Back in March, the Trump administration attempted to call the bluff of the House Freedom Caucus by setting a vote on an Obamacare repeal bill before Speaker Paul Ryan had the votes all lined up. As we reported then (see “In Stinging Defeat, House Republicans Abandon Obamacare Repeal Effort“), the strategy to prioritize speed didn’t work out so well as the bill ultimately had to be pulled at the last minute due to lack of support from Conservatives.
President Trump just called me. Still on phone.
“We just pulled it,” he tells me.
— Robert Costa (@costareports) March 24, 2017
Now, it appears that a very similar process could be playing out in the Senate. As Mitch McConnell has just pointed out, the Senate version of TrumpCare is likely to be revealed this Thursday with a vote ‘likely’ to proceed before Congress goes on its July 4th recess next week.
“For weeks now, we’ve been in intense discussions with all Republican Senators, both in working groups that all members were free to come to if they chose to, and in the larger lunches that we have on Tuesday, Wednesday and Thursday.”
“I expect to have a discussion draft on Thursday and we will go to the bill obviously when we have a CBO score…likely next week.”
— This Week (@ThisWeekABC) June 20, 2017
Although the language of the Senate bill has not been disclosed publicly, one option being considered envisions nearly $1 trillion in Medicaid cuts over a 10 year period. Meanwhile, at least 4 Republican senators have expressed concerns with any bill that would drastically cut their state’s medicaid programs, including Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska). Per the Wall Street Journal:
Under an option being strongly considered, the bill would exact steeper financial cuts to Medicaid than under the House-passed legislation, the people said, a move likely to draw criticism from a number of Republican governors who want to preserve Medicaid open-entitlement funding and the ACA’s expansion of the program.
The entire funding system for the state-federal program for low-income and disabled people would be changed to a per capita cap, which would limit federal spending to states. That is the approach that also passed in the House bill, which would cut federal spending on Medicaid by $834 billion over 10 years.
Under one proposal, the Senate bill would lower Medicaid’s spending growth to a rate set in the House bill until 2025, when it would then be more sharply curtailed, according to people familiar with the discussions. The bill would slow the growth of federal spending on Medicaid by tying its growth rate to a lower price index, a change sought by Sen. Pat Toomey (R., Pa.).
As we noted last month, the nonpartisan Congressional Budget Office estimated the House bill passed in May would leave 23 million fewer Americans with health coverage in 2026 versus current law and would cut the budget deficit by $119 billion.
Meanwhile, Wednesday is a federal filing deadline for insurance companies to decide whether they will participate in the ACA’s exchanges and the rates they want to charge. As we’ve pointed out, so far the 2018 renewals have painted a rather dire outlook for the future of Obamacare as it currently stands. Here are a couple of our recent notes:
- 2018 Obamacare Premium Estimates Are Surging Again Leaving Obama’s “Legacy” On Life Support
- Obamacare “Death Spiral”: Maryland Insurer Seeks 50% Premium Increase For 2018
- Obamacare Death Spiral: First 2018 Coverage Map Reveals At Least 47 Counties With No Coverage
- New Mexico Health Insurer Seeks 80% Premium Increase As Senate Ramps Up Repeal Efforts
Of course, Democrats have minimal power to block an Obamacare repeal effort but that will hardly stop Chuck Schumer from launching a fearmongering campaign to tell voters how the Republican bill will undoubtedly kill Grandpa within a matter of weeks after being passed. Democrats have also taken the Senate floor to blast the “secrecy” with which the Republican bill is being drafted with Schumer describing the Republican process as “the most glaring departure from normal legislative procedure that I have ever seen.” Per Reuters:
Senate Democratic Leader Chuck Schumer said that the closed-door Republican meetings on healthcare amounted to “the most glaring departure from normal legislative procedure that I have ever seen.”
“Republicans are writing their healthcare bill under the cover of darkness because they are ashamed of it,” Schumer charged. The resulting legislation would likely throw millions out of health insurance, he said, while granting “a big fat tax break for the wealthiest among us.”
Which is odd, because we thought that passing Obamacare the first time around, you know “so we could see what was in it,” was also a pretty shocking “departure from normal legislative procedure…”
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