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Senate Republicans' new revised healthcare bill fails to bridge any gaps Republicans' new revised healthcare bill fails to sway many key Senators
(about 1 hour later)
Senate Republicans unveiled a revised healthcare plan on Thursday, seeking to bridge an intra-party divide that has so-far thwarted efforts to make good on a seven-year pledge to dismantle the Affordable Care Act (ACA), Barack Obama’s signature healthcare law. Senate Republicans unveiled a revised healthcare plan on Thursday, seeking to bridge an intra-party divide that has so far thwarted efforts to make good on a seven-year pledge to dismantle the Affordable Care Act (ACA), Barack Obama’s signature healthcare law.
The new bill includes provisions intended to woo moderate and conservative critics. But it was met with fresh skepticism, raising the prospect of a protracted battle in the coming weeks. But the new bill, which includes provisions intended to woo moderate and conservative critics, was met with fresh skepticism and the prospect of a protracted battle to come.
The revised legislation maintains some ACA taxes on the wealthy, a move that drew criticism from staunch conservatives. It also extends an olive branch to the hard right by adopting a controversial amendment by senators Ted Cruz of Texas and Mike Lee of Utah that moderates complained would gut coverage for pre-existing conditions and lead to a spike in premiums. The bill maintains some ACA taxes on the wealthy, as a way to address criticisms from moderates that Republicans are placing a substantial burden on the most sick and poor Americans. It also extends an olive branch to the hard right, by adopting a controversial amendment by Ted Cruz of Texas and Mike Lee of Utah that moderates said could gut coverage for pre-existing conditions and lead to a spike in premiums.
Obstacles to the revised bill were evident even before Republicans met behind closed doors for a briefing on Thursday morning. Key senators leaving a closed-door briefing were unmoved. Susan Collins of Maine, the first senator to voice opposition to the initial plan, said she would vote against the motion to proceed to the bill.
Lindsey Graham of South Carolina and Bill Cassidy of Louisiana touted an alternative proposal, which they said was not an effort to undercut negotiations but a plea to Republican leaders to “see which [plan] gets 50 votes”. “I don’t believe you that you make major changes in an entitlement program [Medicaid] upon which millions of Americans depend without having a single hearing in the Senate to evaluate the impact,” Collins told reporters.
The Graham-Cassidy proposal, drafted in conjunction with former Pennsylvania senator Rick Santorum, maintains taxes on the wealthy and sends resulting revenue directly to the states. It also repeals the healthcare law’s individual mandate, while keeping in place coverage requirements for pre-existing conditions. Shelley Moore Capito, who has opposed efforts thus far due to the impact of Medicaid cuts West Virginia, said she was “very much undecided”.
Senator Rand Paul, who had already launched a crusade against the revised healthcare bill, urged majority leader Mitch McConnell to repeal the ACA in its entirety. “I still think there’s questions, particularly coming from a state that has a high percent of people with pre-existing conditions, I’m concerned about that,” Capito said, adding that she expected another meeting on Thursday afternoon to address the issue of Medicaid.
“I don’t know that this is better than Obamacare,” Paul told Fox News of the revised plan, while reiterating his intention to oppose a procedural vote to advance the legislation. “This isn’t repeal by any means, shape or form.” Ohio’s Rob Portman also confessed to being undecided. Asked if there was any way he could support the bill, given it contains no substantial reforms to the initial Medicaid cuts, Portman said: “We’ll see.”
Underscoring the challenges facing leadership, John Cornyn, the Senate majority whip, pointedly refused to answer any questions. “I’m not going to talk about the whip check,” he said, brushing past reporters.
The revised plan will channel at least $70bn to states, aimed at helping offset costs for low-income individuals. Much of that money would come from maintaining two ACA taxes on households earning more than $250,000 and individuals earning more than $200,000 – a 3.8% investment tax and a 0.9% payroll tax. There is also an additional $45bn in funding against the opioid crisis, a priority for some senators.
The Cruz-Lee amendment allows insurers to offer plans that do not meet ACA requirements. Aides said the language could be revised or dropped at a later stage.
In a partial victory for Republican leaders, Cruz that he would vote in favor of taking up the bill in its current form. The Texas conservative’s support came with a caveat.
“If it’s amended and we lose the protections that lower premiums, my vote could well change,” he said.
Asked about the risk of a handful of Republicans joining Democrats to strip his amendment from the bill, Cruz referred to his so-called Consumer Freedom Option as “the key to bringing together 50 Republicans”. If the measure were stripped from the bill, he added, “it would do substantial damage, and I think it would likely cost the votes needed to pass the bill”.
Lee however said he was undecided, signaling a potential split among allies.
Last month, opposition to an initial healthcare plan from conservatives and moderates forced Republican leaders back to the drawing board. Republicans in the House of Representatives passed their own bill in May. It was regarded by their counterparts in the Senate as dead on arrival.
Obstacles were evident even before Republicans met behind closed doors for a briefing on Thursday morning. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana touted an alternative proposal, which they said was not an effort to undercut negotiations but a plea to Republican leaders to “see which [plan] gets 50 votes”.
The Graham-Cassidy proposal, drafted with former Pennsylvania senator Rick Santorum, maintains taxes on the wealthy and sends resulting revenue directly to the states. It also repeals the ACA’s individual mandate, while keeping in place coverage requirements for pre-existing conditions.
Graham told reporters his focus was on trying to get state governors on board. “Whether we got 50 votes or not, I don’t know,” he said. “But I know this: that if you’re a United States senator, and you’re a governor saying this bill hurts your state, and you’re a Republican and they’re a Republican, you’re pretty much in trouble.”
