Trump suggests Republicans will let ACA market collapse, then rewrite health law

(THIS ARTICLE IS COURTESY OF THE WASHINGTON POST)

Power Post

Trump suggests Republicans will let ACA market collapse, then rewrite health law

 July 18 at 10:52 AM
President Trump predicted Tuesday morning that Republicans may wait for the federal insurance market to collapse and then work to broker a deal to rewrite the nation’s landmark health-care law.In a series of tweets, Trump blamed the demise of a months-long effort to rewrite the Affordable Care Act on Democrats “and a few Republicans,” but he suggested that the drive to overhaul the law was not completely over.

“We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!” he tweeted. He added in a separate tweet: “As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!”

Trump’s latest comments appeared likely to intensify the current political uncertainty on Capitol Hill, where GOP leaders were debating what to do next, as well as raise anxiety among insurers that must commit to staying on the federal health exchange within a matter of weeks.

Republicans are reeling after two more GOP senators declared their opposition Monday to the party’s plan to overhaul the nation’s health-care system, likely ending their quest to make good on a GOP promise that has defined the party for nearly a decade and has been one of Trump’s top priorities.

Two Senate Republicans oppose health-care bill, jeopardizing vote
The U.S. Senate’s healthcare overhaul appears to be in trouble after two more Republicans say they oppose a revised version of the bill. (Reuters)

Senate Majority Leader Mitch McConnell (R-Ky.) opened the Senate on Tuesday morning touting his latest plan — to vote on a pure repeal, with a two-year delay, by taking up the House’s health-care bill. But while conservatives and Trump have been pushing for such a repeal as a last resort, it appeared unlikely that the vote would succeed.

Two Republican senators, Susan Collins (Maine) and Shelley Moore Capito (W.Va.), expressed opposition Tuesday to the repeal-only option, apparently burying it.

“I did not come to Washington to hurt people,” Capito said on Twitter. “I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”

“This doesn’t have to be the end of the story,” McConnell said. “Passing the repeal legislation will allow us to accomplish what we need to do on behalf our people.”

McConnell said the Senate would next take up “a repeal of Obamacare combined with a stable two-year transition period.” He said that President Barack Obama had vetoed such legislation before but that “President Trump will sign it now.”

While he noted that the measure had overwhelming support among Republican senators in 2015, the Senate leader also acknowledged that his party has suffered a political setback.

“I regret that the effort to repeal and immediately replace the failures of Obamacare will not be successful,” he said. “We will now try a different way to bring the American people relief from Obamacare.”

Republican Sens. Mike Lee (Utah) and Jerry Moran (Kan.) issued statements Monday declaring that they would not vote for the revamped measure. The sudden breaks by Lee, a staunch conservative, and Moran, a McConnell ally, rocked the GOP leadership and effectively closed what already had been an increasingly narrow path to passage for the bill.

They joined Sens. Rand Paul (Ky.) and Collins, who also oppose the latest health-care bill. With just 52 seats, Republicans can afford to lose only two votes to pass their proposed rewrite of the ACA. All 46 Democrats and two independents are expected to vote against it.

Lee supports the idea of moving ahead with a straight repeal of the existing law, and his spokesman, Conn Carroll, said Tuesday he would back a motion to proceed on a bill that would achieve that aim. But many centrist Republican senators have said they oppose dismantling key aspects of the ACA without an immediate replacement, given that roughly 20 million Americans have gained coverage under the law.

The confusion over next steps highlights the predicament now faced by Republicans, who have made rallying cries against Obama’s 2010 health-care law a pillar of the party’s identity. They may be forced to grapple with the law’s shift from a perennial GOP target to an accepted, even popular, provider of services and funding in many states, which could make further repeal revivals difficult.

Meanwhile, Trump and other Republicans will confront a Republican base that, despite fervent support for the president, still seeks a smaller federal government and fewer regulations.

