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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 CruzGOP warns economy will tank if Dems win Ex-lawmaker urges Americans to publicly confront officials O'Rourke on calling Cruz 'Lyin' Ted': 'That wasn't the best phrase for me to use' MORE (R-Texas) and Mike LeeMichael (Mike) Shumway LeeSenators pledge action on Saudi journalist’s disappearance Bernie Sanders: US should pull out of war in Yemen if Saudis killed journalist Senators warn Trump that Saudi relationship is on the line 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 McConnellEx-lawmaker urges Americans to publicly confront officials Manchin wrestles with progressive backlash in West Virginia Democrats slide in battle for Senate 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 PaulErdoğan: Turkey to announce findings of Khashoggi investigation on Tuesday Lawmakers point fingers at Saudi crown prince in Khashoggi's death Rand Paul: Saudi explanation of Khashoggi's death 'insulting' MORE (Ky.) and Susan CollinsSusan Margaret CollinsManchin wrestles with progressive backlash in West Virginia Conservatives bankrolled and dominated Kavanaugh confirmation media campaign The Hill's Morning Report — Presented by the Coalition for Affordable Prescription Drugs — Health care a top policy message in fall campaigns 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.