Conservatives Split Over Second Stab at GOP Health Care Bill
Critics say revised Obamacare replacement an improvement but falls short of good policy
Senate Majority Leader Mitch McConnell (R-Ky.) unveiled the 2.0 version of his Obamacare repeal on Thursday after an initial stab drew fire from the right and left flanks of the GOP.
The revised bill includes a version of a proposal from Sen. Ted Cruz (R-Texas) to give states greater flexibility to let insurance companies sell cheaper, less comprehensive policies. It also retains the tax increases on wealthy Americans imposed by the Affordable Care Act. That would allow the government to spend an additional $45 billion to fight the opioid abuse epidemic.
States that did not expand Medicaid under Obamacare would get more money to compensate hospitals for treating the uninsured.
Like the earlier version of the plan, the new bill would eliminate the mandate that people buy insurance, would offer less funding to help people buy insurance, and would slow the growth of spending on the Medicaid program for the poor.
Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.) — representing the polar extremes of the Republican caucus — have signaled opposition. In a Washington Examiner op-ed on Thursday, Paul argued that the bill combines the worst of Obamacare and the bank bailouts during the 2008 financial crisis.
"This time, we're bailing out the big insurance companies," he wrote.
Without Paul and Collins, that would mean that McConnell could afford no more defections, assuming that all Democrats remain opposed.
Conservative policy analysts told LifeZette that the current bill would do more to reduce premiums than a draft Senate leaders floated several weeks ago.
"Overall, the latest version of the Better Care Reconciliation Act is a step in the right direction," said Jean Morrow, a researcher at The Heritage Foundation. "It does start to help to undo the damage Obamacare caused."
Michael Tanner, a senior fellow at the libertarian Cato Institute, said he believes the bill would offer faster relief on premiums — particularly for healthier consumers — than the previous version.
"This is an incremental improvement in the bill," he said. "It still has a long way to go before it's a good bill."
The Main Features
Highlights of the bill include the following:
- $70 billion to assist state-based reforms to reduce premiums. That is above and beyond the $112 billion included in the original draft for that purpose.
- A provision allowing the payment of premiums from tax-sheltered health savings accounts.
- A provision allowing low-income Americans to use subsidies to buy catastrophic health plans.
- A provision changing how the government compensates hospitals for treating people without insurance. States could get waivers for continuing or improving home- and community-based care for the aged and disabled.
- Flexibility to boost spending in cases of public health emergencies. Expanded block grant options would include people who signed up for Medicaid under the Obamacare expansion.
- A fund to make payments to specified insurers for the costs of covering high-risk consumers enrolled in qualified health plans. Insurers could get money if they stay subject to Obamacare regulations.
Some conservative activists said the bill in its present form remains hopelessly fraud, amounting to an insurance company bailout that keeps the basic structure of Obamacare in place.
"Conservatives are duty-bound to vote against the motion to proceed. I agree with Rand Paul."
"Conservatives are duty-bound to vote against the motion to proceed," said David Bozell, president of the conservative group For-America. "I agree with Rand Paul."
Republican Senate leaders insisted that the current bill is a genuine repeal.
"It repeals the core of Obamacare," Sen. John Thune (R-S.D.) told CNN.
The Cruz amendment would let states allow insurance companies to sell cheaper plans that do not comply with Obamacare mandates as long as they also sell Obamacare-complaint policies. That was enough to win support from Cruz for the overall bill. However, Sen. Mike (R-Utah), another conservative who has pressed for more flexibility for states, issued a statement indicating that he has not decided whether to support the bill.
Rep. Jim Jordan (R-Ohio) praised the idea.
"It will actually offer the kinds of plans that consumers want," he told CNN. "Imagine that. Offering plans that patients, consumers and families would actually like to purchase and do so at a lower premium."
Despite Cruz Amendment, Critics Remain
Jason Pye, vice president of legislative affairs at FreedomWorks, called it a "step in the right direction." But he added that his conservative organization is disappointed that the bill retains some Obamacare tax hikes.
Bozell, of ForAmerica, said the Cruz amendment offers "watered-down" relief from costly Obamacare regulations — and little else conservatives have advocated for.
"I want a repeal bill, not just an amendment that does a couple of nice things," he said. (go to page 2 to continue reading)