Senate Republicans unveiled revised legislation Thursday to roll back the Affordable Care Act, but political support has deteriorated so dramatically it is unclear whether GOP leaders even have enough votes to formally open the debate next week.
The revised bill would retain two key Obamacare taxes on the wealthy and earmark an extra $45 billion for opioid treatment. It includes a provision that would give insurers more flexibility to offer striped-down, cheaper plans.
The new bill also includes a provision to expand the ability of Americans who sock away money in tax-deferred Health Savings Accounts to pay their insurance premiums from those funds.
Senate Majority Leader Mitch McConnell (R-Ky.) has been meeting behind closed doors with Republicans to adjust the legislation after he was forced to abandon a vote last month amid a revolt within his own party. The earlier version would have left 22 million more Americans uninsured and has been vehemently opposed by leading doctor, patient and other healthcare advocacy groups.
But the new version may not resolve differences between the GOP’s conservative and centrist factions. And passage remains seriously in doubt.
In fact, even before the revised bill was released, two Republican senators floated their own rival plan.
The alternative proposal – by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana – is only a general outline. It would preserve some taxes in the current health law while creating new block grants that to ship billions of dollars to states, giving them broader authority to redesign their health insurance markets.
“We’re going to see which one can get 50 votes,” Graham told CNN.
There is no specific formula that indicates what this would mean for Medicaid, but the two senators suggest that the program would be restricted in future years by capping federal aid to states, much as other Republican proposals.
“I will be very angry about it and a lot of people will be very upset,” Trump said. Referring to McConnell, Trump added, “Mitch has to pull it off. He’s working very hard.”
But senators are worried GOP leaders don’t have the 50 votes needed from their 52-seat majority for a procedural vote to start debate of the healthcare bill on the Senate floor.
McConnell has indicated he intends to push ahead once the nonpartisan Congressional Budget Office has reviewed the revised legislation. The agency’s estimates are expected Monday.
The new approach sticks to the broad outline of McConnell’s first bill, the Better Care Reconciliation Act, with key revisions largely to bring conservatives on board.
8:55 a.m.: This article was updated after the bill was released.
This article was originally published at 3 a.m.