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 CruzGroup aiming to draft Beto O’Rourke unveils first 2020 video Howard Dean looking for a 'younger, newer' Democratic nominee in 2020 Congress can stop the war on science MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeHillicon Valley: Trump AG pick signals new scrutiny on tech giants | Wireless providers in new privacy storm | SEC brings charges in agency hack | Facebook to invest 0M in local news AG pick Barr wants closer scrutiny of Silicon Valley 'behemoths' Grassroots political participation is under attack in Utah and GOP is fighting back 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.  


Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellTSA agents protest government shutdown at Pittsburgh airport The case for Russia sanctions Pompeo planning to meet with Pat Roberts amid 2020 Senate speculation 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 PaulPressure mounts for Trump to reconsider Syria withdrawal House Republicans call for moving State of the Union to Senate chamber GOP rep: 'Rand Paul is giving the president bad advice' on Afghanistan and Syria MORE (Ky.) and Susan CollinsSusan Margaret CollinsOvernight Defense: Trump unveils new missile defense plan | Dems express alarm | Shutdown hits Day 27 | Trump cancels Pelosi foreign trip | Senators offer bill to prevent NATO withdrawal McConnell blocks bill to reopen most of government Bipartisan senators reintroduce bill to prevent Trump from withdrawing from NATO 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.