WASHINGTON (NBC) — Senate Republicans have unveiled a draft of their legislation to revamp the government’s role in the nation’s health care system, a proposal that includes big reductions to Medicaid, eliminates the Obamacare mandate requiring individuals to purchase insurance and offers tax credits to help people afford insurance while slashing taxes for the wealthy.
The bill winds down the expanded Medicaid program under Obamacare after 2020 — a longer timeline than the House health care bill that was passed in May. But it also makes deeper cuts to the program in the long run by changing the federal funding allocation formula for states to receive fewer federal dollars for Medicaid recipients. It’s an attempt at a compromise to appease those Medicaid advocates like Sens. Rob Portman of Ohio and Susan Collins of Maine as well as conservatives like Sens. Mike Lee of Utah and Ted Cruz of Texas.
The measure also helps people who purchase insurance out of pocket, known as the individual marketplace, afford the insurance through tax credits based on income, combining the ideas behind Obamacare and the House bill. The House bill gave people tax credits based on age, severely impacting older Americans who would see premiums rise by more than 700 percent, according to analysis of the bill.
By basing tax credits on income, the Senate is aiming to ensure older Americans are not penalized. But unlike Obamacare, which gives a subsidy upfront, the Senate bill would provide a tax credit, to be received after the fact.
The details of the bill had been tightly held by Republican leaders as Senate Majority Leader Mitch McConnell wrote a bill that aims to appeal to his most conservative members and the most moderate in his 52-member conference. With no Democrats expected to support a repeal of the Affordable Care Act, McConnell can only afford to lose two votes for the measure to pass.
Virginia Gov. Terry McAuliffe issued a statement on bill’s unveiling:
The legislation unveiled by Republicans in the U.S. Senate today would be a disaster for Virginia families, our health care system and our budget. If this bill becomes law, it will raise costs for thousands of Virginians, particularly those who need health care the most like seniors and individuals with disabilities. Many families will be forced to drop their coverage because they can no longer afford it, putting their economic security and even their lives at risk.
This bill would cost Virginia’s budget hundreds of millions of dollars by placing a per-capita cap on Medicaid, leaving us with the choice to cut critical health and long-term care services for people who need them, slash schools and transportation, or raise taxes. This bill will also significantly impede our efforts to combat the opioid and behavioral health crises Virginia and many other states face by jeopardizing coverage for people who are struggling with addiction.
The content of this legislation and the secretive process the Senate used to devise it are a slap in the face to American taxpayers who expect their leaders to work for them, not for partisan special interests. At a time when we should be working together to expand access to affordable care, this bill will force Americans to pay more for less. On behalf of the people of this Commonwealth, I urge President Trump and Republicans in congress to drop this assault on our health care system and our economy and take the simple steps needed to improve the Affordable Care Act.”
Republican senators filed into a room in the U.S. Capitol Thursday morning, sat in chairs lined up in rows to listen to a presentation of a “discussion draft” of the legislation that could be voted on as early as next week.
Drafts of the bill circulated among Washington lobbyists in the days leading up to its reveal even as Republican Senators remained unaware of its contents.
According to Senate rules, the Senate can vote on this bill only after it is scored by the non-partisan Congressional Budget Office. Senators expect that analysis to be done as early as Friday or perhaps Monday.
The CBO analysis of the House bill says that 23 million people would lose insurance in the next decade under their bill, which President Donald Trump called “mean” in a meeting with senators earlier this month.