All of these forces remained vexing factors Monday as senators bailed on the bill. And no evident solution was offered by the White House — which has been limited in its sale of the GOP plan — or from McConnell, for how to bring together a party in which moderates and conservatives are still deeply divided over the scope of federal health-care funding and regulations.

In many ways, the leadership plan did not go far enough for those on the right, but was too radical for GOP centrists. It scaled back some key ACA requirements and made deep cuts over time in Medicaid, but preserved popular provisions of the law such as a ban on denying coverage to consumers with costly medical conditions.

But the fact that it would reduce federal Medicaid funding and phase out the program’s expansion in 31 states and the District of Columbia rankled several key GOP governors and senators, who feared that their states would be saddled with the unpalatable choice of either cutting off constituents’ health coverage or facing a massive new financial burden.

The opposing pressures have left McConnell in a tough position as he has struggled to find a solution, which is why he has now thrown out the idea of moving to an immediate repeal.

Abolishing several of Obamacare’s central pillars — including the mandate that taxpayers buy coverage, federal subsidies for many consumers’ premiums and Medicaid coverage for roughly 11 million Americans — could wreak havoc in the insurance market. A Congressional Budget Office analysis in January estimated that premiums in the individual insurance market would rise between 20 and 25 percent next year and would roughly double by 2026.

At the same time, according to the CBO, the number of uninsured would spike by 18 million next year and rise to 32 million by 2026.

“For insurers, the worst possible outcome in this debate has always been a partial repeal with no replacement, which is exactly what Congress is about to take up,” said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation, in an email. “Insurance companies would be on the hook for covering people with preexisting conditions, but with no individual mandate or premium subsidies to get healthy people to sign up as well.”

But GOP leaders had no choice but to shift gears after Lee and Moran declared they could not support the party’s current health plan.

“In addition to not repealing all of the Obamacare taxes, it doesn’t go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly Obamacare regulations,” Lee said in a statement.

Moran said the bill “fails to repeal the Affordable Care Act or address healthcare’s rising costs.”

The two senators timed the release of their statements and made clear that modest tinkering around the edges of the legislation drafted by McConnell would not be enough to meet their demands. They joined a pair of GOP colleagues in calling for a complete redrawing of the legislation that would take many months, short-circuiting McConnell’s wish to end the debate this month.

The news threw the effort to pass the legislation into turmoil, with additional Republicans weighing in on Twitter about a flawed process that must take a new direction. Trump tweeted late Monday that “Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan.”

Sen. Lindsey O. Graham (S.C.) called for a “new approach” while Rep. Mark Meadows (N.C.) tweeted, “Time for full repeal.” White House aides, meanwhile, said they still plan to press ahead.

The setbacks appear to have left McConnell and House Speaker Paul D. Ryan (R-Wis.) with few good options. Conservatives have suggested moving a bill that would simply repeal the Affordable Care Act and set up a timeline of several years to figure out how to replace it, a politically risky move that also might lack support to pass.

Another move, which McConnell threatened recently, would be to work with Democrats to prop up the insurance exchange markets that have been imploding in some states — which probably would win passage but would infuriate the conservative base that has been calling for the end of the Affordable Care Act.

“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful,” McConnell said in a statement released late Monday. He revealed plans to move forward with a vote in the coming days anyway, in some ways daring his Republican opponents to begin debate and open the legislation up to amendments.

Democrats quickly jumped at the opportunity to declare the effort dead.

“This second failure of Trumpcare is proof positive that the core of this bill is unworkable,” said Minority Leader Charles E. Schumer (N.Y.). “Rather than repeating the same failed, partisan process yet again, Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health-care system.”

But Ryan showed little interest Tuesday in making common cause with Democrats, telling reporters that House leaders “would like to see the Senate move on something” to keep the repeal-and-replace process alive.

In a closed-door conference meeting, according to several members present, Ryan told colleagues that the ball remains in the Senate’s court and announced no plans for further action on health care in the House. He also urged House members to be patient and not to openly vent frustration with the Senate, the members said.

