New GOP Health Care Bill keeps Medicaid cuts, allows cheaper plans
While the cuts to Medicaid will remain in place, new carve outs have been created to protect certain populations if states chose.
BY LEIGH ANN CALDWELL, NBC News
(NBC News) - Details of the highly anticipated Senate health care bill revision released Thursday shows the bill keeps in place deep cuts to Medicaid and the elimination of the current mandate requiring people to purchase insurance.
But changes designed to address concerns of both moderate and conservative Republicans who had different objections to the original bill are also in the new version, including a last-minute addition from Sen. Ted Cruz, R-Texas to allow individuals to purchase cheaper, skimpier health plans. It also keeps some of the Obamacare taxes on the wealthy as an enticement for moderate votes.
That inclusion is a win for conservatives who wanted more choices for consumers. Still, Sen. Mike Lee, R-Utah, who had been working with Cruz on similar ideas, said that he was shut out of the final language and is unsure if this is something he can support at this time.
The new bill was released as GOP members huddled in a closed-door meeting to discuss the details of a measure that has been debated ever since Senate Majority Leader Mitch McConnell postponed a vote on the original version two weeks ago due to a lack of support. With no Democrats expected to vote for anything that overturns Obamacare, McConnell needs 50 of the 52 GOP senators to pass the bill. Other details were made to gain votes from both sides of the GOP spectrum.
Here is how the bill changes to appease moderates:
- A $45 billion fund to help people with opioid addiction.
- An extension of three Affordable Care Act taxes: the 3.8 percent tax on investments on the wealthy; a .9 percent surtax on Medicaid for the wealthy; and a tax on insurance executive's compensation.
- $70 billion to states to help stabilize the cost of health care and implement new reforms, bringing the total in this fund to $182.
Here is how the bill changes to appease conservatives:
- Health Savings Accounts, which are accrued from pre-tax dollars, can be used to pay for health insurance premiums.
- Catastrophic health plans would be offered and people could be eligible for tax credits to help pay for them.
- A health plan with narrow coverage but cheaper premiums would be offered for people in the individual market.
While the cuts to Medicaid will remain in place, new carve-outs have been created to protect certain populations if states chose. It remains to be seen whether that will be enough to appease moderate members concerned about the size of the cuts.
Senators will get a chance to react to the proposed changes after their lunch and leadership can begin assessing whether or not they have the votes to bring it to the floor.
Sen. Rand Paul, R-Texas, came out Wednesday and said he'd vote against it and Sen. Susan Collins, R-Maine, indicated earlier in the week that a complete overhaul would be necessary to win her support.
McConnell hopes to hold a vote on the measure next week, but first a Congressional Budget Office analysis of how much the bill would cost and how many people would lose insurance must be released. That report is expected Monday.