Senate leaders on Wednesday were putting the final touches on legislation that would reshape a big piece of the U.S. health-care system by dramatically rolling back Medicaid while easing the impact on Americans who stand to lose coverage under a new bill.
A discussion draft circulating Wednesday afternoon among aides and lobbyists would roll back the Affordable Care Act’s taxes, phase down its Medicaid expansion, rejigger its subsidies, give states wider latitude in opting out of its regulations and eliminate federal funding for Planned Parenthood.
The bill largely mirrors the House measure that narrowly passed last month but with some significant changes aimed at pleasing moderates. While the House legislation tied federal insurance subsidies to age, the Senate bill would link them to income, as the ACA does. The Senate proposal cuts off Medicaid expansion more gradually than the House bill,\ but would enact deeper long-term cuts to the health-care program for low-income Americans. It also removes language restricting federally subsidized health plans from covering abortions, which may have run afoul of complex budget rules.
Senate Majority Leader Mitch McConnell (R-Ky.) intends to present the draft to wary GOP senators at a meeting Thursday morning. McConnell has vowed to hold a vote before senators go home for the July 4 recess, but he is still seeking the 50 votes necessary to pass the major legislation under arcane budget rules. A handful of senators, from conservatives to moderates, are by no means persuaded that they can vote for the emerging measure.
Aides stress that the GOP plan is likely to undergo more changes to garner the 50 votes Republicans need to pass it. Moderate senators are concerned about cutting off coverage too quickly for those who gained it under the ACA, also known as Obamacare, while conservatives don’t want to leave big parts of the ACA in place.
So it wouldn't be as stridently anti-women as the House version, but it would make deeper cuts to Medicaid over a longer period of time, resulting in even more long-term damage. At this point calling your local Senate office is a really smart idea, because if this passes, tens of millions of Americans are going to lose coverage outright, will be unable to get new coverage thanks to "pre-existing conditions" and millions more will be locked out by lifetime or annual limits on treatments on group plans.
In other words, we'll be back to the bad old days of the Bush era, only with Medicaid block grants and one in five Americans not having insurance.
And believe me, my two Senators will absolutely vote to take insurance from half a million here in Kentucky and won't lose a wink of sleep. Your state may fare better, so make those phone calls.