariz.) both tried to clear Shanahan’s nomination on Friday and then set up a final vote on Shanahan’s nomination in the evening, but was blocked both times by Schumer.

The New York Democrat argued Republicans shouldn’t expect cooperation when they are trying to pass ObamaCare repeal without hearings and along party lines.

“Given the frustration he remarked on that our side has on healthcare … I would say to the gentleman that we would be happy to consider the nominee in the regular order. And maybe once things change a little bit on healthcare ... we can move a lot of things quickly,” he said.

Bob Work — Shanahan’s predecessor, if he’s confirmed — had his last day in the No. 2 spot on Friday.