Publicly, he emphasized that the Senate had “a razor-thin majority” and that passing legislation is “a hard process.”

Republican leaders had returned to the Capitol on Monday still pledging to press ahead with plans to pass a far-reaching overhaul, but the day had begun with uncertainty as the health of Sen. John McCain (R-Ariz.) put the future of the flagging effort deeper in doubt.

In a speech on the Senate floor, McConnell said that he had spoken with McCain on Monday morning and that “he’ll be back with us soon.” The Arizonan is recovering from surgery to remove a blood clot above his left eye that involved opening his skull.

McConnell had delayed action on the health-care bill until ­McCain’s return in hopes that he could be persuaded to vote yes. That hope faded after Lee’s and Moran’s announcements, however, with McCain issuing a statement from Arizona calling for a fresh, bipartisan start.

Senate Republicans have been under self-imposed pressure to complete their work on health care. As they have struggled to show progress, McConnell has said he would keep the chamber in session through the first two weeks of August, postponing the start of the summer recess period to leave time to work on other matters.

Kelsey Snell, Mike DeBonis and Ed O’Keefe contributed to this report.

GOP Healthcare Bill Written For Everyone Except Themselves: They Keep Golden Plan We Have To Pay For

(THIS ARTICLE IS COURTESY OF THE WASHINGTON POST)

New GOP health care bill will determine winners, losers

 July 15 at 2:36 AM
WASHINGTON — Republicans’ latest health care plan would create winners and losers among Americans up and down the income ladder, and across age groups.It would give consumers more responsibility for their insurance choices, a goal long held by conservatives who argue that’s key to a true health care market. Younger adults and healthy people in the solid middle class may find more agreeable options. But low-income people may not be able to afford coverage, along with older and sicker adults.

And there are potential unintended consequences for people with employer-provided insurance, currently about 170 million Americans. Allowing individuals to pay premiums from tax-sheltered accounts may create incentives for employers to stop offering coverage, say some independent analysts.

The legislation would put limits on federal spending for Medicaid, a partnership program with states to cover low-income people, the disabled and nursing home residents. The drawback is that state officials could eventually face no-win choices, such as having to pick between paying for coverage for low-wage working mothers and support services for elderly people trying to stay out of nursing homes.

As Senate Majority Leader Mitch McConnell, R-Ky., steers toward debate and votes next week, here is a look at some of the latest changes and major issues:

___

CRUZ’S PLAN

The new Senate bill incorporates the core of a proposal from Sen. Ted Cruz, R-Texas, that would reorganize the market for policies purchased by individuals. As many as 20 million Americans get coverage this way, about half through subsidized markets like HealthCare.gov, created under former President Barack Obama.

Cruz would change basic requirements that Obama’s law imposed on individual plans, including standard benefits such as pregnancy, maternity and newborn care; wellness visits and mental health treatment. The law also requires the same premium rates for sick and healthy people.

Under the Cruz approach, an insurer can offer plans that don’t comply with such requirements, provided they also offer coverage that does. The problem, say critics, is that the healthy would flock to low-premium, skimpy plans, leaving the sick to face escalating prices for comprehensive coverage.

“Healthy people would have opportunities to buy lower-premium, skinnier plans, while people with pre-existing conditions not eligible for premium subsidies could find themselves priced out of insurance,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.

The latest bill includes another $70 billion to help states keep health insurance affordable for older, sicker customers. But it’s not clear how those backstops would work, and the federal funding eventually would end.

Some insurers are worried because of a technical change with huge practical implications: Health plans that enroll healthier customers would no longer have to cross-subsidize those with sicker patients, as is currently required.

“We think it is unworkable,” said Justine Handelman, top Washington lobbyist for the BlueCross BlueShield Association. She predicted skyrocketing costs for taxpayers also, stuck with the bill for sicker patients.

___

EMPLOYER ESCAPE HATCH?

McConnell’s new bill made a major change to tax-sheltered health savings accounts, which was also advocated by Cruz.

