Senate GOP releases bill to cut Medicaid, alter 'Obamacare'

Senate Majority Leader Mitch McConnell R-Ky. joined by from left Sen. John Barrasso R-Wyo. Sen. John Thune R-S.D. and Majority Whip John Cornyn R-Texas speaks following a closed-door strategy session at the Capitol in Washington Tuesday June

Senate Republicans, who have promised a repeal of the Affordable Care Act for seven years, took a major step on Thursday to achieve that goal as they unveiled a bill to end the health law's mandate that almost everyone have health care, remake and cut the Medicaid program and create a new system of federal tax credits to help people buy health insurance.

The measure also helps people who purchase insurance out of pocket, known as the individual marketplace, afford the insurance through tax credits based on income, combining the ideas behind Obamacare and the House bill.

If all three of those senators oppose the bill, it dies. They both plan to hold town halls to speak with Montanans about their thoughts.

McConnell said a fresh CBO score on the new bill was expected next week, and there will be "robust debate" on the floor. "I look forward to hearing directly from Montanans on this legislation, including on the 17 teletownhall I'll be hosting next Wednesday".

Sen. Bill Nelson lashed out at the GOP health care plan released Thursday, deeming it "just as bad as the House bill".

As with the House, the Senate also proposes giving states either a per capita cap on Medicaid spending or a block grant of funds. Wyden hasn't yet seen the bill but said that, based on the House bill, he believes it is likely to reduce health-care benefits while delivering "hundreds of billions of dollars to the very fortunate" in tax cuts.

"We have to act", McConnell said. "Because Obamacare is a direct attack on the middle-class and Americans deserve better than the failing status quo".

There are 52 GOP senators, and if necessary Vice President Mike Pence could make a tie breaking vote.

U.S. Senate Minority Leader Chuck Schumer (C) condemns the firing of FBI Director James Comey in a speech on the floor of the Senate in this video grab taken on Capitol Hill in Washington, U.S., May 10, 2017.

Schumer says, "We live in the wealthiest country on earth". Even though Republicans amended Obamacare in the American Health Care Act, it's not clear how keeping the law mostly intact is a winning strategy.

"As now drafted, this bill draft does not do almost enough to lower premiums", Cruz said in a separate statement obtained by CNN's Dana Bash.

One congressional analysis indicates between 13 million and 23 million people with private health insurance or government-supported Medicaid might lose coverage if the House-passed version advances unchanged.

Trump says at the start of a White House event on technology he is hopeful Congress will get something done on health care "with heart".

Some of the biggest changes this bill makes are to Medicaid, the entitlement program that provides health care to low-income Americans. The additional funds would continue through 2020, and be gradually reduced until they are entirely eliminated in 2024.

Ending Obama's expansion has caused major rifts among GOP senators. Republican senators from states that expanded Medicaid, such as Ohio's Rob Portman, want to extend that phase-out to seven years. The program now gives states all the money needed to cover eligible recipients and procedures.

The Senate also backs away from some last minute House concessions to conservatives that would have allowed states to opt out of several protections for those with pre-existing conditions, but insurers would not be allowed to charge higher premiums to those with pre-existing conditions.

While the House legislation would peg federal insurance subsidies to consumers' age, the Senate bill would factor in income as well, as the ACA does. That law extended the program to some low-income Americans above the poverty level. But younger people would still get more generous subsidies than they do under current law. That's because they're keyed to the cost of a bare-bones plan, and because additional help now provided for deductibles and copayments would be discontinued. If that happens, people on medical assistance in New Mexico face severe challenges, according to Edwin Park, vice president for health policy with the Center on Budget and Policy Priorities. In the Senate, reconciliation bills aren't subject to filibuster and the scope of amendments is limited, giving this process real advantages for enacting controversial budget and tax measures. "They wrote their plan in secret and are rushing forward with a vote next week because they know how much harm their bill does to millions of people". Trump has been threatening to discontinue those payments, and some insurance companies have cited uncertainty as a reason they are abandoning some markets and boosting premiums. A vote on the bill reportedly could happen as early as next week.

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