Senate Republican leaders on Thursday unveiled a revised version of their bill to repeal and replace ObamaCare as they race toward a high-stakes vote next week.
The measure includes changes aimed at winning over additional votes, with leadership making concessions aimed at bringing both conservatives and moderates on board. (READ THE BILL HERE.)
But Senate Majority Leader Mitch McConnellMitch McConnellPelosi calls for revoking Kushner’s security clearance The Hill’s 12:30 Report Senate Republicans unveil revised healthcare bill MORE (R-Ky.) is facing a tough task in finding enough votes to pass the bill. Sens. Susan CollinsSusan CollinsCollins a ‘no’ on latest healthcare draft Senate Republicans unveil revised healthcare bill Free Kevin Hassett! Trump pick a victim of Senate partisanship MORE (R-Maine) and Rand PaulRand PaulSenate Republicans unveil revised healthcare bill New GOP healthcare bill includes version of Cruz amendment CNN panel: Trump voters say they’re ‘scared’ on healthcare MORE (R-Ky.) appear to be firmly against the measure, and one other defection would kill the bill
Overall, McConnell appears to have shifted the revised bill more toward the conservatives than the moderates.
Importantly, the bill largely keeps the Medicaid sections the same, meaning that deeper cuts to the program will still begin in 2025, and the funds for ObamaCare’s expansion of Medicaid will still end in 2024.
The changes to Medicaid have emerged as a top concern for moderates such as Sens. Rob PortmanRob PortmanSenate Republicans unveil revised healthcare bill Overnight Healthcare: Senate GOP outlines revised health bill | Bill to be released Thursday | Study finds Cruz change could raise premiums for 1.5M Overnight Finance: GOP goes after arbitration rule | Bill allocates .6B for Trump border wall | Fed officials cautious on rate hike | McConnell aiming for debt vote before August recess MORE (R-Ohio), Shelley Moore CapitoShelley Moore CapitoSenate Republicans unveil revised healthcare bill Tax credits bring much needed relief Overnight Healthcare: Senate GOP outlines revised health bill | Bill to be released Thursday | Study finds Cruz change could raise premiums for 1.5M MORE (R-W.Va.) and Lisa MurkowskiLisa MurkowskiSenate Republicans unveil revised healthcare bill Conservatives: Working with Dems on healthcare a waste of time McConnell presses holdouts: Let’s vote MORE (R-Alaska).
The Congressional Budget Office (CBO) found that those Medicaid changes in the original bill would result in 15 million fewer people being enrolled in the program and cut spending by $772 billion over 10 years.
For the conservatives, the measure includes a version of an amendment from Sens. Ted CruzTed CruzCruz supports new ObamaCare replacement bill The Hill’s 12:30 Report Senate Republicans unveil revised healthcare bill MORE (R-Texas) and Mike LeeMike LeeThe Hill’s 12:30 Report Senate Republicans unveil revised healthcare bill New GOP healthcare bill includes version of Cruz amendment MORE (R-Utah) aimed at allowing insurers to offer plans that do not meet all of ObamaCare’s regulations, including those protecting people with pre-existing conditions.
Conservatives argue the change would allow healthier people to buy cheaper plans, but moderates and many healthcare experts warn that premiums would spike for the sick people remaining in the more generous insurance plans.
Senate Republicans had vowed to not change the ObamaCare protections for people with pre-existing conditions in the healthcare bill, which is why the debate over the Cruz-Lee amendment has been heated.
A Senate GOP aide said Thursday it is possible that the Cruz amendment would not be analyzed by the CBO in time for the vote next week. It is possible the Department of Health and Human Services could provide an alternative analysis.
Lee cautioned that he was not involved in the changes to the proposal, including the amendment, and would have to review the new language before deciding whether to support it.
The bill does include new funding, $70 billion over seven years, aimed at easing costs for those sick people remaining in the ObamaCare plans.
In addition, another $70 billion has been added to the original $112 billion “stability fund” to help bring down insurance premiums.
However, the new measure does not boost the generosity of the tax credits, as some moderates wanted. It still replaces ObamaCare’s tax credits to help people afford insurance with a smaller, scaled-down tax credit that provides less assistance.
The Kaiser Family Foundation found premium costs would increase an average of 74 percent for the most popular healthcare plan, given the reduced assistance in the GOP bill.
The new measure will leave in place two ObamaCare taxes on the wealthy, in a departure from the initial bill.
That original measure lacked the support to pass, as more moderate members pointed to the CBO’s finding that 22 million fewer people would have insurance over a decade.
Senate Republicans are now awaiting a new score of the revised legislation from the CBO, which could come early next week.
The new bill does include $45 billion to fight opioid addiction, but moderates such as Capito and Portman who hail from states where the problem is rampant have said they also want changes to the Medicaid portion of the legislation.
In a change that could appeal to Murkowski, the bill sets aside 1 percent of the stability funds for states with costs that are 75 percent above the national average, which would benefit high-cost states like Alaska.
— This story was updated at 12:54 p.m.