Proposals being pushed by Sen. Ted Cruz (R-TX), with the support of other conservative senators and outside groups, will be included in the revised Obamacare repeal language being unveiled Thursday, Senate aides confirmed to TPM.
An amendment allowing insurers to sell unregulated plans – which would be cheaper but could discriminate against people with pre-existing conditions – as long as they also sold an Obamacare-compliant policy, will be in the base text, as first reported by Axios. According to Axios, the amendment might still be changed or removed altogether, and the language in the draft bill will appear in brackets.
In the days leading up the revised bill’s unveiling, expected late Thursday morning, other Republicans were already throwing out suggestions to tweak Cruz’s idea to make it more workable and appealing to the conference.
The idea has been controversial, as other Republicans have raised concerns that it would destabilize the marketplace and make insurance unaffordable for sick people — concerns echoed by the insurance industry this week.
Additionally, the revised text will include conservatives’ request that consumers be allowed to use their health savings accounts to pay for premiums, a conservative aide said.
Even with news that some form of the proposals were going to be in the base text of the bill, there was no guarantee that it was enough to shore up the support of the hard-right flank of the Senate GOP conference that has been resisting the bill.
Sen. Mike Lee (R-UT) stopped short of promising his support Thursday morning, saying he hadn’t seen the exact language yet.
Just FYI – The Cruz-Lee Amendment has not been added to BCRA. Something based on it has, but I have not seen it or agreed to it. 1/2
— Mike Lee (@SenMikeLee) July 13, 2017
I am withholding judgment and look forward to reading it. 2/2
— Mike Lee (@SenMikeLee) July 13, 2017
Additionally, Sen. Rand Paul (R-KY) indicated on Wednesday he was likely to vote against the revised bill, even with the Cruz-supported language.
Senate Republicans can lose just two votes and still pass their bill.
The Congressional Budget Office is analyzing the language, and GOP senators said they hope to see a score in the days to come.
Outlines of the changes to the draft legislation leaked to the Washington Examiner, Vox and other outlets described language that would allow Obamacare’s tax credits for individual plans to be used on catastrophic coverage plans.
“These plans are higher deductible plans that cover three primary care visits a year and have federal protections that limit an individual’s out-of-pocket costs,” the outline posted by Vox said.
The other big change in the revised bill, according to the leaked outlines, is its retention of three Affordable Care Act taxes that were repealed in the initial version of the legislation: the net investment tax, the Medicare payroll tax on high-earners, and a tax on insurance industry executives.
The additional money, it appears, will in part go to subsidizing insurers for the coverage of high-cost individuals who otherwise stand to see their premiums skyrocket under the Cruz scheme. The leaked outline does not specify how large that subsidy will be.
Additionally, the revised bill adds $70 billion to a fund for states to set-up programs that lower premiums or cover high-cost individuals.
On the Medicaid side, the revised bill makes adjustments to the formula determining payments for uncompensated hospital care, according to the leaks. It also outlines waivers that will be available to states for home-based care for Medicaid’s disable, blind, and elderly populations. And it appears that funding for public health emergencies, such as the Zika outbreak, will not fall under the new caps instituted on the traditional Medicaid program by the Republican plans.
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