The blurry outlines of an Obamacare overhaul are slowly coming into focus as Senate Republican leaders prod their members toward a health-care vote next week.
But the picture is fluid. And Democrats are blasting off fireworks in the background ahead of Senate Majority Leader Mitch McConnell's (R-Ky.) July 4th deadline.
McConnell is holding his plan unusually close to the vest, even for him. While leaks are common for bills of this magnitude, lawmakers and aides are being guarded in what they disclose and few of the finer details have trickled across town to K Street.
We do know this: There will likely be legislation for Republicans to view this week. Much of its largest outlines will mimic the House version passed in May. Parts of it will be different. It’s almost certain to result in millions fewer Americans having insurance. It will also enact big savings for Medicaid. Here’s what we know so far – and what we don't – about the emerging bill:
1. The bill’s 50-vote pathway to passage is most likely to circumvent Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.), the two senators at each end of their party’s spectrum. Collins, a moderate, was the only Republican currently in Congress to vote against an Obamacare repeal bill in 2015, and the libertarian-minded Paul was the only one in his party to oppose a budget resolution earlier this year kicking off the whole process.
If that’s the case, McConnell will have to get every single other Republican on board in the closely divided Senate (and that's counting on Vice President Pence as a tie-breaker) – including Sen. Lisa Murkowski (R-Alaska), who has lately been displaying her displeasure at how the whole health-care effort is unfolding.
2. The Senate measure seems poised to enact deeper Medicaid cuts than the House bill. The Senate bill is shaping up not only to convert Medicaid to a leaner per-capita funding system, but also tie its growth rate to an even slower-growing index than under the House version (the Consumer Price Index for urban consumers, instead of what's known as CPI-Medical). Conservative senators, most prominently Sen. Patrick J. Toomey (R-Pa.), love this idea.
3. The Senate legislation is likely to gradually phase down the Affordable Care Act’s higher federal payments for the expanded Medicaid population. The phase down could take three years, or maybe longer. This would be a concession to moderates who don’t want to look like they’re pushing people off Medicaid too abruptly.
4. The measure seems ready to repeal or delay some or all of the ACA’s taxes. The levies that might be repealed include the ACA's health-insurance tax and a tax on medical devices -- two revenue streams the industry has vigorously lobbied to eliminate. But lawmakers have yet to make a final decision on that front. Much of the final verdict will have to do with how much funding they need to free up in order to pay for the bill’s ultimate benefits.
5. The Senate bill is likely to include a more generous version of insurance subsidies, tying them not just to age as in the House bill, but also to income.
6. The measure will likely exclude language banning federally subsidized health plans from covering abortions. The Senate parliamentarian has yet to make a final decision on whether such language is allowed under budget reconciliation rules. But from what we're hearing, even antiabortion advocates for such a ban acknowledge it's not likely to pass muster under the so-called "Byrd rules" governing what can go in the Senate bill.
Here’s something else we know: Democrats are doing all they can to get in the way. They ultimately can’t block Republicans from passing a health-care bill, since all the GOP needs is a simple majority using budget rules.
But last night Senate Democrats launched a series of mostly symbolic moves, including speeches that went late into the night and slowed down other Senate business, my colleague Sean Sullivan reports:
“The aim, Democrats said, was to draw attention to the secretive process Republican leaders are using to craft their bill and argue that the GOP proposals would hurt Americans,” Sean writes. “The Democrats lack the power to prevent a vote and they don’t have the numbers to defeat a bill without Republican defections. So they are focusing this week on nonbinding protests.”
At one point last night, more than a dozen Democratic senators sat at their desks on the Senate floor and took turns standing and asking for committee hearings on the as-of-yet unreleased measure and for the text to be released for greater public scrutiny, Sean reports.
Each time, McConnell -- who is the one spearheading his party's strategy -- calmly rose from his desk at the front of the chamber and objected to their requests.