Under the bill, health savings accounts could be used to pay premiums with pre-tax money. Under current law, they can only be used to cover out-of-pocket costs, such as deductibles and copayments.

The change is meant to level the playing field for people buying individual plans, as compared to people getting employer coverage. The value of workplace insurance is tax-free for employees and tax-deductible for employers.

But some analysts say McConnell risks undermining workplace coverage.

The upside is that the change might encourage more self-employed people to buy individual health insurance policies. The downside is that some employers may see it as an invitation to drop health benefits, particularly since the GOP also would repeal Obama’s requirement that larger companies provide health care or face fines.

“Allowing individuals to purchase insurance with pre-tax dollars eliminates one of the advantages to employer-provided insurance,” said Elizabeth Carpenter of the Avalere Health consulting firm. “That may lead some employers to consider whether or not they want to continue to offer health insurance.”

___

THE POOR AND THE SICK

McConnell kept some of the Obama-era tax increases used by Democrats to finance expanded coverage. But the money will be going to shore up private insurance, not the Medicaid program. Medicaid accounts for half or more of the 20 million Americans gaining coverage as a result of the Affordable Care Act.

Medicaid covers low-income people, from many pregnant women and newborns, to disabled people and many elderly nursing home residents. The GOP bill would start by phasing out enhanced federal financing for Obama’s Medicaid expansion, adopted by 31 states. Perhaps more significantly, it would limit future federal funding for the overall program. As a result, it’s estimated Medicaid would cover 15 million fewer people by 2026.

The bill would add $45 billion to help states confronting the opioid epidemic pay for treatment and recovery. But that hasn’t swayed the American Medical Association, which points out that people in recovery also need comprehensive health insurance.

Republican governors don’t like the Medicaid cuts, and some have been vocal. About half the states that expanded Medicaid now have GOP chief executives.

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Nevada Gov. Brian Sandoval, a Republican who oversaw a Medicaid expansion, said more than 200,000 people gained coverage in his state.

“You think about 210,000 men, women and children, senior citizens, the drug addicted, the chronically ill,” Sandoval said. “These are people that used to get their treatment in emergency rooms, if they got any treatment at all. I keep going back to the fact that they are living a better quality of life.”

___

Associated Press writer Jennifer McDermott in Providence, Rhode Island, contributed to this report.

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

What’s Inside Mitch McConnell’s Latest Health-Care Proposal

(THIS ARTICLE IS COURTESY OF THE ATLANTIC NEWS AGENCY)

What’s Inside Mitch McConnell’s Latest Health-Care Proposal

The revised Senate bill would keep more of Obamacare’s taxes while allowing insurers to wiggle out of its regulations. Will Republicans go for it?

J. Scott Applewhite / AP

revised Senate health-care bill

Seeking to quell a revolt from more than one-fifth of his conference, Majority Leader Mitch McConnell agreed to forego two significant tax cuts for the wealthy and instead pour hundreds of billions of dollars back into the proposal he released two weeks ago. There’s now $45 billion to combat opioid addiction and even more funding to help mitigate higher insurance costs for low-income people and to stabilize the individual markets. An additional $70 billion would go to states to help drive down premiums, on top of $112 billion that was in the original proposal. McConnell’s target was senators toward the center of the Republican ranks, who represented the largest bloc of opposition to his first legislative draft.To woo conservative critics, the majority leader added a provision based on a proposed amendment from Senators Ted Cruz of Texas and Mike Lee of Utah—backed by pressure from a number of activist groups—that would allow insurance companies to sell stripped-down, inexpensive plans that don’t conform to Obamacare’s standards as long as they offer at least one policy that does. Well, sort of. McConnell’s draft includes the Cruz-Lee idea in brackets, an indication of its polarizing and therefore precarious status within the GOP health-care debate.

