With the Senate healthcare vote expected sometime between midnight and 2am, moments ago the full text of the Senate "Skinny" bill which may or may not pass, has been released. Here is the summary version of what is hereby known as the "The Health Care Freedom Act":
- REPEAL THE INDIVIDUAL MANDATE — Obamacare's individual mandate forced the American people to purchase insurance they frequently didn't want, couldn't afford or actually use. This plan permanently protects Americans from this onerous mandate.
- REPEAL THE EMPLOYER MANDATE — Obamacare's employer mandate too often forced job creators to forgo hiring new workers or keep an employee's hours low. This anti-jobs mandate is repealed for eight years, which provides employers a greater incentive to hire more employees.
- PROVIDE FLEXIBILITY TO STATES (1332 WAIVERS)— States can access additional flexibility to use waivers that exist in current law to provide more options for consumers to buy the health insurance they want. It also allows the Department of Health and Human Services to approve waivers faster.
- INCREASE HSA CONTRIBUTIONS — Increase contribution limits to tax-free Health Savings Accounts for three years to help pay for out-of-pocket health costs and expensive prescription medications.
- REPEAL THE MEDICAL DEVICE TAX — Both Democrats and Republicans have opposed this tax on medical innovation. The legislation repeals this tax for three years.
- FUND COMMUNITY HEALTH CENTERS — Prioritize health funding for Community Health Centers across the country.
The full bill also includes a provision for defunding Planned Parenthood, which is the reason for the community health center language.
As the NYT reports, after three days of debate, Republican leaders had little to show for it and were struggling to devise even a stripped-down plan on which at least 50 of the 52 Senate Republicans could agree. The Senate majority leader, Mitch McConnell of Kentucky, was doing whatever he could to secure votes and win Senate approval on Friday for a bill that would repeal at least a few provisions of the Affordable Care Act. That raised the spectacle of senators pressed by their leaders to vote on legislation that some of them despise, with a promise that a “yes” would not really be approval, just a vote to start House-Senate negotiations on something better.
Senators Lindsey Graham South Carolina, John McCain of Arizona and Ron Johnson of Wisconsin, all Republicans, simply demanded ironclad assurances from House leaders that the bill would not be enacted.
“I’m not going to vote for a bill that is terrible policy and horrible politics just because we have to get something done,” Mr. Graham said, calling the stripped-down bill a “disaster” and a “fraud” as a replacement for the health law.
Five GOP senators, Sens. Lindsey Graham (S.C.), David Perdue (Ga.), Ron Johnson (Wis.), Mike Rounds (S.D.) and Ted Cruz (Texas), spoke with Ryan via phone in Sen. John Cornyn's leadership office outside of the Senate floor.
"Yes, he said, listen why would we want to own a bill that increases premiums and doesn't fix ObamaCare — that's all I wanted to hear from him," Graham told reporters when asked if Ryan guaranteed the House wouldn't pass a paired down Senate repeal bill.
Pressed if he would vote "yes" on the Senate GOP healthcare bill after his conversation with Ryan, Graham said he would. Johnson added that "of course" the talk with Ryan was enough to assuage his concerns. "We just wanted to hear it right from Paul. ... We got that assurance. He said we could tell you — this is going to go to conference," the conservative GOP senator said.
Johnson added that any bill that passes the Senate "will not pass the House. This will go to conference. ... That's what we got." Johnson and Graham, as well as GOP Sens. Bill Cassidy (La.) and John McCain (Ariz.), warned earlier Thursday that they could not support moving forward with a "skinny" repeal bill until they got a guarantee that the House would not leapfrog a conference with Senate and pass the bill.
Paul issued a statement saying the House was "willing" to go to conference on the healthcare bills, but that it was up to Senate Republicans to first show they could pass a bill.
McCain told reporters while heading into the Senate chamber for a pair of votes that Ryan's statement wasn't sufficient. He then appeared to walk that back slightly, telling Bloomberg that he declined to say how he would vote, saying he wanted to talk to his state's governor.
Earlier, Sen, Shelley Moore Capito told reporters while leaving the GOP caucus room that she "didn't know how to interpret" Ryan's statement.
Senate Majority Leader Mitch McConnell (R-Ky.) will need 50 of 52 GOP senators to support the "skinny" repeal proposal, which he unveiled on the Senate floor on Thursday night
Some further observations on the bill from Politico's Burgess Everett (via Twitter):
- McConnell says the bill "restores freedom to Americans, that Obamacare took away."
- McConnell is selling the skinny bill as good policy and also as a path to conference.
- This bill was not designed for Collins and Murkowski, so GOP looking for everyone that voted to open debate to support the skinny bill.
- Murphy: "This is nuclear grade bonkers what is happening here"
Some more from NBC's Frank Thorp (via Twitter):
- Sen Rounds on mtg with @SpeakerRyan: "He acknowledged that this particular bill was designed to get us to conference..."
- More Rounds: "(@SpeakerRyan) said we will bring it to conference. And we asked, can we say that publicly, and he said, yes."
- Sen Rounds: "(Speaker Ryan) has given us about as good of an assurance as you can get that he intends to send this to conference."
- The vote series including the vote on the 'skinny repeal' bill is expected to happen around midnight tonight.
Having been written off earlier, it increasingly looks as if the bill may just have enough support to pass, with the tie-breaking vote from Mike Pence who is expected to be present for a potential vote later.
The full text of the pared-down "skinny bill" is below (link):