La.’s senators say it eliminates inequity for their state, but neither publicly backs it
WASHINGTON — Senate Republican leader Mitch McConnell of Kentucy released his new but still-reeling health care bill Thursday (July 13) . It bids for conservative support by letting insurers sell low-cost, skimpy policies and reaches for moderates with added billions of dollars to combat opioid abuse and help states rein in consumers’ skyrocketing insurance costs.
Allowing insurers to offer bare-bones plans, however, threatens to alienate moderates and perhaps other conservatives. And the measure retains cuts in Medicaid — the health insurance plan for poor and disabled people and nursing home patients — that moderate Republican senators have fought.
The 172-page legislation, the Senate GOP’s plan for rolling back much of President Barack Obama ‘s health care law, faces a do-or-die vote next week on which McConnell has no margin for error. Because Democrats uniformly oppose the effort, McConnell needs the votes of 50 of the 52 GOP senators to prevail, and two have already said they will vote «no»: conservative Rand Paul of Kentucky and moderate Susan Collins of Maine.
Underscoring the measure’s dicey prospects, No. 3 Senate Republican leader John Thune of South Dakota said, «We’ve got a long way ahead of us yet. The floor is going to be a wild place next week.»
Louisiana’s two Republican senators, John Kennedy and Bill Cassidy, said the latest version of the bill corrects a funding issue that would have treated Louisiana unfairly compared to other states. Neither, however, committed publicly to backing the bill.
«This unfair treatment would have cost Louisiana $2 billion in health care funding. This was a legitimate issue that needed to be fixed, and I’m pleased to say it has been, » Kennedy said. «Now we can focus on creating a health care system that actually works.»
«The problem with Obamacare is that it picks winners and losers, » Cassidy said. «As we repeal and replace Obamacare, we need to do so with something that is fair to all Americans. This draft resolves a Louisiana-specific issue, and I look forward to working to ensure it meets all of President Trump’s goals.»
Even before McConnell released his new draft, Cassidy and Sen. Lindsey Graham, R-S. C., floated their own rival plan. Their proposal only a general outline, to preserve some taxes in the current health law while creating new block grants to ship billions of dollars to states and give them broader authority to redesign their health insurance markets.
«We’re going to see which one can get 50 votes, » Graham told CNN.
Seeking to rally support, McConnell, reminded GOP senators that obliterating the 2010 statute has been a central tenet for the party’s candidates. «This is our chance to bring about changes we’ve been talking about since Obamacare was forced on the American people, » he said.
Democrats chose a different word to describe the measure, one which President Donald Trump himself used to describe the House-passed version of the measure despite having applauded it previously. «The new Republican Trumpcare bill is every bit as mean as the old one, » said Senate Minority Leader Chuck Schumer of New York. He said the provision allowing scanty coverage makes it «even meaner.»
Conservative Sen. Ted Cruz, R-Texas, has demanded language letting insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by Obama’s 2010 statute. Moderate Republicans have objected that the idea would make policies excessively costly for people with serious illnesses because healthy people would flock to the cheaper coverage.
Sen. Mike Lee, R-Utah, who’d partnered with Cruz, tweeted that the version they crafted wasn’t put in the bill. «Something based on it has, but I have not seen it or agreed to it.»
A summary of the bill said some stripped-down policies would cover three primary care visits per year and limit out-of-pocket costs. It said consumers could use federal tax credits to help pay for them.
But the Cruz provision appeared in the legislative text in brackets, meaning specific language was still being composed. That could give McConnell, Cruz and other conservatives time to work out a provision with broader support.
The retooled measure retains McConnell’s plan to phase out the extra money that 31 states, including Louisiana, have used to expand Medicaid under Obama’s statute, and to limit tightly the overall program’s future growth. Since its creation in 1965, Medicaid has provided open-ended federal money to help states pay the program’s costs.
The rewritten package would add $70 billion to the $112 billion that McConnell originally sought, for states to use to help insurers curb the growth of premiums and consumers’ other out-of-pocket costs. It has an added $45 billion for states to combat the misuse of drugs such as opioids. That’s a boost over the $2 billion in the initial bill and an addition demanded by Republicans from Midwest and Northeast states that have been ravaged by the drugs.
To help pay for the added spending, the measure would retain three tax increases Obama’s law slapped on higher-earning people to help finance his law’s expansion of coverage. Under the current statute, families making more than $250,000 annually got a 3.8 percent boost on their investment income tax and a 0.9 percent increase in their payroll tax. Obama also imposed a new tax on the salaries of high-paid insurance executives.
The measure would eliminate other tax boosts Obama levied on insurers, pharmaceutical producers and other health industry companies.
The revised bill also would let people use money from tax-favored health savings accounts to pay health insurance premiums, another favorite proposal of conservatives.
McConnell’s new bill offered only modest departures from the original version, which he yanked off the Senate floor two weeks ago to avoid certain defeat at the hands of a broad range of unhappy Republicans. The reworked measure’s key elements remain.
