Reuters/Carlos Barria
- The newest Republican Obamacare repeal bill will come to the Senate floor next week, Majority Leader Mitch McConnell's office said.
- It is unclear if the GOP will have the needed 50 votes in the Senate before the deadline to pass the bill.
- The Graham-Cassidy-Heller-Johnson plan would lead to massive shifts in federal healthcare funding.
Senate Majority Leader Mitch McConnell's office said Wednesday that the leader will bring the latest Republican healthcare bill to the floor for a vote some time next week amid a furious GOP push to repeal the Affordable Care Act before a looming deadline.
"It is the Leader's intention to consider Graham-Cassidy on the floor next week," said a spokesperson for McConnell.
The Graham-Cassidy-Heller-Johnson (GCHJ) legislation was released one week ago by four Republican senators - Lindsey Graham, Bill Cassidy, Dean Heller, and Ron Johnson - and is likely the party's last-ditch repeal effort for now.
The pressure is on because Republicans are attempting to use a procedure known as budget reconciliation to pass the bill. The process allows them to avoid a Democratic filibuster and pass the bill with only a simple majority. Republicans currently hold 52 seats in the Senate.
But the rules that allow Republicans to use reconciliation will run out at the end of September, per a ruling from the Senate parliamentarian. This has spurred intense urgency to pass the legislation.
The intention to introduce the bill to the floor likely means that the GOP is close to the necessary votes - and that McConnell may be pressuring some wavering members. Cassidy told reporters that the bill is supported by 48 or 49 Republicans.
Republican Sen. Rand Paul of Kentucky has already come out against the bill. Other possible holdouts include Sens. Susan Collins of Maine, Lisa Murkowski of Alaska, and John McCain of Arizona, the three Republicans whose "no" votes killed previous iterations of the Senate healthcare bill.
Democrats opposition to the bill has been fierce. Senate Minority Leader Chuck Schumer attacked the bill on the Senate floor Tuesday.
"What we do know is that this new Trumpcare bill, the Graham-Cassidy legislation, is worse in many ways than the previous versions of Trumpcare," Schumer said.
Democrats also complained that the GCHJ will not receive a full score from the Congressional Budget Office to measure the effects on insurance coverage and costs for Americans. The CBO said it will release a truncated score that examines the impact on the federal budget. Under reconciliation rules, the CBO must say the bill would lower the federal deficit more than the House's American Health Care Act, which passed that chamber earlier this year.
Studies from independent health policy think tanks showed that the bill would have drastic ramifications for all corners of the healthcare market.
Here's a rundown of the major provisions of the bill:
- Shift to a block-grant system for federal healthcare funding to states. The bill would give states the lump sum of money to fund their healthcare needs instead of the current system in which the federal government matches a percentage of their actual spending. The block grants would also be doled out in such a way that some states would end up getting more - especially those that did not expand Medicaid under Obamacare - while others would see their funding slashed.
- Allow states to waive some Obamacare regulations. The bill would allow states to apply for waivers that would let them do away with Obamacare regulations if it brought down costs. While there is a provisions in GCHJ that says this can't be used to deny people with pre-existing conditions coverage, experts say it could allow insurers to charge sick people more for insurance.
- Maintain many Obamacare taxes. To avoid adding too much to the federal deficit - and being disqualified from the reconciliation process - the bill would preserve many major taxes created under Obamacare, such as the tax on net investment income. Other smaller taxes, like the medical device tax, would be eliminated.
- Eliminate the individual and employer mandates. People who do not sign up for insurance would not face a tax penalty under the plan, and companies would not be compelled to offer coverage, though states could pass their own mandates. A study by the Commonwealth Fund found this would increase the number of uninsured by up to 18 million by 2019.
- Pay cost-sharing subsidies through 2019. Such a move would help the insurance exchanges established by Obamacare stay stable in the short term - something Democrats have urged. When the block grants kick in, however, these payments would end.
- Cut off all money after 2026. The large block grants to help states would be eliminated after 2026. Commonwealth estimated this would lead to around 32 million more uninsured compared to the current system after that year.