McConnell needs to pick up support from both ends of the ideological spectrum. He can afford only two Republican defections, and at least 10 of his members had come out against the first version of the Better Care Reconciliation Act before McConnell abandoned plans to bring it up for a vote last month. Two of those critics, Senator Susan Collins of Maine in the center and Senator Rand Paul of Kentucky on the right, appear to have hardened in their opposition this week. Collins said it would take “a complete overhaul” to win her support, and Paul has gone on a media tour to rail against the revised proposal, saying that based on what he had heard, it was even worse than the original because it repealed less of Obamacare and included a bigger “bailout” for insurers.

Within hours after the revised draft’s release, both Paul and Collins reiterated their opposition to it an d said they would vote against even bringing it up for debate. As on the final vote, McConnell needs at least 50 Republicans to sign off on the procedural motion, and with Paul and Collins apparently out, he needs every other member of his conference to agree.

In a speech on the Senate floor after unveiling the bill to Republicans, McConnell pleaded with his colleagues to allow it at least to come up for debate. “I hope every senator will vote to open debate. Because that’s how you change the status quo,” he said. “This is our opportunity to really make a difference on health care. This is our chance to bring about changes we’ve been talking about since Obamacare was forced on the American people. It’s our time to finally build the bridge away from Obamacare’s failures and deliver relief to those who need it.”While McConnell picked quick support from several party loyalists, most of the holdouts on the original draft remained undecided. Senators Rob Portman of Ohio and Shelley Moore Capito of West Virginia said they would review the bill, as did Senator Dean Heller of Nevada, a sharp critic initially who is under intense pressure in the run-up to a reelection campaign next year. In an ominous sign for McConnell, however, Capito said in a statement she still had “serious concerns” about the proposal.

McConnell all but ignored complaints from moderates to soften the bill’s deepest and most contentious cuts—a $772 billion reduction in Medicaid spending over a decade, with hundreds of billions in additional cuts in the 10 years after that. The cuts, which include a four-year phase-out of Obamacare’s Medicaid expansion and a change in the program’s growth rate, would not begin until 2020. According to the Washington Post, McConnell told moderates to support the bill with those cuts included because they would never go into effect.

Though rather cynical, it’s an assumption held by some in Washington-based on the likelihood that Democrats will win control of the House in 2018 or the presidency in 2020 and work with Republicans to put off the Medicaid cuts.While the new bill maintains most of the Medicaid cuts, it changes the formula under which hospitals would be reimbursed for treating patients that can’t pay their bill. And it would allow states some wiggle room if a public health emergency was declared or to seek a waiver to access more funds to cover the elderly and disabled, according to a summary posted by the Senate Budget Committee.

Yet like the entire bill itself, McConnell’s Medicaid bet is a risky one. Senators like Collins, Lisa Murkowski of Alaska, Heller, Portman, and Capito have strongly opposed the cuts to Medicaid and were already frustrated with the secretive, top-down process McConnell has led on the health-care bill. And conservative activists and senators have pointed to the Medicaid changes as one of the few things they like about a proposal that does not truly fulfill their promise to repeal Obamacare. They had already stomached the Senate’s longer lead-time in ending the ACA’s Medicaid expansion, but will they recoil at McConnell’s reported admission that the reforms might not endure at all?

In another blow to Collins and Murkowski, McConnell also retains provisions blocking federal funds from going to Planned Parenthood and banning the use of subsidies to purchase plans that cover abortion. Both senators had criticized those aspects of the original bill, and if both Collins and Paul vote against the legislation as they’ve indicated, Murkowski’s opposition on those grounds could sink it entirely.

Cruz has demanded the inclusion of his Consumer Freedom Choice Amendment in the underlying Senate bill as the price for his support. But the version that McConnell included was different, Lee tweeted shortly before Republicans were scheduled to see the revised bill for the first time.

