A handful of Republican senators took to the morning talk shows on Sunday to explain their reservations about the latest version of the Republicans’ bill to repeal and replace Obamacare. Sens. Susan Collins (R, Maine), Rand Paul (R Ky.) and Ron Johnson (R Wis.) all said they believe the bill won’t pass this week.
As we noted Thursday, at least five Republican lawmakers said they couldn’t support the bill – more than the two maximum defections that Republicans could afford, assuming none of the 46 senate Democrats and neither of the two independent candidates who caucus with them break ranks to vote for the bill. NBC’s Chuck Todd says that number could actually be as high as eight.
Two themes appear to have emerged. Moderates like Collins and Nev. Sen. Dean Heller fear backlash from their constituents related to cuts to Medicare that would reduce coverage for senior citizens, who typically vote in larger numbers than younger cohorts of the population.
Conservatives like Paul and Texas Sen. Ted Cruz believe the bill doesn’t go far enough to eliminate regulations that they say have helped drive up the cost of health care, and are rapidly pushing the US insurance market into a “death spiral” – a situation where most healthy people opt out of insurance markets because premiums have risen to unaffordable levels.
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Appearing on ABC's “This Week,” Susan Collins told host George Stephanopoulos that she was worried about the impact on elderly voters in her state who depend on Medicaid, though she hasn’t officially come out against the bill.
“ For my part, I'm very concerned about the cost of insurance for older people with serious chronic illnesses, and the impact of the Medicaid cuts on our state governments, the most vulnerable people in our society, and health care providers such as our rural hospitals and nursing home, most of whom are very dependent on the Medicaid program. So threading that needle is going to be extremely difficult.”
You can watch the rest of Collins' appearance below:
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Paul, who was also on “This Week,” said the bill doesn’t do enough to prevent a death spiral, and instead tries to combat it by offering a $100 billion handout to the insurers.
“The Republican plan acknowledges that we're going to still have this death spiral, which is sicker and sicker people in the individual market and the healthy people don't buy insurance, they acknowledge this by putting over $100 billion of insurance bailout money to try to say, oh we're going to tamp down prices. We're going to fix the problem, we're going to acknowledge the will continue forever and we're just going to pile taxpayer money into it. That is just not a conservative notion to add a new federal program to bailout insurance programs."
“… if they cannot get 50 votes, if they get to impasse, I've been telling leadership for months now I'll vote for a repeal. And it doesn't have to be 100 percent repeal. So, for example, I'm for 100 percent repeal, that's what I want. But if you offer me 90 percent repeal, I'd probably would vote it. I might vote for 80 percent repeal.”
You can watch the rest of Paul’s remarks below:
In an appearance on NBC's "Meet the Press," Johnson told Todd that he’s taken issue with the rushed nature of the process, saying constituents and health-care industry types haven’t had enough time to weigh in with their input.
“…what I'd like to do is slow the process down, get the information, go through the problem-solving process, actually reduce these premiums that have been artificially driven up because of Obamacare mandates. So let's actually fix the problem. But in the end, I come from manufacturing base. I will look at whatever I'm forced to vote on, and I'll ask myself, "Is this better tomorrow than where we are today? Is it continuous improvement?" And that's what will guide my decision.”
You can watch Johnson's remarks in full below:
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Despite the mutiny in the ranks, Sen. John Cornyn, the GOP whip, said that the Senate leadership is working to turn the holdout senators over the weekend. He said he expects procedural votes on the bill will start Wednesday, according to the Los Angeles Times.
Then again, President Donald Trump said in March that a vote on the House version of the bill would proceed, before ultimately deciding to delay the vote after Speaker Paul Ryan failed to turn enough members.
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Here are some initial takeaways from the draft bill, which was unveiled earlier this week:
- Ends ACA mandates for individuals AND employers
- Funds the ACA's cost-sharing subsidies through 2019 but then only provides tax credits for people with incomes up to 350% of the federal povery level
- Tax cuts largely similar to those in the House bill. That includes repealing a 3.8% tax on investment income retroactively to January 2017 and delaying the repeal of a 0.9% payroll tax until 2023
- Contributes $62 billion to a "State Innovation Fund"
- Seeks funding for insurers through 2021
- Allows 'children' to stay on parental plans until the age of 26
- Bill suspends 'Cadillac Tax' on employer health plans through 2025
- Medicaid: The plan would roll back the Affordable Care Act’s Medicaid expansion more gradually than the House version would, but would ultimately make deeper cuts to the program. While states' funding from Washington would be capped for the first time in the history of the Medicaid program, states would be given a choice of the formula used -- 'block grants' or 'per capita caps' -- to curb it under the bill.
- Planned Parenthood: The bill would strip federal funding from Planned Parenthood Federation of America for one year. It also prohibits tax credits from being used to purchase plans that offer abortion coverage.
You can read the full text of the bill here.