McConnell reveals new health bill; Granite Staters react
WASHINGTON (AP) — Senate Republican leader Mitch McConnell released his new but still-reeling health care bill Thursday, bidding for conservative support by letting insurers sell low-cost, skimpy policies and reaching for moderates with added billions to combat opioid abuse and help states rein in consumers' skyrocketing insurance costs.
However, allowing insurers to offer bare-bones plans threatens to alienate moderates and perhaps other conservatives. And the measure retains cuts in Medicaid — the health insurance plan for the poor, disabled and nursing home patients — that moderate Republican senators have fought.
The 172-page legislation, the Senate GOP's plan for rolling back much of President Barack Obama's health care law, faces a do-or-die vote next week on which McConnell has no margin for error. Since Democrats uniformly oppose the effort, McConnell needs the votes of 50 of the 52 GOP senators to prevail, and two have already said they will vote "no" — conservative Sen. Rand Paul of Kentucky and moderate Sen. Susan Collins of Maine.
Underscoring the measure's dicey prospects, No. 3 Senate Republican leader John Thune of South Dakota said, "We've got a long way ahead of us yet. The floor is going to be a wild place next week."
Seeking to rally support, McConnell, R-Ky., reminded GOP senators that obliterating the 2010 statute has been a central tenet for the party's candidates.
"This is our chance to bring about changes we've been talking about since Obamacare was forced on the American people," he said.
But Democrats chose a different word to describe the measure, one which President Donald Trump himself used to describe the House-passed version of the measure despite having applauded it previously.
"The new Republican Trumpcare bill is every bit as mean as the old one," said Senate Minority Leader Chuck Schumer of New York. He said the provision allowing scanty coverage makes it "even meaner."
Conservative Sen. Ted Cruz, R-Texas, has demanded language letting insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by Obama's 2010 statute. Moderate Republicans have objected that the idea would make policies excessively costly for people with serious illnesses because healthy people would flock to the cheaper coverage.
Sen. Mike Lee of Utah, who'd partnered with Cruz, tweeted that the version they crafted wasn't put in the bill, adding, "Something based on it has, but I have not seen it or agreed to it."
Rep. Carol Shea-Porter of New Hampshire, said the changes to the bill make a "heartless plan" even worse and criticized Cruz's proposed amendment.
"The Cruz amendment would allow insurance companies to discriminate against people with pre-existing conditions and to push bare-bones plans, bringing us back to the days when Americans experiencing a health crisis too often found out that care wasn’t covered in the moment that they needed it most."
Shea-Porter also said the GOP healthcare bill would hinder efforts to combat the opioid epidemic.
"The Senate bill would send our communities backward in their fight against the heroin, Fentanyl, and prescription opioid crisis, kicking millions off Medicaid and private insurance while allowing insurance companies to weaken or eliminate coverage of behavioral health and substance use treatment.”
Sen. Jeanne Shaheen of New Hampshire, echoed Shea-Porter's concerns regarding the opioid epidemic.
“Senate Republican leaders are not listening to the American people,” Shaheen said. “The fundamentals of this repeal bill have not changed: it would drive up premium costs, eliminate protections for pre-existing conditions, leave millions of working families without coverage, and would undermine our efforts in New Hampshire to combat the opioid epidemic.
A summary of the bill said some stripped-down policies would cover three primary care visits per year and limit out-of-pocket costs, and said consumers could use federal tax credits to help pay for them.
But the Cruz provision appeared in the legislative text in brackets, meaning specific language was still being composed. That could give McConnell, Cruz and other conservatives time to work out a provision with broader support.
The retooled measure retains McConnell's plan to phase out the extra money 31 states have used to expand Medicaid under Obama's statute, and to tightly limit the overall program's future growth. Since its creation in 1965, the program has provided open-ended federal funds to help states pay the program's costs.
The rewritten package would add $70 billion to the $112 billion McConnell originally sought that states could use to help insurers curb the growth of premiums and consumers' other out-of-pocket costs.
It has an added $45 billion for states to combat the misuse of drugs like opioids. That's a boost over the $2 billion in the initial bill and an addition demanded by Republicans from states in the Midwest and Northeast that have been ravaged by the drugs.
To help pay for the added spending, the measure would retain three tax increases Obama's law slapped on higher- earning people to help finance his law's expansion of coverage. Under the current statute, families earning more than $250,000 annually got a 3.8 percent boost on their investment income tax and a 0.9 percent increase in their payroll tax. Obama also imposed a new tax on the salaries of high-paid insurance executives.
The measure would eliminate other tax boosts Obama levied on insurers, pharmaceutical producers and other health industry companies.
The revised bill would also allow people to use money from tax-favored health savings accounts to pay health insurance premiums, another favorite proposal of conservatives.
McConnell's new bill offered only modest departures from the original version, which he yanked off the Senate floor two weeks ago to avoid certain defeat at the hands of a broad range of unhappy Republicans.
The reworked measure's key elements remain. It would ease Obama's requirements that insurers cover specified services like hospital care, erase Obama's penalties on people who don't buy coverage and make federal health care subsidies be less generous.
Sen. Maggie Hassan of New Hampshire said that it is "abundantly clear" that there is no fixing the GOP healthcare bill.
“I urge my colleagues across the aisle to take the time to listen to the voices of their constituents who would be hurt under this legislation," Hassan said. "I stand ready to work with anyone who is serious about lowering health care costs and expanding coverage for hard-working Granite Staters and Americans, but this backward bill would do just the opposite." ?
Trump said Wednesday he will be "very angry" if the Senate fails to pass the health care measure and said McConnell must "pull it off."
Paul told reporters the revised measure has nothing "remotely resembling repeal." Collins has long complained the measure will toss millions off coverage and objected to its Medicaid cuts.
The New Hampshire Healthcare Association also released a statement calling the healthcare bill a "real 'death panel' bill" because of the way it would cut Medicaid for seniors and the disabled. They called the changes an attack on the Medicaid system that has been in place since long before the Affordable Care Act.
"New Hampshire long-term care wouldn’t survive it [the GOP healthcare bill]. We already have the nation’s second-oldest population and third-worst nursing home funding crisis," the statement read. "McConnell should just admit his real goal is gutting the 1965 Medicaid Act."
AP reporters Ricardo Alonso-Zaldivar, Erica Werner and Kevin Freking contributed to this report. NH1 News reporter Jesse Reynolds also contributed to this report.