22 million fewer Americans insured under Senate GOP bill

Alvin Kelly
June 27, 2017

"No one from leadership has reached out to us", he added. However, experts say it would be unlikely that these folks would buy coverage since the deductibles would be thousands of dollars a year. He celebrated the House bill then said it was mean. They also talk about how premiums will go up for lower-income, older, poorer Americans.

"The CBO has consistently proven it can not accurately predict how healthcare legislation will impact insurance coverage", the White House said in a statement.

As time went on, the cuts to Medicaid that the legislation contains would start to have a dramatic effect. The CBO did not evaluate the revised version of the bill that included the new waiting period, which could provide healthier people with an incentive to maintain insurance coverage.

The CBO score paved the way for a potential floor vote this week. The CBO said while most insurance markets would remain stable under the Senate bill, the legislation would drive out insurers that serve a "small fraction" of the population, or these areas will see premiums rise very high.

Senate Majority Leader Mitch McConnell is pushing for a vote by the end of the week and he can only lose two votes. President Trump spent Monday morning venting on Twitter about how President Obama did "NOTHING about Russia" and its election meddling - despite Trump's frequent claims that the whole Russian Federation controversy is "fake news" and a Democratic Party "hoax". "1 in 5 Mainers are on Medicaid". Yes, believe it or not, Kellyanne Conway was lying when she told ABC on Sunday, "These are not cuts to Medicaid".

Sen. Susan Collins, R-Maine, and several other moderate GOP senators have also expressed concerns about the measure's impact on coverage. Republicans hold a 52-48 majority in the Senate, and Vice President Mike Pence could break a 50-50 vote if two Republicans defected.

SHAPIRO: So walk us through the political strategy here. But it is also a vote that will come back to haunt many senators when they reflect on their careers - and when more objective observers pass historical judgment on those careers.

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Meanwhile, a nonpartisan coalition of patient and consumer groups - American Cancer Society Cancer Action Network and the March of Dimes among them - urged senators to vote against the bill, saying it "will do irreparable harm to patients, particularly those living with chronic illnesses". This is a really wonky piece of legislation - what's got you tied up? If you don't do that, you are going to anger the base of the Republican Party, and it will be impossible for us to proceed with anything else, any other priorities for Republicans like tax reform.

Senators from Medicaid expansion states huddled on Monday evening, hoping to persuade McConnell to pour more money into Medicaid and opioid treatment, but budget hawks are eyeing an opportunity to pocket the savings and decrease the deficit. That is a - would be a generational achievement for conservatives. But if they do take the leap, Democrats competing in the 2018 midterms will be able to turn that slogan around with a clarion call to "repeal and replace" the American Health Care Act, or whatever the final legislation ends up being called. And he's going to try to sell it to them.

He noted the complicated road in the coming days to pick a plan "that everybody is going to like", but argued the alternative to changing USA health care policies is the collapse of the current law.

Republicans say McConnell is ready for the vote to happen, even as they are uncertain about the prospects - eager to move on from the issue one way or another. And this would presumably, in decades to come, push more people off the Medicaid rolls.

Photo Senator Susan Collins of ME, a Republican, after a vote on Capitol Hill this month. Tell us about Dean Heller of Nevada, who's another interesting player in this debate.

"I'm not happy with the score", said Heller, the most vulnerable Senate Republican in 2018. He's already facing a tremendous amount of social media and advertising from people who want him to vote to save Obamacare.

SHAPIRO: NPR's Mara Liasson, thank you.

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