Just FYI – The Cruz-Lee Amendment has not been added to BCRA. Something based on it has, but I have not seen it or agreed to it. 1/2

9:52 AM – 13 Jul 2017

I am withholding judgment and look forward to reading it. 2/2

While Lee was undecided, Cruz told reporters that he would support the bill as long as his amendment stayed in and no other changes were made. His position appeared to mimic the new stance of conservative activist groups, who have conceded that Republicans can’t fully repeal the Affordable Care Act but in recent days made the adoption of Cruz’s amendment striking at its core regulations their final demand. Even Grover Norquist, the anti-tax activist who has prioritized the repeal of Obamacare’s tax increases, issued a statement signaling he was okay with McConnell’s decision to keep some of them now as long as the leadership committed to getting rid of them in subsequent tax-reform legislation. Norquist told me in an interview last month that keeping the taxes on the wealthy even temporarily was “a bad idea.”

Illustrating McConnell’s challenge in navigating the bill to passage, the changes that Cruz and Lee are demanding could solidify opposition among moderates or lose even more votes among Republicans leery of doing anything that threatens protections for people with preexisting conditions. The health-care industry is aligned against the proposal, which would essentially create separate insurance markets for sick and healthy people. Even the insurance industry’s top lobbying group, America’s Health Insurance Plans, came out in public opposition to the amendment after staying quiet through much of the Senate debate. Whether the Cruz amendment stays in the bill is in doubt. A senior GOP policy staffer said Thursday the provision was put in brackets in the bill text because “the policy is continuing to be worked on as members react to it.” Republicans have asked the Congressional Budget Office to score versions of the bill with and without the Cruz policy, but it’s unclear whether the report released next week will fully assess the amendment.

The next big test for McConnell will come early next week, when the CBO releases its analysis. The original bill fared little better with the CBO than the legislation House Republicans passed in May; the budget office found that the Senate bill would result in 22 million fewer people having health insurance after a decade. McConnell is hoping that the infusion of money into the subsidy and stabilization programs will improve that number and boost support for the bill. But if three or Republicans vote against a procedural motion to bring the proposal to the floor next week, it won’t even see a formal debate.In an indication of how dicey the revised bill’s prospects were, two Republican senators, Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, chose the day of its release to unveil their own, competing idea for a partial replacement of Obamacare. Appearing on CNN before a crucial GOP meeting, they proposed a plan that would do away with Obamacare’s individual and employer mandates but keep most of its tax increases. But instead of funding a federal subsidy program, that revenue would be sent to the states so that they could craft their own health-care plans as they saw fit.

“If you like Obamacare and you want to repair it, you can,” Graham said on CNN. “If you want to replace it, you can.”

The idea is in line with an earlier proposal from Cassidy and Collins that would have allowed states to choose whether they kept Obamacare or not. That plan went nowhere, but with Republicans nearing a stalemate on health care, the senators are betting that their colleagues will give it another look.

There Must Be Only One Health Insurance Program Allowed In America!

 

Americans are you sick and tired of the D.C. politicians playing with your healthcare and with your ability to pay for it? Obamacare, Trump-care, repeal and replace, repeal and don’t replace, this amendment and that amendment, are you sick of the political noise and of the politicians not giving a damn about you or your family? Personally I am sick of both political parties who only cater to the Lobbyist and not the voters. This latest GOP Healthcare plan showed once again that the Republican so-called Leadership only cares about the Lobbyist as they released copies of the Bill to Lobbyist before even releasing it to other ‘rank and file’ Republican Senators. For 7 years Republican Lawmakers whined, complained, threatened and promised to repeal and replace ‘Obamacare’ right away as soon as they were in a position to do so. Yet after all of that time they didn’t even have the beginning of any plan.

 

Here is my plan, yet not just my plan as I have seen a few other people voice this same opinion in writing and verbally. It is a simple plan and it is the most ‘Constitutional’ plan that I believe exist. If indeed if these bought and paid for politicians believe in the Constitution and the Scriptures about all people being created equal and that all people should be treated as equals then there is only one Healthcare program that should be for all people. The concept is simple and it should be legal as it is and has been in place for some folks for decades now. I will quit talking and just spit it out now.—I do not know anything about the plan that covers all of the Senators and Congress men and women and the President but what ever that plan is—that should be the plan that all of the American people have with no exceptions. After all, if it is good enough for ‘our public servants’ then it is good enough for their supposed bosses, ‘We The People’ then it is good enough for the American people also, isn’t it?

