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.

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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 McConnellGOP senators balk at lengthy impeachment trial Graham: Senate trial 'must expose the whistleblower' Graham says Schiff should be a witness in Trump impeachment trial 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 CorkerLindsey Graham basks in the impeachment spotlight The Hill's 12:30 Report — Presented by Nareit — White House cheers Republicans for storming impeachment hearing GOP senators frustrated with Romney jabs at Trump 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 CruzWarren goes local in race to build 2020 movement Trump holds chummy meeting with Turkey's Erdoğan Overnight Defense: Trump hosts Erdoğan at White House | Says Turkish leader has 'great relationship with the Kurds' | Highlights from first public impeachment hearing MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeFed chief urges Congress to expand US workforce while economy still strong On The Money: Retirement savings bill blocked in Senate after fight over amendments | Stopgap bill may set up December spending fight | Hardwood industry pleads for relief from Trump trade war Retirement bill blocked in Senate amid fight over amendments 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 PaulSenate GOP waves Trump off early motion to dismiss impeachment charges McConnell discounts quick dismissal of Trump impeachment articles: 'We'll have to have a trial' GOP motions to subpoena whistleblower MORE (Ky.) and Susan CollinsSusan Margaret CollinsLawmakers under pressure to pass benefits fix for military families Senate GOP waves Trump off early motion to dismiss impeachment charges GOP senators warn against Trump firing intelligence community official 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 CornynGOP senators balk at lengthy impeachment trial Overnight Health Care: Trump officials making changes to drug pricing proposal | House panel advances flavored e-cig ban | Senators press FDA tobacco chief on vaping ban Senate GOP waves Trump off early motion to dismiss impeachment charges 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 BarrassoCentrist Democrats seize on state election wins to rail against Warren's agenda Eleven GOP senators sign open letter backing Sessions's comeback bid GOP senators discuss impeachment with Trump after House vote MORE (Wyo.) said, “What we had in the original bill has not changed with regard to Medicaid.”

Peter Sullivan contributed.