Thursday, July 13, 2017

GOP Senators Skirmish Over Yet Another Healthcare Plan


Texas Sen. Ted Cruz tells reporters on Thursday he will now back the latest version of a Senate bill to repeal and replace the Affordable Care Act, after an amendment he's been pushing was accepted by Senate Majority Leader Mitch McConnell. The Cruz proposal, modified from an earlier version endorsed by Sen. Mike Lee (R-Utah), would create a fund that would help insurance providers cover people with higher medical costs, but to qualify, insurers would have to offer at least one plan that fully complies with all of Obamacare's regulations. Once they do that, they would be able to offer other "bare bones" policies that do not meet all of Obamacare's requirements, thus providing cheaper options to younger and healthier individuals.

Senate Republicans have offered yet another sketchy notion of how to repeal and replace the Affordable Care Act. The most recent outline, pushed out Thursday, July 13, by Senate Majority Leader Mitch McConnell and not yet reviewed and “scored” by the Congressional Budget Office, was promptly challenged by Sen. Lindsey Graham, (R-South Carolina), and Sen. Bill Cassidy, (R-Louisiana), who are promoting an alternative approach that would leave much of the actual work of determining what kinds of health insurance would be offered and how it would be paid for up to individual states.
None of the proposals address the steep cuts in Medicaid funding proposed in the bill offered before the Senate’s July 4 break, making it unlikely that any of the latest ideas will make it to a vote without considerable revision and development into bill form. Conflicting proposals and objections by other senators, notably Ted Cruz (R-Texas), Rand Paul (R-Kentucky) and Susan Collins (R-Maine), make a vote on anything even less likely. With two no votes, Vice President Mike Pence could provide the 51st vote needed for passage. But if three Republican senators defect, as seems increasingly likely, the bill cannot pass as proposed.
One alternative idea floated immediately was the prospect of making “no-frills” health insurance coverage available to hold down premiums. Doing so, however, would again raise the prospect of no coverage or insufficient coverage for pre-existing conditions. Such plans do not meet minimum standards of the current ACA, and insurers currently can’t force customers with serious illnesses to pay higher premiums. A current obligation to cover specific “essential health benefits” could also be lost in the new GOP proposals. The Congressional Budget Office assessment of the previous Senate “wish list” for healthcare funding would throw at least 22 million people off health insurance, cut $770 billion from Medicaid and greatly increase premiums and deductibles for those who can afford to stay in the health insurance market. The new plan restores $45 billion to fund programs to fight opioid abuse, but the fiscal impact of other notions released Thursday probably won’t be known before Monday, July 17, at the earliest.

Resources

Changes in the Senate’s attempt to repeal and replace the Affordable Care Act are outlined here.
Strong opposition could kill any prospect of a vote on the new proposal, Politico reports.
The latest healthcare proposals could mean much higher premiums for people who need more thorough coverage for preexisting conditions, the Kaiser Family Foundation says. A New York Times graphic outlining what’s dividing senators on healthcare proposals is here.
Winning support from Republican governors will be key to adoption of insurance law changed that would leave much of the actual work to the individual states, the Washington Post reports.

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