Paul still opposes GOP health care bill, despite changes

Sens. John McCain of Arizona, Kentucky’s Rand Paul and Texas’ Ted Cruz have all expressed opposition to the bill. (If Collins, Paul and McCain continue to be no votes on the bill, it will fail).

Republicans can’t afford to lose any more votes, so the plan’s authors now seem to be targeting states whose senators are possible “no” votes. Lindsay Graham, R-SC, a lead sponsor of the repeal bill, yelling “shame, shame, shame”.

The hearing was an attempt to create a normal legislative process for a bill that critics say is being rushed through by GOP leaders to meet a September 30 deadline.

Sen. Lisa Murkowski, R-Alaska, has not given any indication about which way she would vote.

The nonpartisan Congressional Budget Office has said it does not have enough time to estimate how the latest GOP bill would impact health coverage. Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Dean Heller of Nevada and Ron Johnson of Wisconsin – would give states more decision-making authority on how to allocate health care dollars. That would include relaxing requirements that all plans cover an essential benefits package and refrain from basing premiums on enrollees’ health status. “That’s pretty much as much of a reason as the substance of the bill”.

All the money from those programs would be rolled up and redistributed to states in the form of block grants.

In another report, S&P Global Ratings said that the bill “represents nothing short of an overhaul” to the fiscal relationship between federal government and individual states, which could increase pressure on states’ budgets. Just minutes into the hearing, Senator Hatch said, “The committee will be in recess until we get order“, then left.

Cassidy was scheduled to defend his bill at a hearing later Monday by the Senate Finance Committee.

Unless the White House and party leaders can persuade at least one of the three to come around, three GOP “no” votes will be enough to kill the legislation because all Senate Democrats oppose it. The CBO, in its dry language, painted a picture of chaos under the bill, as states scrambled to set up their own coverage systems starting in 2020, when the ACA system of exchanges and premium subsidies would end and the new $1.2 trillion block grant system would start. And it would place a federal spending cap on Medicaid.

But Collins, in a lengthy statement outlining her opposition, appeared unmoved by the revisions, criticizing the rushed legislative process and last-minute changes.

If Graham-Cassidy does become law, some changes would be immediate, but others would take effect two years from now and depend on how states and insurance companies decide to operate under the new system. In a Sunday morning interview on CNN’s “State of the Union“, Collins said it is “very hard for me to envision a scenario where I would end up voting for this bill”.

It was unclear if Senate Majority Leader Mitch McConnell, R-Ky., would hold a roll call.

Democratic Senator Patty Murray of Washington, who until last week had been working on a limited package of bipartisan fixes with Senator Lamar Alexander, said getting the two parties working together again was “the right thing to do”. Murray and Alexander are the top members of their respective parties on the Senate Health, Education, Labor and Pensions committee.

The Brookings research indicates that the Cassidy/Graham proposal, if it becomes law, will leave more Americans uninsured after 2026 than there were before the Affordable Care Act legislation was introduced.