In a continued effort to repeal and replace Obamacare, Senate Republican leaders unveiled an updated draft health care bill Thursday.
The revised bill represents Senate Majority Leader Mitch McConnell’s attempt to bring both moderate and conservative defectors back into the fold after a number of Republican senators from both ideological persuasions announced their opposition to the original Senate bill.
The bill provides an additional $70 billion in federal funds to offset the cost of rising premiums, on top of the $100 billion included in the original draft. In a significant departure from the previous version, the new draft keeps Obamacare’s additional taxes on the wealthy. Had the GOP repealed the 3.8 percent tax on investment income and the 0.9 percent payroll tax paid by the wealthy, it would have saved $231 billion over the next decade, according to The New York Times.
In an effort to appease conservative defectors, the new draft includes the so-called Cruz amendment, a provision introduced by Sen. Ted Cruz of Texas and Sen. Mike Lee of Utah, which allows providers to offer non-Obamacare compliant plans as long as they also offer at least one Obamacare compliant option.
The Cruz amendment has faced heavy criticism from moderate Republicans and Democrats alike, who claim the amendment would split risk pools, sending premiums soaring for the elderly and the sick. The amendment allows the healthy and the young to buy less comprehensive and cheaper plans, leaving the old and sick who buy Obamacare compliant plans in a separate risk pool.
The revised draft seeks to address this issue by establishing a government fund to reimburse providers for the cost of insuring high risk people who remain on the Obamacare exchanges.
“They’re trying to find a way to make his approach workable within the context of the other, broader insurance marketplace,” GOP Sen. John Thune of South Dakota told the Wall Street Journal in reference to the inclusion of the Cruz measure. He added a cautionary note, saying that nothing is final and the CBO score, to be released next week, will likely affect support for the bill.
Like the older version, the new bill includes substantial cuts to Medicaid, places caps on reimbursements for states and rolls back Obamacare’s Medicaid expansion. This despite the fact that Medicaid cuts were a major sticking point for moderate GOP lawmakers and governors in states that accepted expanded Obamacare Medicaid subsidies. (REVISED: Here’s The One Significant Change Of The New Senate Obamacare Bill)
The bill also includes $45 billion to combat the opioid crisis in a bid to appease GOP Sens. Rob Portman of Ohio and Shelley Moore Capito of West Virginia, both of whom voiced opposition to the original version for insufficient abuse prevention funds.
Notably, for the first time the new draft allows consumers to use tax advantaged health care savings accounts to pay for their premiums.
It remains unclear whether the bill goes far enough to appease conservatives, as Sen. Rand Paul of Kentucky has already said he will oppose an essential procedural vote expected to take place next week. Moderate GOP Sen. Susan Collins of Maine, who has voiced concerns about Medicaid cuts, is also likely to oppose the bill.
If Paul and Collins vote against the bill, GOP leadership can’t afford any additional defectors, as they need a simple majority to pass the bill under budget resolution rules.
GOP Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana introduced an alternative plan Thursday morning, which they believe has a better chance of passing. The alternative bill would keep many Obamacare taxes in place but would hand the funds over to the states.
The Congressional Budget Office is expected to release their report early next week indicating how the proposed bill would affect the federal budget. The CBO estimated that the original Senate bill would leave 22 million people uninsured relative to the current law. The report proved a major factor leading to the internal dissent which caused the GOP leadership to cancel the vote before the July 4 recess.
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