By Alana Abramson
June 23, 2017

The fate of the Senate GOP health bill could lie with three female Republican lawmakers who, like many of their colleagues, were left out of the group responsible for drafting it.

When Senate Majority Leader Mitch McConnell selected the group of 13 lawmakers who would work on drafting a health care bill to replace the Affordable Care Act in May, none of the five female Republican Senators were included. Because all Senate Democrats are expected to vote against the bill, McConnell can only lose a maximum of two Republican votes. Consequently, the three female Senators who have expressed reservations about policies included in the bill — West Virginia’s Shelley Moore Capito, Maine’s Susan Collins, and Alaska’s Lisa Murkowski — could make or break the plan. (The fourth female Republican Senator, Iowa’s Joni Ernst, said in a statement that she was reviewing the bill. The fifth, Nebraska’s Deb Fischer, not did return a request for comment.)

None of the women have yet to signal they will oppose the bill, which McConnell unveiled Thursday after nearly two months of work that took place primarily behind closed doors. But they have issued lukewarm statements about the legislation. A statement from Collins’ spokeswoman noted a “number of concerns,” but said that she was still reviewing the legislation. Capito and Murkowski used similar language in their statements, saying respectively that they would “evaluate” the bill and “crunch the numbers.”

Several male Republican Senators, including Ted Cruz, Ron Johnson, Mike Lee, and Rand Paul, said Thursday they would not support the bill in its current form. But the female Republicans are in a unique position given the bill’s potential impact on a range of women’s health issues. Further complicating matters is the fact that McConnell did not include any female Senators in the team drafting the bill. (Capito’s office described her as an “active participant” in the process, but she was not a permanent member of McConnell’s group.) The omission raised eyebrows among some Democrats.

“The GOP is crafting policy on an issue that directly impacts women without including a single woman in the process,” tweeted Democratic Senator Kamala Harris. “It’s wrong.”

Of course, the three women could end up supporting McConnell’s bill. But there are reasons to believe they may not, or will at least seek changes before it comes to a vote.

Before the bill was revealed, Capito told Axios that it would be a problem for her if the proposal capped Medicaid spending. (Over half a million West Virginians rely on Medicaid, up 59% since the program was expanded under the Affordable Care Act.) Indeed, McConnell’s draft slashes Medicaid funding. In her statement on the bill, Capito said she is reading it to determine if it “provides access to affordable health care for West Virginians, including those on the Medicaid expansion.”

Collins, meanwhile, said the language in McConnell’s bill defunding Planned Parenthood “unfair and short sighted.”

“There already is a ban on the use of federal funds for abortions,” said Collins. “That already exists and to single out Planned Parenthood which provides services to so many low-income women for family planning and woman care is just wrong and not logical.”

Murkowski, meanwhile, said that “it’s no secret that healthcare needs to be reformed, but it needs to be done right,” adding that she remains “committed to ensuring that all Alaskans have access to affordable, quality healthcare.”

For his vision of American health care to become reality, McConnell may have to convince these three women to stand with him. But experts say that’s far from a sure thing. “Because there was a clear exclusion of women from supposed dialogue, there is a visible exclusion of women from that process, it is now striking to both wonder and observe whether or not at the end of the day it’s those same women that could make or break the process,” said Kelly Dittmar, an assistant political science professor at Rutgers University-Camden.

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