Sen. Rand PaulRandal (Rand) Howard PaulGOP political operatives indicted over illegal campaign contribution from Russian national in 2016 White House debates vaccines for air travel Senate lawmakers let frustration show with Blinken MORE (R-Ky.) is outlining a list of demands to win his support for the GOP's latest ObamaCare replacement bill that would require major changes to the legislation.
Paul's primary demand, according to his office, is to substantially reduce the central component of the bill sponsored by GOP Sens. Lindsey GrahamLindsey Olin GrahamThe Hill's 12:30 Report - Presented by Facebook - Biden meets with lawmakers amid domestic agenda panic The Hill's Morning Report - Presented by Alibaba - House Democrats plagued by Biden agenda troubles Graham tries to help Trump and McConnell bury the hatchet MORE (S.C.) and Bill CassidyBill CassidyGOP warns McConnell won't blink on debt cliff House passes bill to prevent shutdown and suspend debt limit Louisiana delegation split over debt hike bill with disaster aid MORE (La.): block grants to states with money to spend on health care.
"Graham/Cassidy keeps and redistributes/spends over a trillion dollars," Paul says in a document provided by his office.
"My promise to the voters was to repeal Obamacare - not block grant and keep Obamacare," he adds. "If Obamacare were truly repealed, this entire trillion dollars would not be spent. This is the primary obstacle to my support, and only a significant reassessment of this trillion-dollar spending regime would get my support."
A "significant reassessment" of the spending, though, is likely to cost the GOP other votes, most notably Sen. Lisa MurkowskiLisa Ann MurkowskiGOP warns McConnell won't blink on debt cliff Graham tries to help Trump and McConnell bury the hatchet Trump, allies launch onslaught as midterms kick into gear MORE (R-Alaska), who is already focused on whether the bill does enough to help people afford coverage.
Finding some way to win Paul's vote, however unlikely, is crucial for GOP leaders, given that they can only lose two votes. Sen. John McCainJohn Sidney McCainCollins to endorse LePage in Maine governor comeback bid Meghan McCain: Country has not 'healed' from Trump under Biden Biden steps onto global stage with high-stakes UN speech MORE (R-Ariz.) is also against the bill, and Sen. Susan CollinsSusan Margaret CollinsCollins to endorse LePage in Maine governor comeback bid McConnell privately urged GOP senators to oppose debt ceiling hike GOP senator will 'probably' vote for debt limit increase MORE (R-Maine) said Sunday that it's "very difficult" for her to imagine supporting the measure.
Paul, who has repeatedly bashed the bill in television interviews and on Twitter, also wants states to have even more freedom to repeal ObamaCare regulations. The "default," he says, should be that all its regulations are repealed, and states can opt in to keep some regulations if they choose.
Further action to repeal those regulations is politically fraught, though, given that they include protections for people with pre-existing conditions.
Finally, Paul wants both executive action from the Trump administration and committee time to consider legislative action on a favored cause of his, known as Association Health Plans, which allow businesses and individuals to band together to buy health insurance as a group.