The Senate releases its revised health care bill

Before the July recess, things weren’t looking too great for Senate Republicans and their bill to overhaul the Affordable Care Act. At least seven senators opposed the plan on varying but nonetheless substantial concerns. Angry constituents protested outside the offices of their senators in an attempt to raise their own voices in relation to the polarizing bill, which included high premiums and sizable cuts to Medicaid. To top it all off, the CBO’s scoring of the bill did not portend conducive numbers for the future of health care should the legislation see the light of day. Senate Majority Leader Mitch McConnell knew that drastic amendments would have to be made in order to capture necessary support from his deeply divided party, and yet, these amendments would also have to toe a fine balance between conservative and moderate views in order to appease both types of Republicans.

On Thursday, Senate Republican leaders released their revised health care bill to decidedly mixed reviews. It’s like a kind of feast where the host tries to provide a dish to everyone’s taste, but ends up dissatisfying more people due to the over-bloated table. There’s something for everyone, but not enough for anyone.
Let’s break these changes down:

  • To the scorn of many critics, the previous Senate bill repealed two significant taxes on people with high incomes, which would effectively reduce federal revenue by $231 billion over the 2017-2026 period. The revised Senate bill reneged on this provision, preferring to keep the taxes intact.
  • To address the concerns of more moderate Republicans, the bill has been allotted hundreds of billions of dollars for sundry uses. For instance and as discussed in a previous article, $45 billion will be allotted to combat the opioid crisis, and $70 billion, on top of the $112 billion already promised in the original proposal, will be purposed to drive down high premiums/stabilize a fluctuating market.
  • At the end of the bill, the Senate Majority Leader gave a nod to the proposed amendment by Senators Ted Cruz and Mike Lee. This provision allows for insurance companies to sell policies that don’t quite match the ACA’s standards, so long as they continue to offer one policy which does. Essentially, these lesser policies, stripped down and inexpensive as they are, will likely appeal to young, healthy individuals, while older, sicker ones will be left to purchase more comprehensive plans with higher premiums.

These three changes substantially differentiate the revised bill from the original bill, but it is also important to note that the revised bill did not touch the hefty Medicaid cuts which generated such heavy outrage about its predecessor. It is likely that these cuts will once again affect the CBO’s report on the bill, which is expected by Republicans as early as next week.

In addition, the new bill has already drawn opposition by Republicans, two of whom are hesitant to even move the bill to debate by a procedural motion. As is true with the final vote, Mitch McConnell needs fifty votes from his fellow Republicans to even open the bill for debate, and judging by his statements on Thursday, it is emphatically evident that the Senate Majority Leader wants to see the bill debated:

“I hope every senator will vote to open debate. That’s how you change the status quo. This is our opportunity to really make a difference on health care. This is our chance to bring about changes we’ve been talking about since Obamacare was forced on the American people. It’s our time to finally build the bridge away from Obamacare’s failures and deliver relief to those who needed.”