Senate Republicans Alter Health Care Bill To Avoid 'Death Spiral'

Alvin Kelly
June 27, 2017

The Congressional Budget Office on Monday released its analysis of the Senate Republican healthcare bill, projecting significant coverage losses both immediately and over the next decade if the legislation were to become law.

But the BCRA gets to the heart of one of Trump's campaign promises: to not cut Medicaid.

Despite potential roadblocks, Trump said Republicans were working "very hard to get there, with no help from the Democrats".

Senate Majority Leader Mitch McConnell of Kentucky faces a daunting legislative task in keeping his conference tightly unified on the health care bill, which would undo parts of Democrats' 2010 health law (PL 111-148, PL 111-152).

McConnell can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate, which would allow passage of the bill with Vice President Mike Pence casting the tie-breaking vote.

Imagine you are negotiating with two creditors who say you owe them $1,000 and you insist you owe nothing. But she said it will be "extremely difficult" for the White House to be able to find a narrow path to attract both conservatives and moderates.

"I'm watching [the developments] but I'm just going to wait and see [before I pass judgment]", unusual said. Molina Healthcare said it preferred the Obamacare mandate, said that and the Senate bill, even after revised, would simply delay care. But if this is going to be an arrow in Trump's rhetorical quiver, he should at least try to understand how problematic this argument is.

In a strongly worded statement that reflects the "unanimous" views of its board, the National Association of Medicaid Directors said the Republican health care bill would be "a transfer of risk, responsibility, and cost to the states of historic proportions". "They're doing the same old Washington thing, throwing more money at the problem".

The Senate bill keeps this overall structure, but by adjusting subsidy numbers and implementing policies that are projected to increase premiums, low-income people by and large end up with higher health-care costs.

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McConnell wanted to have the bill voted on before the Fourth of July recess, meaning the Senate has only around one week to consider a bill that many saw for the first time on Thursday.

"And honestly, nobody can be totally happy", Trump said.

McConnell has said he's willing to make changes to win support, and in the week ahead, plenty of backroom bargaining is expected.

Senate Republicans watched support for their Obamacare repeal bill slide into perilous territory after Monday's release of a non-partisan report forecasting that the plan would leave 22 million more Americans uninsured by 2026.

After some rumblings that a vote on the legislation could be held as late as August 1, Senate whip John Cornyn, R-Texas, now says a vote will be held this week. Under Obamacare financial assistance is based on an insurance plan that covers all but 30% of the expected cost of defined health services. Otherwise, the House could pass a new version and bounce it back to the Senate. The Orwellian-sounding Better Care Reconciliation Act is, many experts were quick to note, is primarily a massive tax cut for the rich, paid for by deep cuts to the social safety net.

"If they get to impasse, I've been telling leadership for months now, I'll vote for a repeal".

When I look at this legislation, I am reminded of the health care systems of Western Europe or Canada, where health care is treated as a human right, not a privilege for those with means.

Collins also said she will fight to strip from the Senate bill a provision to block federal funds for the women's health organization Planned Parenthood. "And whether they can tell me anything other than providing tax cuts to the rich as being a rationale".

As negotiations among Senate Republicans moved through the weekend, five of their number had announced they were "No" on the bill as presented by the drafters. "We don't have too much of a choice, because the alternative is the dead carcass of Obamacare". In a tweet, they say they are listening to stories of children with pre-existing conditions and adults fearing lifetime caps. Susan Collins of ME and Bob Portman of OH registered "serious concerns".

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