New GOP healthcare bill includes version of Cruz amendment

The revised healthcare bill that Senate Republicans are unveiling Thursday will include a version of a controversial amendment from Sens. Ted CruzRafael (Ted) Edward CruzTrump's Texas endorsement boosts a scandal-plagued incumbent while imperiling a political dynasty Trio of Senate Republicans urges Supreme Court to overrule Roe v. Wade Overnight Defense: US launches another airstrike in Somalia | Amendment to expand Pentagon recusal period added to NDAA | No. 2 State Dept. official to lead nuclear talks with Russia MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeSenate confirms Biden's Air Force secretary Trio of Senate Republicans urges Supreme Court to overrule Roe v. Wade Biden signals tough stance on tech with antitrust picks MORE (R-Utah) that has become a sticking point in the negotiations.

The amendment would allow insurers to sell plans that do not meet ObamaCare regulations if they also sell a plan that does meet those rules.

But in a nod to centrists worried that the GOP bill could cause too many people to lose coverage, it would add extra funding to try to compensate for higher costs for sick people, sources say.  

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Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellHouse to resume mask mandate after new CDC guidance Five takeaways from a bracing day of Jan. 6 testimony McCarthy, McConnell say they didn't watch Jan. 6 hearing MORE (R-Ky.) almost certainly needs Cruz and Lee to back the GOP bill for it to pass the Senate.

He is likely to lose votes from Republican Sens. Rand PaulRandal (Rand) Howard PaulSenators reach billion deal on emergency Capitol security bill GOP Rep. Cawthorn says he wants to 'prosecute' Fauci Writer: Fauci, Paul clash shouldn't distract from probe into COVID-19 origins MORE (Ky.) and Susan CollinsSusan Margaret CollinsOvernight Health Care: CDC advises vaccinated to wear masks in high-risk areas | Biden admin considering vaccine mandate for federal workers Eight Republicans join Democrats to confirm head of DOJ environmental division The Hill's Morning Report - Presented by Facebook - Crunch time for bipartisan plan; first Jan. 6 hearing today MORE (Maine), which would mean he could not afford another defection and still have Vice President Pence break a 50-50 tie. 

A number of centrist GOP votes are also in doubt, however, and accommodating their concerns while winning over Lee and Cruz is a tricky maneuver. 

A source familiar with the revised bill said it will include funding specifically intended to help offset the costs for the sick people remaining in the ObamaCare plans in a bid to keep centrist Republicans on board.

In addition, the Cruz–Lee amendment language in the bill is expected to be in brackets, which is an indication that it is subject to change or removal.  

Conn Carroll, a spokesman for Lee, said Lee was not a party to the revised amendment text being included in the bill and has "no idea" what it says. Lee will not know if he can vote for the motion to proceed to the bill until he reads the text, Carroll said. 

A person briefed on the Cruz language says it would place people who buy qualified health plans and plans free from federal regulations into "a single pool," referring to a unified risk pool. This could limit how much the reform would reduce the costs for people who buy the bare-bones plans.

Aside from the amendment and the funding boost, the revised bill is not expected to be drastically different from what was released last month. 

Importantly, the new bill contains the same changes to Medicaid, a blow to moderates who had pushed for easing the cuts to the program. 

The bill does include provisions to exempt Medicaid spending during public health emergencies from a new cap on Medicaid payments, according to a summary obtained by The Hill. It also allows states to apply for a waiver for home-based services for aged, blind and disabled people. 

The bill will also not repeal two ObamaCare taxes on the wealthy or a tax on health insurance executives' pay. 

The measure adds $70 billion to the $112 billion already in the measure in the "stability fund" aimed at bringing down premiums. It also adds $45 billion to fight opioid addiction.  

It is unclear whether the language will satisfy conservatives, or how much it will end up angering moderates. Moderates have been pushing back on the Cruz–Lee amendment, worried about spiking costs for people with pre-existing conditions.   

Critics argue the Cruz–Lee proposal would result in skyrocketing costs for sick people remaining in the ObamaCare plans as healthy people switch to skimpier, cheaper plans. 

- This story was updated at 10:22 a.m. Alexander Bolton contributed.