“This is going to be a long evening because there are a lot of folks who are frustrated,” Sen. Cory Booker (D-N.J.) said at one point.
https://www.washingtonpost.com/news...02-930a:homepage/story&utm_term=.4a77f43b8cf6
But the picture is fluid. And Democrats are blasting off fireworks in the background ahead of Senate Majority Leader Mitch McConnell's (R-Ky.) July 4th deadline.
McConnell is holding his plan unusually close to the vest, even for him. While leaks are common for bills of this magnitude, lawmakers and aides are being guarded in what they disclose and few of the finer details have trickled across town to K Street.
We do know this: There will likely be legislation for Republicans to view this week. Much of its largest outlines will mimic the House version passed in May. Parts of it will be different. It’s almost certain to result in millions fewer Americans having insurance. It will also enact big savings for Medicaid. Here’s what we know so far – and what we don't – about the emerging bill:
1. The bill’s 50-vote pathway to passage is most likely to circumvent Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.), the two senators at each end of their party’s spectrum. Collins, a moderate, was the only Republican currently in Congress to vote against an Obamacare repeal bill in 2015, and the libertarian-minded Paul was the only one in his party to oppose a budget resolution earlier this year kicking off the whole process.
If that’s the case, McConnell will have to get every single other Republican on board in the closely divided Senate (and that's counting on Vice President Pence as a tie-breaker) – including Sen. Lisa Murkowski (R-Alaska), who has lately been displaying her displeasure at how the whole health-care effort is unfolding.
2. The Senate measure seems poised to enact deeper Medicaid cuts than the House bill. The Senate bill is shaping up not only to convert Medicaid to a leaner per-capita funding system, but also tie its growth rate to an even slower-growing index than under the House version (the Consumer Price Index for urban consumers, instead of what's known as CPI-Medical). Conservative senators, most prominently Sen. Patrick J. Toomey (R-Pa.), love this idea.
3. The Senate legislation is likely to gradually phase down the Affordable Care Act’s higher federal payments for the expanded Medicaid population. The phase down could take three years, or maybe longer. This would be a concession to moderates who don’t want to look like they’re pushing people off Medicaid too abruptly.
4. The measure seems ready to repeal or delay some or all of the ACA’s taxes. The levies that might be repealed include the ACA's health-insurance tax and a tax on medical devices -- two revenue streams the industry has vigorously lobbied to eliminate. But lawmakers have yet to make a final decision on that front. Much of the final verdict will have to do with how much funding they need to free up in order to pay for the bill’s ultimate benefits.
5. The Senate bill is likely to include a more generous version of insurance subsidies, tying them not just to age as in the House bill, but also to income.
6. The measure will likely exclude language banning federally subsidized health plans from covering abortions. The Senate parliamentarian has yet to make a final decision on whether such language is allowed under budget reconciliation rules. But from what we're hearing, even antiabortion advocates for such a ban acknowledge it's not likely to pass muster under the so-called "Byrd rules" governing what can go in the Senate bill.
Here’s something else we know: Democrats are doing all they can to get in the way. They ultimately can’t block Republicans from passing a health-care bill, since all the GOP needs is a simple majority using budget rules.
But last night Senate Democrats launched a series of mostly symbolic moves, including speeches that went late into the night and slowed down other Senate business, my colleague Sean Sullivan reports:
“The aim, Democrats said, was to draw attention to the secretive process Republican leaders are using to craft their bill and argue that the GOP proposals would hurt Americans,” Sean writes. “The Democrats lack the power to prevent a vote and they don’t have the numbers to defeat a bill without Republican defections. So they are focusing this week on nonbinding protests.”
At one point last night, more than a dozen Democratic senators sat at their desks on the Senate floor and took turns standing and asking for committee hearings on the as-of-yet unreleased measure and for the text to be released for greater public scrutiny, Sean reports.
Each time, McConnell -- who is the one spearheading his party's strategy -- calmly rose from his desk at the front of the chamber and objected to their requests.
“This is going to be a long evening because there are a lot of folks who are frustrated,” Sen. Cory Booker (D-N.J.) said at one point.
https://www.washingtonpost.com/news...02-930a:homepage/story&utm_term=.4a77f43b8cf6
