GOP Sen. Mike Lee of Utah pledged Thursday afternoon that he will not vote for the Senate’s bill to repeal major portions of Obamacare unless the legislation includes an amendment he is pushing with Sen. Ted Cruz of Texas.
The amendment, known as “Consumer Choice,” allows insurers to sell plans that do not follow regulations created under Obamacare for patients with pre-existing conditions, with the caveat that insurers have to sell at least one plan that adheres to Obamacare’s mandates. The proposal would allow insurers to sell cheaper plans with fewer benefits. (RELATED: White House Backs Free Market Amendment To Obamacare)
“The entire bill is unacceptable,” without the addition of the Consumer Choice amendment, Lee’s spokesperson Conn Carroll told Axios in an email.
Declaring himself a no vote pits Lee against Cruz, who has repeatedly hinted that the bill is a work in progress and has room for improvement. Lee would join a handful of conservative senators who are currently leaning towards voting against the bill. (RELATED: Sen. Ben Sasse Is Uncommitted On Senate Health Care Bill)
One of the key critiques of the Senate bill was that it failed to include a high-risk pool for older, sicker patients and that, in doing so, would make coverage unaffordable for the most at-need consumers.
The Cruz-Lee amendment effectively creates a de facto high-risk pool through incentivising customers with a history of health problems to purchase insurance in one marketplace and healthier consumers to purchase insurance in another. Essentially, the amendment would bifurcate the insurance market to create a pool of at-risk insurees in one market and a pool of healthier consumers in another. (RELATED: Ted Cruz Could Solve The Key Problem With Senate Obamacare Repeal Bill)
Consumers would also have the option of opting out of the healthier marketplace when and if they get sick. Yet, not everyone believes the marketplace would work in such a seamless fashion.
There is some concern that, say, a middle-class American could not afford insurance on either marketplace if they got sick or had a pre-existing condition.
A middle-class individual with a pre-existing condition who is also making over the $42,000 threshold may be barred from purchasing insurance on the non-compliant, healthier insurance marketplace, because the cost of obtaining insurance without subsidies could be too onerous. At the same time, the Obamacare-compliant insurance marketplace is likely to experience premium increases as high as 20 percent in 2018, which could also be prohibitive to many consumers.
One positive result of the amendment is it could work to soothe some wayward conservatives who want a more limited government approach to health care, while also satisfying the concerns of moderates who want to see pre-existing conditions covered under the new bill.
Doing away with Obamacare’s pre-existing conditions requirement could be as toxic to the fate of the bill as the proposed decreases to Medicaid expansion pose.
The Congressional Budget Office is currently reviewing portions of the bill Senate Majority Leader Mitch McConnell. The initial scores of the first two Senate drafts did not bode well for the bill, predicting 22 million would lose insurance if the legislation was passed and President Donald Trump signed it into law.
McConnell still appears to be short of the 50 votes needed to pass the measure through the Senate’s budget reconciliation process. A coalition of 10 Senate Republicans is calling upon the leader to either shorten the legislation substantially in order to pass it or postpone the vote till after the August recess, Politico reports.
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