What’s on the table
Key changes that could bring the skeptics on board
Majority Leader Mitch McConnell, R-Ky., delayed a vote on the Senate health care bill that would repeal and replace Obamacare after it became clear the legislation lacked enough votes for even an initial motion to bring the bill to the floor.
At least eight senators have come out against the bill, and a handful of others have raised concerns. Republicans can lose just two votes because no Democrats are expected to back the bill.
Here are some of the key changes that could bring various factions on board:
UNREGULATED OPTIONS FOR INSURANCE PLANS Conservative Sens. Mike Lee, RUtah; Ted Cruz, R-Texas; and Rand Paul, R-Ky., have all said they want less regulation in health care coverage. Lee is looking for an addition to the bill that would allow insurance companies that are offering regulated plans to also be able to offer unregulated options.
Basically, that would mean that as long as an insurer offers plans that cover the minimum benefits required by the Affordable Care Act — including maternity care, substance abuse treatment and prescription drugs — the insurer could also offer policies don’t include these services. Those plans would cost less because they don’t cover as many procedures.
The concern from moderates would be that healthier people would likely buy the cheaper plans with fewer benefits, leaving only the oldest and sickest people to buy the “regulated coverage,” causing prices to go up. That would essentially do away with the ACA’s ban on insurers basing prices on a customer’s health status.
LONGER PHASE-OUT OF MEDICAID EXPANSION Thirty-one states plus Washington, D.C., expanded Medicaid enrollment under Obamacare. Medicaid is a joint federal-state program that provides health insurance for the poor, disabled and elderly. Republicans want to decrease funding for the program. The current health care bill will decrease funding for the expansion over a three-year period. It will also cap funding for Medicaid overall.
For someone like Sen. Dean Heller, R-Nev. — whose state expanded Medicaid and whose Republican governor has been a vocal opponent of any legislation that would hamper the expansion —a longer phase-out or more money for Medicaid may help get him on board.
A longer phase-out means more federal spending. Conservatives feel the Senate health care bill is already expensive enough.
MORE MONEY FOR OPIOID ADDICTION Sens. Shelley Moore Capito, RW.Va., and Rob Portman, R- Ohio, have both expressed concerns about the impact of the GOP bill on the opioid crisis, which has taken a horrific toll on their home states.
The current Senate bill would provide $2 billion in opioid treatment for one year and a threeyear phase-out of Medicaid expansion. If McConnell plumps up the addiction funding, that could help draw Capito and Portman in.
DROP EFFORT TO DEFUND PLANNED PARENTHOOD Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, both expressed concern that the legislation would pull Medicaid funds from Planned Parenthood centers.
It is currently against the law for federal dollars to fund abortions, but anti-abortion activists want to stop all funding to Planned Parenthood. If McConnell removes the funding cut, he may get Murkowski’s and Collins’ support.