Senate Majority Leader Mitch McConnell (R-KY) today unveiled another version of a bill to repeal much of the Affordable Care Act, though it’s not clear that this revised plan can get 50 votes by next week’s tentatively scheduled vote.
The GOP health-care bill released today includes a controversial amendment offered by Sen. Ted Cruz (R-TX) that would allow insurers to sell low-cost plans that don’t comply with Obamacare coverage requirements, provided they also offer at least one plan that does. Cruz and Sen. Mike Lee (R-UT) have said the amendment needs to be included in the final bill to win their support.
Cruz said the proposal will lower premiums and give consumers more choices, though critics have argued that providing the option of a cheap plan that doesn’t cover things like mental and substance abuse treatment will attract younger, healthier consumers and create split risk pools – one with sick people and those with preexisting conditions, and one with healthy young people.
Senate leaders are floating the Cruz proposal in the revised bill, leaving open the option of cutting it out of the final plan depending on how the Congressional Budget Office (CBO) scores its impact on the federal budget deficit and the overall number of uninsured. Senate leaders said they expect two scores from CBO next Monday, one with the Cruz amendment and one without.
Even after days of reworking sections of the bill, McConnell is at serious risk of losing more GOP votes than he can afford. McConnell can only lose two Republican votes and still get the 50 he needs to take up and pass the legislation.
Sen. Rand Paul (R-KY) has flatly stated he is a ‘no’ on McConnell’s revised bill, which he said is worse than the original proposal. The new version, he said, keeps some of the taxes imposed by the Affordable Care Act that the original bill would have repealed. Indeed, Senate leaders have decided to keep two key Obamacare taxes on high earners to help pay for changes to their bill meant to win over moderate Republicans, including more money for tax credits for low-income Americans and funding for opioid-abuse programs.
Those changes may not be enough to win support from Senate moderates, including Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK), who oppose the huge cuts to Medicaid in McConnell’s bill and the roll-back of Medicaid expansion funding to states beginning in 2021.
“If the Medicaid cuts remain the same in the new version of the Senate bill, I will vote no on the motion to proceed,” Collins said yesterday.
Meanwhile, as the Senate looks for consensus on changes to the bill, President Trump has said he will be “very angry” if the Senate does not get a bill passed. “I am sitting in the Oval Office with a pen in hand, waiting for our senators to give it to me,” Trump said Wednesday. “It has to get passed. They have to do it.”