WASHINGTON
— After weeks of secret negotiations, Senate Republicans on Thursday
released their much-anticipated proposal to repeal Obamacare, unveiling a
plan that would cut Medicaid and reduce penalties for not buying
insurance.
But
despite pledges to walk back key pieces of the House’s American Health
Care Act, approved by that chamber last month, the Senate bill appears
strikingly similar. Though Trump heaped public praise on the bill, Trump
reportedly called it “mean” at a closed-door lunch. The nonpartisan
Congressional Budget Office said the House plan would result in 23
million fewer people covered than under current law.
“From what I understand their bill tracks in many ways along the lines of the House bill,” said House Speaker Paul Ryan, R-Wis.
Among
the notable changes between the two bills: The Senate policy-crafters
elected to drop waivers allowing states to let insurers raise costs for
people with preexisting conditions. That key piece was added to AHCA in
an effort to entice conservatives to support the bill.
But
the Senate version would actually have deeper cuts to Medicaid than the
AHCA as part of Congress’ attempts to phase out the Obama
administration’s expansion of the program to funnel more money to states
to help low-income Americans.
The
House version would end those subsidies in three years, a timeframe
supported by more conservative members including Senate Majority Leader
Mitch McConnell, R-Ky. But more moderate Senate lawmakers argued that
more years were needed.
In
an effort to forge a compromise, the Senate plan would end the extra
Medicaid payouts after four years. But it would also begin capping the
amount of money each state can receive from the program. Currently
states can get funds from Medicaid to cover all eligible recipients.
Senate
Majority Leader Mitch McConnell walks to the Senate floor of the U.S.
Capitol after unveiling a draft bill on health care in Washington on
June 22, 2017.Like
the House bill, the Senate’s version would end the penalties levied on
individuals who chose not to purchase insurance, a key piece of
Obamacare. It would also roll back tax increases on wealthier Americans
and health insurance companies.
Another
key piece of Obamacare, subsidies helping poorer Americans purchase
health insurance, would be reformed under both the AHCA and the Senate
plan. The Senate plan, however, would factor in both age and income,
whereas its House counterpart solely uses age.The
Senate legislation would also shift one of the key pieces of the House
version, a $115 billion fund to help stabilize state marketplaces, into a
separate bill reauthorizing the Children’s Health Insurance program this year.
Sen.
Lisa Murkowski, R-Alaska, leaves a meeting of GOP senators at the
Capitol on June 22, 2017, where most had their first chance to look at
legislation aimed at overhauling the Affordable Care Act. (Photo: Chip
Somodevilla/Getty Images)
But
like the House bill, the Senate proposal defunds Planned Parenthood for
a year, a potential deal breaker for Sens. Lisa Murkowski, R-Alaska,
and Susan Collins, R-Maine. The Senate bill also prevents any insurance
plans on the exchange from covering abortion except in the case of rape
and incest and encourages private plans not to cover abortion as well.
McConnell said the bill was a needed improvement over Obamacare.
“Republicans believe we have a responsibility to act, and we are,” McConnell said on the Senate floor.
“Democrats
imposed Obamacare on our country,” he said. “They said it would lower
costs; it didn’t. They said it would increase choice, but of course, it
didn’t.”
But
many of McConnell’s members declined to comment as they left a
closed-door meeting where the Republican senators were briefed on the
proposal. Others said they were still reviewing the discussion draft
presented Thursday morning, which stretched over 140 pages.
“Obviously we have a lot to look at,” Murkowski told reporters while leaving the meeting.
Democrats
wasted no time, however, in blasting the proposal, referencing the
president’s derisive comments about the bill and arguing it is little
different from the AHCA, which 21 percent of Americans support,
according to a Quinnipiac poll last month.
“The
president said the Senate bill should have heart. But this bill is
heartless,” Senate Minority Leader Charles Schumer, D-N.Y., said in a
floor speech.
McConnell
said on the floor that the Congressional Budget Office would score the
Senate bill next week and then proceed to a debate and vote
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