Senate GOP to offer new healthcare bill on Thursday

Senate GOP to offer new healthcare bill on Thursday
© Greg Nash

Senate Republican leaders plan to unveil on Thursday a new version of their legislation to repeal and replace ObamaCare ahead of a possible vote next week.

The revised legislation will include concessions to centrists and conservatives designed to win the necessary 51 votes for passage.

Overall, however, it retains many of the core elements of the GOP’s previous measure, which was shelved last month after a group of Republican senators threatened to block it on the floor.

The concessions include keeping in place taxes that would provide more revenue for tax credits and state funding to help low-income people buy insurance.

But the rollback of expanded Medicaid under ObamaCare, a top priority of conservatives, is largely kept in place.

GOP leaders are hoping that the pressure to fulfill their seven-year-old promise to do away with ObamaCare and to get something major accomplished before the August recess will be enough to round up enough votes. 

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellLawmakers feel pressure on guns Bipartisan group of House lawmakers urge action on Export-Import Bank nominees Curbelo Dem rival lashes out over immigration failure MORE (R-Ky.) announced Tuesday that he will delay the August recess by two weeks, a move that could give Republicans more time to pass healthcare reform — but could also be used to move on to other issues.

Republicans are feeling pressure to put some points on the board, as so far they have no major legislative accomplishments since President Trump took office.

“We’re going to do healthcare next week,” McConnell told reporters, noting that the reconciliation process he plans to use to pass it with a simple majority is time-limited.

“Then we’re going to turn to other issues.”

It’s far from clear that McConnell will have the votes to win passage — or even to advance the bill. Opponents withheld support for a procedural motion on McConnell’s first attempt to prevent it from being discussed.

At the same time, some Republicans offered some hopeful words for the bill on Tuesday.

 “I feel good about the direction it’s going,” said Sen. Bob CorkerRobert (Bob) Phillips CorkerCongress punts fight over Dreamers to March Drama surrounding Shulkin — what is the future of VA health care? Blackburn pushes back on potential Corker bid: 'I'm going to win' MORE (R-Tenn.) after discussing the bill with colleagues at a private lunch meeting.

Republicans will get two draft bills — one that includes an amendment sponsored by conservative Sens. Ted CruzRafael (Ted) Edward CruzOvernight Health Care: Trump eases rules on insurance outside ObamaCare | HHS office on religious rights gets 300 complaints in a month | GOP chair eyes opioid bill vote by Memorial Day HHS official put on leave amid probe into social media posts Trump, Pence to address CPAC this week MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeThe 14 GOP senators who voted against Trump’s immigration framework Prison sentencing bill advances over Sessions objections Grassley ‘incensed’ by Sessions criticism of proposed sentencing reform legislation MORE (R-Utah) to allow insurance companies to sell plans that do not comply with federal regulatory requirements as long as they offer at least one plan that does and one draft that does not include it.

GOP leaders have submitted both versions to the Congressional Budget Office (CBO).

Senate Republican aides close to the negotiations last week panned the Cruz–Lee proposal as a nonstarter that was opposed by a majority of the GOP conference. Centrists say it could gut the federal requirement that insurance companies not discriminate against people with pre-existing medical conditions.

Cruz and Lee have dug in their heels, however, and insisted on including the measure, knowing they have leverage because two other Republicans — Sens. Rand PaulRandal (Rand) Howard PaulDem wins Kentucky state House seat in district Trump won by 49 points GOP's tax reform bait-and-switch will widen inequality Pentagon budget euphoria could be short-lived MORE (Ky.) and Susan CollinsSusan Margaret CollinsOvernight Tech: Judge blocks AT&T request for DOJ communications | Facebook VP apologizes for tweets about Mueller probe | Tech wants Treasury to fight EU tax proposal Overnight Regulation: Trump to take steps to ban bump stocks | Trump eases rules on insurance sold outside of ObamaCare | FCC to officially rescind net neutrality Thursday | Obama EPA chief: Reg rollback won't stand FCC to officially rescind net neutrality rules on Thursday MORE (Maine) — are viewed as all but certain to vote against the existing bill.

“I continue to believe that the consumer freedom amendment is the key to getting 50 votes and passing ObamaCare repeal,” Cruz said after discussing the legislation with colleagues over lunch. With 50 votes, Senate Republicans would then rely on Vice President Pence to cast the tiebreaking vote.

He argued that “the administration has strongly supported” his idea, noting that Pence endorsed it during an appearance Monday on the “Rush Limbaugh Show.”

A Republican senator familiar with the talks with Cruz and Lee said negotiators are exploring modifications to their provision to make it more palatable to moderates.

One idea is to add language to the Cruz–Lee amendment that would specifically protect people with pre-existing conditions, said the senator familiar with the talks. But a stumbling block there is that Lee is insisting it not be attached to the community rating requirement, which assures that those with existing medical conditions can buy affordable plans.

Another is to merge the risk pools of those buying health plans exempt from federal requirements and those buying so-called qualified plans, so that the cost of insuring sicker populations would be offset by the lower risk of covering healthier people who opt for cheaper plans.

“That’s been discussed. I know Sen. [Mike] Rounds [(R-S.D.)] and Sen. [Bill] Cassidy [(R-La.)] had some ideas on that and making it workable,” said Senate Republican Whip John CornynJohn CornynLawmakers feel pressure on guns Kasich’s campaign website tones down gun language after Florida shooting Murphy: Trump’s support for background check bill shows gun politics ‘shifting rapidly’ MORE (Texas).

Cruz on Tuesday declined to comment specifically on the proposed modifications to his amendment.

“There continue to be positive conversations about how to structure the legislative language. What is critical, I believe, is that we drive down the cost of premiums,” he said.

Whether McConnell decides to bring to the floor the version of the bill that includes the Cruz–Lee language will depend largely on what the CBO projects its impact will be on future premiums and the number of people without insurance over the next decade.

Cornyn said there is also discussion of keeping ObamaCare’s 23.8 percent capital gains tax and 0.9 percent Medicare surtax in place for only a few years, another possible concession to conservatives.

“That’s being discussed. Whether that’s in healthcare or in tax reform, I’m sure we’ll revisit it again,” he said.

Language phasing out the generous federal payments for states that expanded Medicaid eligibility and implementing a less generous formula for indexing Medicaid to inflation will be kept in place.

Senate Republican Policy Committee Chairman John BarrassoJohn Anthony BarrassoThe 14 GOP senators who voted against Trump’s immigration framework Overnight Energy: Senate panel advances Trump pick for EPA No. 2 | Pruitt questions ‘assumptions’ on climate | Dems want Pruitt recused from climate rule review Senate panel advances Trump pick for No. 2 official at EPA MORE (Wyo.) said, “What we had in the original bill has not changed with regard to Medicaid.”

Peter Sullivan contributed.