New health care bill revealed; will GOP support it?
2 Republicans already say ‘no’ to latest draft
WASHINGTON — Republican leaders unveiled a new health care bill Thursday in their increasingly desperate effort to deliver on seven years of promises to repeal and replace “Obamacare.” They immediately lost two key votes, leaving none to spare as the party’s own divisions put its top campaign pledge in serious jeopardy.
The reworked bill Senate Majority Leader Mitch McConnell, R-Ky, presented to fellow Republicans aims to win conservatives’ support by letting insurers sell low-cost, skimpy policies. At the same time, he seeks to placate hesitant moderates by adding billions to combat opioid abuse and help consumers with skyrocketing insurance costs.
But it was not clear whether the Republican leader has achieved the delicate balance he needs after an embarrassing setback last month when he abruptly canceled a vote in the face of widespread opposition to a bill he crafted largely in secret.
The new draft bill is full of three weeks’ worth of small tweaks and goodies throughout, but its most substantial policy change came at the behest of two Senate conservatives, Ted Cruz of Texas and Mike Lee of Utah. They wanted to roll back the Affordable Care Act’s regulations of health insurance, and largely got their wish.
Moderate Sen. Susan Collins of Maine told reporters she had informed Mr. McConnell she would be voting against beginning debate on the bill, citing in part cuts in the Medicaid health program for the poor and disabled. Sen. Rand Paul of Kentucky, who has repeatedly complained that Mr. McConnell’s efforts don’t amount to a full-blown repeal of Obamacare, also announcedhe was a “no.”
That means Mr. McConnell cannot lose any other Republican
senators. With Democrats unanimously opposed in a Senate split 52-48 in favor of the GOP, he needs 50 votes, with Vice President Mike Pence breaking the tie, to get past a procedural hurdle and begin debate on the bill.
Even before the revised Better Care Reconciliation Act was released, two Republican senators floated their own rival plan.
The surprise alternative proposal — by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — is only a general outline. It would preserve some taxes in the current health law while creating new block grants to ship billions of dollars to states, giving them broader authority to redesign their health insurance markets.
“We’re going to see which one can get 50 votes,” Mr.Graham told CNN, even though the plan did not appear to be gaining traction.
Ms. Collins also said that she hopes Senate Minority Leader Chuck Schumer, DN.Y., will be willing to work with Republicans to fix the legislation.
The showdown vote is set for next week, although Mr. McConnell could cancel again if he’s short of support. He and other GOP leaders are urging senators to at least vote in favor of opening debate, which would open the measure up to amendments.
Mr. McConnell said the 172-page legislation is the senators’ opportunity to make good on years of promises.
“This is our chance to bring about changes we’ve been talking about since Obamacare was forced on the American people,” he said.
Like legislation earlier passed by the House after struggles of its own, the Senate bill would get rid of Obamacare’s mandates for individuals to buy insurance and for companies to offer it, repeal taxes and unwind the Medicaid expansion created by the Affordable Care Act. Analyses by the Congressional Budget Office have found the House bill and the earlier Senate version both would eliminate insurance coverage for more than 20 million people over the next decade.
The new bill contains language demanded by Mr. Cruz letting insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by former President Barack Obama’s 2010 statute.
The Cruz provision appears in the legislative text in brackets, meaning specific language is still being composed.
The retooled measure retains Mr. McConnell’s plan to phase out the extra money 31 states have used to expand Medicaid under Mr. Obama’s statute, and to tightly limit the overall program’s future growth.
The rewritten package would add $70 billion to the $112 billion Mr. McConnell originally sought that states could use to help insurers curb the growth of premiums and consumers’ other out-of-pocket costs.
It has an added $45 billion for states to combat the misuse of drugs like opioids. That’s a boost over the $2 billion in the initial bill.
To help pay for the added spending,the measure would retainthree tax increases Mr. Obama’s law slapped on higher-earning people.
And the legislation has a provision that appears to benefit only one state, Alaska, by setting aside some federal assistance for states with extremely high premiums.