New GOP health care bill could allow cheaper plans with fewer benefits

(THIS ARTICLE IS COURTESY OF CNN)

New GOP health care bill could allow cheaper plans with fewer benefits

  • Cruz’s so-called Consumer Freedom amendment is contentious among Republicans
  • The amendment would allow insurers to sell cheaper plans with fewer benefits

Washington (CNN) Senate Republicans unveiled their newest health care bill Thursday as they continue to search for the majority needed to repeal and replace Obamacare.

Now, it’s up to senators to decide if they like it.
The new bill includes major changes to the original. One of the most significant was the inclusion of an amendment by Texas Sen. Ted Cruz, which would allow insurers offering Obamacare plans to also offer cheaper, bare-bones policies. The amendment was included in an effort to earn more conservative support, but could also drive away some moderates who fear the amendment could drive up premiums for those with pre-existing conditions.
It also contains significant new funding for opioid treatment and money for states meant to lower premiums for high-cost enrollees. But it would keep two Obamacare-era taxes on the wealthy and maintains significant cuts to Medicaid, meaning 15 million fewer people could insured by the program by 2026.
Majority Leader Mitch McConnell is still in search of the 50 votes he needs to pass the bill — he can only afford to lose two senators — but the hope for leadership is that a few changes may be able to finally get Republicans on a path to repeal and replace Obamacare after seven years of campaign promises.
Already on Thursday Sen. Rand Paul of Kentucky said he wouldn’t even support the motion to debate the bill on the floor.
Sen. Susan Collins, a Republican from Maine, also told reporters that she would not vote for the motion to proceed unless she saw significant signs from the nonpartisan scoring agency — the Congressional Budget Office — that the cuts to Medicaid would be less severe than she anticipated.
“The only thing that can change that is if the CBO announcement, which come out on Monday, indicates that there would be far fewer in Medicaid than I believe there are now,” Collins said.
Emerging from a meeting with fellow senators Thursday, Republicans were cautiously optimistic with many saying they needed to sit down to read the bill before they made any final decisions.
Sen. Jeff Flake, an Arizona Republican, said he was “still thinking” as reporters swarmed him.
Sen. Bill Cassidy of Louisiana said “I always want to say I criticized Nancy Pelosi for saying ‘we got to pass the bill to know what’s in it.’ I want to know what’s in it before I say I’m gonna pass the bill.”
Moderates from Medicaid expansion states continued to voice their concerns about the new bill. West Virginia Republican Sen. Shelley Moore Capito said she was “very much undecided” and would meet once again with McConnell this afternoon.
“I still think there’s a lot of unanswered questions particularly coming from a state that has a high percent of people with pre-exiting conditions,” she said.
Alaska Sen. Lisa Murkowski, one of the GOP holdouts, was unhappy that reporters had seen a summary distributed to lobbyists before she had seen the bill.
Asked if she was upset by how the process unfolded, she said “yes.”
“I think that as a courtesy to those of us who are actually making the decisions that we would actually have an opportunity to see it first,” Murkowski added.
A major question remains whether President Donald Trump can use his bully pulpit to actually move senators.
Trump has lobbied for Republicans to move quickly. The President said Wednesday he would be “very angry” if Republicans can’t pass the bill.
“I don’t even want to talk about it because I think it would be very bad,” Trump said in an interview with the Christian Broadcasting Network. “I will be very angry about it and a lot of people will be very upset.”

What’s new?

