Senate Republicans brace for release of health bill Thursday

(Bloomberg) Senate Republicans are beginning to learn the details of the health-care bill they may be asked to vote on next week, with senators saying the measure envisions a more gradual transition away from Obamacare than the House-passed version.

Republican Thom Tillis of North Carolina said the draft bill, which GOP leaders plan to release Thursday morning, would effectively delay the repeal of Obamacare until 2020, allow more generous tax credits for people buying individual insurance policies, and create a longer transition period for ramping down Obamacare’s expansion of Medicaid.

“It will probably put some on my side of the aisle outside their comfort zone,” he told reporters Wednesday. “We have to look at these soft-landing strategies most importantly for the insured population but also to a secondary degree for the states so they have time to plan out their transition strategies as well.”

Senate Majority Leader Mitch McConnell
Senate Majority Leader Mitch McConnell, a Republican from Kentucky, speaks during an interview in Washington, D.C., U.S., on Tuesday, May 16, 2017. Addressing the controversy over last weeks firing of FBI Director James Comey, the Kentucky Republican said Trump should choose an "apolitical" successor adding he had recommended former Supreme Court nominee Merrick Garland to the president. Photographer: Andrew Harrer/Bloomberg

Senate Majority Leader Mitch McConnell said Wednesday that a “discussion draft” of the health-care measure will be released online Thursday, and the No. 2 Senate Republican, John Cornyn of Texas, said the Congressional Budget Office will probably release its estimate of the bill on Monday, although he’s hoping it could be as early as Friday.

The Senate may vote next week, McConnell said Tuesday, adding that Republicans will make “every effort to pass a bill that dramatically changes the current health-care law.”

But even members of the GOP’s health-care working group, which was charged with drafting the bill, say they aren’t ready to back it.

‘Take Some Time’

"What I need in order to get yes: I need the information, I need to hear from constituents and that’s going to take some time,” Ron Johnson of Wisconsin said after a closed-door meeting Wednesday. “Never say never, maybe we’ll have enough time."

McConnell also defended the secretive process of drafting the bill, in which few people besides him and some top-level Republican aides are aware of the proposal’s contents.

“I do find it particularly laughable the complaints about process,” he said Tuesday. McConnell said final details of Obamacare were worked out in then-Majority Leader Harry Reid’s office as he struggled to get enough Democrats to back it. Still, the Obamacare proposal had undergone multiple committee hearings before that final stage, unlike the Senate Republicans’ emerging plan.

Anthem Pulling Back

Senate Republicans are unveiling their plan at a critical time for Obamacare’s insurance exchanges, where consumers can purchase individual coverage. Wednesday is the deadline for health insurers to decide whether they’ll participate in the Obamacare marketplace next year.

Anthem Inc., one of the last large multistate insurers that hadn’t significantly pulled back from the market, announced Wednesday it’s pulling individual plans from most insurance markets in Wisconsin and Indiana next year. The insurer blamed "continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies."

Conservative Republican senators sounded a skeptical note about McConnell’s emerging plan, which could suggest that the 50 votes needed to pass the measure may be elusive.

Rand Paul of Kentucky said he’s very concerned that the Senate bill would include more subsidies for insurance than the House version.

“All of this discussion sounds to me like the federal government micromanaging and buying insurance for people,” he told reporters. “The insurance companies make $15 billion a year in profit. I’m not for giving the insurance companies any money.”

Asked whether he’ll vote no, Paul said he wants them to start over and repeal Obamacare.

Paul and Republican Susan Collins of Maine confirmed that the tax credits for health-care coverage in the Senate bill will be adjusted for income, and not be just based on age, as in the House bill.

"I think it is going to be more generous in certain ways,” Collins said. “I don’t know whether the tax credit will phase out slowly over time over income levels, or whether it’s going to be abrupt cliffs, which is a major problem we had with” Obamacare.

McConnell’s closed-door approach and his call Tuesday for rapid action drew fire from members of his own party, including Lisa Murkowski of Alaska, Mike Lee of Utah and Rob Portman of Ohio.

Republicans control the Senate 52-48 and plan to use an expedited procedure to pass a health plan with as few as 50 votes, plus a tie-breaker from Vice President Mike Pence. That means McConnell can afford to lose no more than two Republicans in order to pass a bill, which is opposed by all Democrats and the chamber’s two independents.

Senate Minority Leader Chuck Schumer criticized the secret bill-drafting process as "reckless" in a Senate floor speech Wednesday.

"They are ashamed of their bill," the New York Democrat said. "They don’t want the American people to see that their health-care bill is little more than a vehicle to give another tax cut to the wealthy."

The House measure would cut Medicaid by $834 billion over a decade, repeal $664 billion of Obamacare’s tax increases on the wealthy and the health-care industry, and end requirements that individuals get health insurance and that most employers provide it. It would replace Obamacare subsidies with tax credits based primarily on age, and let states get waivers from some of the Affordable Care Act’s consumer protections.

The nonpartisan CBO says the House bill would cause 23 million more Americans to be without health insurance by 2026. A May 16-22 Kaiser Family Foundation poll said 55 percent of Americans have an unfavorable view the bill, H.R. 1628.

Abortion Politics

Republicans are trying to navigate a number of controversial issues, including abortion policy. Restrictions on abortion funding in the House bill are opposed by at least two Senate Republicans—Collins and Murkowski—but if removed could thwart House approval of a final measure.

Collins said she expects the Senate to drop House language that would broaden Obamacare’s ban on using federal tax credits to fund most abortions. She said it appears that the Senate parliamentarian will rule that the provision couldn’t be included under the chamber’s fast-track procedure.

Tillis said they are trying to retain as many of the House’s abortion restrictions as they can, but his understanding is that some don’t pass muster with the Senate parliamentarian.

“There may still be ways to address the concerns of members, including my own,” he said, without elaborating on how they might do that.

A senior GOP aide familiar with the emerging health proposal said it’s clear after talks with the parliamentarian that Republicans who back further restrictions on funding abortion will have a "steep hill to climb" to convince the parliamentarian that such language can be included in the bill.

President Donald Trump last week told Senate Republicans to draft a more scaled-down version than the House, even referring to the House bill as “mean,” according to news reports. White House spokesman Sean Spicer Tuesday told reporters, "The president clearly wants a bill that has heart in it." He added, "Any ideas are welcome to strengthen it."

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