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The GOP's furious push to pass a new healthcare bill to destroy Obamacare is coming into focus

Bob Bryan
Mitch McConnell

(Senate Majority Leader Mitch McConnell.Reuters/Carlos Barria)

  • The newest Republican Obamacare-repeal bill will go to the Senate floor next week, Majority Leader Mitch McConnell's office said.
  • It is unclear whether the GOP will have the needed 50 votes before the deadline to pass the bill.
  • The Graham-Cassidy-Heller-Johnson plan would lead to massive shifts in federal healthcare funding.

Senate Majority Leader Mitch McConnell's office said Wednesday that the leader would bring the latest Republican healthcare bill to the floor for a vote next week amid a furious GOP push to repeal the Affordable Care Act, the healthcare law also known as Obamacare, as a deadline looms.

The Graham-Cassidy-Heller-Johnson legislation was released one week ago by four Republican senators: Lindsey Graham, Bill Cassidy, Dean Heller, and Ron Johnson. It's most likely the party's last-ditch repeal effort for now.

The pressure is on because Republicans are attempting to use budget reconciliation to pass the bill, a process that would allow them to avoid a Democratic filibuster and pass the bill with only a simple majority. Republicans hold 52 seats in the Senate.

But the rules that allow Republicans to use reconciliation will expire at the end of September, per a ruling from the Senate parliamentarian, spurring intense urgency to pass the legislation.

The intention to introduce the bill to the floor most likely means the GOP is close to the necessary votes — and that McConnell may be pressuring some wavering members. Cassidy has told reporters that 48 or 49 Republicans support the bill.

Republican Sen. Rand Paul of Kentucky has already come out against the bill. Other possible holdouts include Sens. Susan Collins of Maine, Lisa Murkowski of Alaska, and John McCain of Arizona, the three Republicans whose "no" votes killed previous iterations of the Senate healthcare bill.

Democrats' opposition to the bill has been fierce. Senate Minority Leader Chuck Schumer on Tuesday attacked the bill on the Senate floor.

"What we do know is that this new Trumpcare bill, the Graham-Cassidy legislation, is worse in many ways than the previous versions of Trumpcare," Schumer said.

Democrats also complained that the bill would not receive a full score ahead of its introduction from the nonpartisan Congressional Budget Office. The score measures the effects on insurance coverage and costs for Americans. The CBO has said, though, that it will release a truncated score that examines the effect on the federal budget.

The bill must be projected to lower the federal deficit to qualify for reconciliation. The CBO said it would include in its score whether the bill would reduce the deficit more than the House's American Health Care Act, which passed that chamber earlier this year.

Studies from independent health-policy think tanks have found that the bill would have drastic ramifications in all corners of the healthcare market.

Here's a rundown of the major provisions of the bill:

  • Shift to a block-grant system for federal healthcare funding to states. The bill would give states a lump sum of money to fund their healthcare needs, which differs from the current system, in which the federal government matches a percentage of a state's actual spending. The block grants would also be doled out in such a way that some states would end up getting more — especially those that did not expand Medicaid under Obamacare — while others would see their funding slashed.
  • Allow states to waive some Obamacare regulations. The bill would allow states to apply for waivers that would let them do away with Obamacare regulations if doing so would lower costs. While there is a provision in the bill that says insurers can't use this to deny coverage to people with preexisting conditions, experts say it could allow insurers to charge them more.
  • Maintain many Obamacare taxes. To avoid adding too much to the federal deficit — and being disqualified from reconciliation — the bill would preserve many major taxes created under Obamacare, such as the tax on net investment income. Other smaller taxes, like the medical-device tax, would be eliminated.
  • Eliminate the individual and employer mandates. People who do not sign up for insurance would not face a tax penalty under the plan, and companies would not be compelled to offer coverage, though states could pass their own mandates. A study by the Commonwealth Fund found that this would increase the number of uninsured by up to 18 million by 2019.
  • Pay cost-sharing subsidies through 2019. Such a move would help the insurance exchanges established by Obamacare stay stable in the short term — something Democrats have urged. When the block grants kick in, however, these payments would end.
  • Cut off all money after 2026. The large block grants to help states would be eliminated after 2026. Commonwealth estimated this would lead to about 32 million more uninsured people compared with the current system after that year.

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