The revised legislation has $45 billion in opioid treatment funding — a top request from senators like Rob Portman of Ohio and Shelley Moore Capito of West Virginia — as well as in state stabilization money aimed at lowering premiums for high-cost enrollees.
But another concern for moderate senators — that the Senate bill makes steep cuts to Medicaid funding — was not addressed in the new version. The original bill calls for slashing $772 billion from Medicaid by 2026, compared to current law, leaving 15 million fewer people insured by the program.
In a retreat from a key GOP promise, the bill would also keep two Obamacare-era taxes on the wealthy. That came as members said they worried about the optics of cutting taxes for the rich while also slashing funding for subsidies that go to help low-income people to buy insurance. Retaining the taxes, which saves the federal government $230 billion over 10 years, provides McConnell money to help boost the stabilization fund, sources said. But it is also likely to infuriate conservative lawmakers and lobbying groups.
The legislation would allow consumers to use their health savings accounts to pay their premiums for the first time, which Cruz called “very significant.”

Graham plan

Also Thursday, GOP Sens. Cassidy and Lindsey Graham of South Carolina proposed an alternative approach to replacing Obamacare that would keep much of the federal taxes in place and sending that money to the states to control.
They say that one of the primary reasons Republicans are having such a hard time agreeing is because they are working from the Obamacare template — particularly federal control of health insurance.

Cruz amendment

Cruz’s so-called Consumer Freedom amendment is considered contentious among Republican senators with some moderates having raised concerns that it could hurt those with pre-existing conditions. The amendment would allow insurers that offer Obamacare plans on the exchanges to also sell policies that are exempt from certain of the law’s mandates. That could allow carriers to provide less comprehensive plans with lower premiums, which would likely attract younger and healthier Americans.
But that would leave the sicker, more expensive consumers in the Obamacare plans, causing their premiums to spike.
Offering Obamacare plans will also make insurers eligible for new federal funding aimed at helping insurers pay for high-cost enrollees.
Sen. Mike Lee — a Utah Republican and close Cruz ally — tweeted Thursday morning to say that he has not seen the newest version of the Cruz amendment included in leadership’s health care bill and was unsure if he could support it.
There’s also no guarantee the Cruz amendment — in whatever form — will even get a Senate vote. It could be stripped from bill at any time as GOP leaders negotiate and work their way through Senate rules.
Insurers, who have largely stayed on the sideline in the health care debate, voiced strong opposition to the amendment, saying it would destabilize the individual market. Two major lobbying groups said this week that it would create two sets of rules and make coverage unaffordable to those who are sick.
“I’m writing to make clear my view on how the ‘Consumer Freedom Option’ is unworkable as it would undermine pre-existing condition protections, increase premiums and destabilize the market,” Scott Serota, CEO of Association of Independent Blue Cross Blue Shield Plans, wrote to Senators Cruz and Lee earlier this week.

The U.S. Constitution Says All Are Created Equal, GOP House And Senate Say Hell No

 

Once again the GOP federal Congress and Senate show their disdain (the feeling that someone or something is unworthy of one’s consideration or respect; contempt) for the poor and the working class American people. The GOP in their healthcare bill they are pushing down the throats of the American people show how much they despise at least the bottom 90% (incomes) of the people. I live in Kentucky so Senator Mitch McConnell is one of my two Senators so I am hoping that the next time he comes up for reelection that the people of this State vote this horses behind out of office. I am a registered voting Independent, I personally can’t stand either the Republican or the Democratic Party leaderships as in my opinion neither have any interest in being honest with the American people.

 

Even though this next ‘idea’ is not one I invented I have felt this way for many years concerning health care in America. There is only one health plan that should be allowed here in our Country and that is: every single person in America should have exactly the same insurance as the Congressmen, Congresswomen, the U.S. Senators and the President have, exactly the same as theirs. They are supposed to be the servants but they have illegally made themselves into our slave masters. I do not know anything about what their plans are, I do not know if they have to pay anything out of their own pockets for the monthly costs or if they have deductibles but shouldn’t ‘We The People’ be allowed to have at least as good of healthcare as ‘our servants’? For these people to be bringing ‘other’ healthcare bills to the ‘floor’ for a vote is pure and total hypocrisy! Okay, these are just my thoughts on this issue, what are your thoughts on this issue?

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