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What We Know About The Senate Obamacare Repeal Bill

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Robert Donachie Capitol Hill and Health Care Reporter
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Senate Republicans are slated to reveal their version of Obamacare repeal to the public Thursday, although it does not appear that they have enough support to pass the legislation in a vote anticipated next week.

The plan is expected to differ from the House Republicans bill — the American Health Care Act — which passed in early May.

1) Obamacare Medicaid Expansion Funding

The Senate bill is expected to include a 3-year phase out of the federal funding granted to the Obamacare Medicaid expansion program, starting in 2020. The 3-year timeframe is Senate Majority Leader Mitch McConnell’s idea and was devised to help bridge the divide between conservative and moderate Republicans who had drastically different policy preferences regarding the Medicaid expansion program. (RELATED: Trump To Meet With Wavering Senators On Obamacare Repeal)

Moderate senators wanted something closer to a 7-year timeframe for rolling back funds. Senate conservatives, like House conservatives, wanted a quicker, 2-year rollback of the Medicaid expansion program. Some 20 Republican senators are in states that chose to expand Medicaid under Obamacare, and many are concerned about the number of Medicaid recipients who would lose coverage under the House bill.

The Senate bill will cap the Medicaid expansion program funding, starting in 2025, and the cap will be tied to the rate of inflation. This differs substantially from the House version, which capped the program’s funding at the rate of medical inflation and added on one additional percentage point.

The House bill includes an aggressive rollback of federal funds granted to Obamacare’s Medicaid expansion program, and would allow for some insurance companies to charge higher premiums to consumers with drug addictions.

2) Timing Of The Repeal

The Senate version also differs from the House bill in that it makes way for a more gradual repeal of Obamacare, in an effort to give constituents more time to adjust. The Senate bill looks to delay the repeal effort until 2020, which could give Republicans in Medicaid expansion states a break in the 2018 and 2020 election cycles.

3) State Waivers For Obamacare’s “Essential Health Benefits”

The Senate version will include waivers for states that wish to opt out of certain provisions of Obamacare, but unlike the House bill, it will not allow states to waive essential health benefits for individuals with pre-existing conditions.

One provision of the House bill that drew a great deal of flack from Obamacare supporters was that it cut funding for Planned Parenthood for one year. The Senate version is also expected to include this yearlong cut in funding to the organization.

The Senate version will eliminate Obamacare taxes and will delay the “cadillac tax” on employer-provided health insurance plans.

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