Graham said he would support the current bill if it came down to it, but criticized the plan as “Washington-centric”. “The one thing we make a mistake on as a conference I think is: we kind of blew by home,” he said.
Rand Paul of Kentucky, who had already launched a crusade against the revised bill, urged majority leader Mitch McConnell to repeal the ACA in its entirety.
“I don’t know that this is better than Obamacare,” Paul told Fox News, while reiterating his intention to oppose a vote to advance the legislation. “This isn’t repeal by any means, shape or form.”
“People forgot their promise,” Paul added, saying the revised plan amounted to a bailout of insurance companies. “This is not who we are as Republicans.”“People forgot their promise,” Paul added, saying the revised plan amounted to a bailout of insurance companies. “This is not who we are as Republicans.”
On Capitol Hill on Thursday, Arizona senator Jeff Flake said he was “still digesting it”, when asked if he might support a motion to proceed next week. Some Republicans countered that the current plan was simply the first stage in unraveling Obamacare.
Last month, opposition to an initial healthcare plan from conservatives and moderates alike forced Republican leaders to go back to the drawing board. Republicans in the House of Representatives passed their own bill in May, which was regarded by their counterparts in the Senate as dead on arrival. Ron Johnson of Wisconsin, who opposed the previous bill but was willing to advance and debate the revised legislation, said the ACA taxes could be done away with later in the year, through tax reform.
The biggest obstacle in June was a score from the nonpartisan Congressional Budget Office (CBO), which projected that 22 million more Americans would lose their health insurance over a 10-year period if the Senate Republican plan became law. It would also have reduced the federal budget deficit by $321bn over that period, mostly due to draconian cuts to Medicaid. Florida’s Marco Rubio advocated similar tactics. He also said he wanted to see further changes to the bill but disagreed with those who vowed to block it. “I think the sooner we can get to the floor and start to debate … in front of the American people, the better it’s going to be for everybody,” he said.
Many moderates were concerned about the impact the bill would have on low-income Americans who rely on Medicaid. Conservatives like Paul and Cruz were alienated by the fact that the proposal left much of the architecture of the ACA in place. Republican leaders are targeting a procedural vote to take up the bill by the end of next week, following a score from the nonpartisan Congressional Budget Office (CBO) that could arrive as early as Monday.
The revised plan keeps in place steep cuts to Medicaid but will put at least $70bn into states aimed at helping to offset the costs of low-income individuals. Much of that money would come from maintaining two ACA taxes on households earning more than $250,000 and individuals earning more than $200,000 – a 3.8% investment tax and a 0.9% payroll tax. There is also an additional $45bn in funding against the opioid crisis, a priority for some senators. The CBO score was the biggest blow to Senate negotiations in June, with a projection that 22 million more Americans would lose their health insurance over a 10-year period if the Republican plan became law. It would also have reduced the federal budget deficit by $321bn over that period, mostly due to draconian cuts to Medicaid.
The Cruz-Lee amendment allows insurers to offer plans that do not meet ACA coverage requirements. Aides said the language could be revised or dropped at a later stage. McConnell this week postponed the chamber’s August recess by three weeks, in an attempt to allow for more time to craft a new plan. Discussions have nonetheless been clouded by protesters who have swarmed Republican offices, and constituents who have pressured vulnerable senators by phone or at town halls.
McConnell this week postponed the chamber’s August recess by three weeks, in an attempt to allow for more time to craft a new plan. Discussions have nonetheless been clouded by an aggressive campaign on Capitol Hill by protesters, who have swarmed Republican offices, and constituents who have pressured vulnerable senators by phone or at town halls. Collins said healthcare was the only topic her constituents raised when she returned to Maine for the 4 July holiday. Most, she said, thanked her for taking a stand.
Susan Collins, a Republican from Maine who was the first to voice her opposition to the initial plan, said healthcare was the only topic her constituents raised when she returned home for the 4 July holiday. Most, Collins said, thanked her for taking a stance against the bill.
On the eve of the new bill’s rollout, a coalition of healthcare providers representing half a million doctors in the US stormed the Capitol as part of a last-ditch effort to persuade Republicans not to repeal the ACA.On the eve of the new bill’s rollout, a coalition of healthcare providers representing half a million doctors in the US stormed the Capitol as part of a last-ditch effort to persuade Republicans not to repeal the ACA.
Around 10 senators were paid a visit by the presidents of the American Academy of Family Physicians, the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association and the American Psychiatric Association. About 10 senators were paid a visit by the presidents of the American Academy of Family Physicians, the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, the American College of Physicians, the American Osteopathic Association and the American Psychiatric Association..
Elsewhere on Thursday, attorney general Jeff Sessions and health secretary Tom Price revealed what they called the “largest healthcare fraud takedown operation in American history”. Federal and state officials charged 412 people, including 56 doctors, with writing unnecessary prescriptions.Elsewhere on Thursday, attorney general Jeff Sessions and health secretary Tom Price revealed what they called the “largest healthcare fraud takedown operation in American history”. Federal and state officials charged 412 people, including 56 doctors, with writing unnecessary prescriptions.
The bust is part of a Republican strategy to crack down on fraud while also proposing revolutionary cuts to the programs concerned.The bust is part of a Republican strategy to crack down on fraud while also proposing revolutionary cuts to the programs concerned.
“Someone who instantly understands the importance of saving and strengthening Medicare and Medicaid for future generations is President Donald Trump,” said Price, at the press conference.“Someone who instantly understands the importance of saving and strengthening Medicare and Medicaid for future generations is President Donald Trump,” said Price, at the press conference.
Additional reporting by Jamiles Lartey and Jessica GlenzaAdditional reporting by Jamiles Lartey and Jessica Glenza
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