Republican Health Care Bill Revealed: Less Medicaid, More Tax Cuts

WASHINGTON, DC — Senate Republicans released a bill Thursday that would end many of the sweeping health care reforms that became law in 2010 under the Affordable Care Act, eliminating penalties for those who don't buy insurance and cutting hundreds of billions of dollars from Medicaid, the government program that provides health coverage for the the poorest of people, pregnant women, the elderly and the disabled.

Money from the cuts would be redirected to select companies and the wealthiest 2 percent among individuals in the country in the form of tax cuts that would total close to $1 trillion.

Senate Majority Leader Mitch McConnell, who drafted the legislation in secret with a handful of aides, is likely to call for a vote next week, trying to push through an exceptionally complex 142-page bill that would fundamentally alter how health care is paid for and delivered in the United States and effectively end coverage altogether for millions of Americans who are currently insured.

The bill still faces difficult obstacles. It cannot pass the Senate if any more than two of the chamber's 52 GOP members refuse to vote for it.

SEE ALSO: How To Call Your Senators About The Republican Health Care Bill

That's a distinct possibility. Many of the provisions in McConnell's legislation mirror those included in a bill that House Republicans passed in May, despite being wildly unpopular among voters and Senators from both parties.

As with the House bill, the Senate's version could hit middle class and older Americans with sizable increases in the cost of insurance. (Want updates on the race to replace Obamacare and other political news out of DC? Sign up here for free email newsletters and breaking alerts from the White House Patch.)

An analysis from the Congressional Budget Office of the cost and impact of the Senate's bill, called the "Better Care Reconciliation Act of 2017," will not be completed until next week. Until then, the most reliable information the Senate can look to is the budget office's analysis of the House health plan.

Among the many changes that the Senate bill would make to current law:

• Elimination of the mandate that employers with 50 or more employees provide health insurance
• Freezes Medicaid funding for Planned Parenthood for one year
• Forbids insurers from refusing to cover people with preexisting conditions — but lets states redefine the mandated "essential health benefits," which critics say is a giant loophole for insurers to avoid covering certain health costs.

"I regret that our Democratic friends made clear early on they did not want to work with us," McConnell said on the chamber floor after the bill was revealed Thursday. "Obamacare isn't working by any measure."

Obamacare's guarantee that children can stay on their parents' plans until age 26, however, is preserved in the Senate's draft of the bill — just as it was under the House's "American Health Care Act."

Medicaid cuts would be phased in more slowly than they would under the House's version.

Obamacare's large cash pool for subsidies to help middle class families pay for insurance would be cut by the Senate.

One key difference in the House and Senate bills: The House bill would radically restructure the subsidy system by basing the size of payouts on a recipient's age. In contrast, the subsidies in the new Senate bill would be cut but they would be based on income and geography, as in Obamacare.

Senate Minority Leader Chuck Schumer, a Democrat, took to the chamber floor after McConnell spoke, criticizing his Republican colleagues for their work.

"If you need treatment for opioid addiction, your plan may no longer cover it," he said.

Schumer called the bill "heartless" and said it was at least as bad, if not worse, than the House's.

"Simply put, this bill will result in higher costs, less care, and millions of Americans will lose their health insurance," he said, adding, "Every senior in America should read fine print of this bill."

McConnell lashed back at Schumer, accusing him of going on the offensive Thursday before he'd even had time to read the bill's language.

"The bill Republicans announced today is even worse than expected and by far the most harmful piece of legislation I've seen in my lifetime," Vermont Independent Sen. Bernie Sanders tweeted Thursday.

Protesters, many in wheelchairs, gathered outside McConnell's office after release of the bill in opposition to the proposed legislation. Capitol Police began physically removing the protesters from the hallway, saying they would be charged with disorderly conduct:

Rumblings about defections have already started.

"It looks like we’re keeping Obamacare, not repealing it," said Kentucky Republican Sen. Rand Paul, suggesting he would oppose the bill. However, he noted that he hasn't been fully able to read the bill yet and would not commit to voting against it.

Maine Republican Sen. Susan Collins, one of the most centrist members of the party in the Senate, has previously criticized the House bill because it blocks funds to Planned Parenthood — a provision the new bill would preserve. In a statement, her communications director said the senator had many "concerns" about the bill, including the impacts on coverage, premiums and changes to Medicaid. She said Collins would wait until the Congressional Budget Office evaluates the impact of the bill.

The CBO previously projected that the House bill would add an additional 23 million people to the rolls of the uninsured by 2026.

President Trump, who once promised that he would never cut Medicaid, has said he's confident a "great bill" would emerge from the Senate's drafting process. He held a celebratory press conference in the Rose Garden when House Republicans passed their health care bill.

At a meeting Thursday morning, he told the attendees: "How do you like the health care folks? It’s going to be very good. A little negotiation, but it’s going to be very good."

Later Thursday afternoon, President Obama posted an essay on Facebook opposing the bill: "The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America."

He also defended the gains made under the Affordable Care Act.

"For the first time, more than ninety percent of Americans know the security of health insurance," he wrote. "Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past."

He continued: "It was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it."

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