How the Senate health bill compares to House, 'Obamacare'

Sens. John Cornyn and Ted Cruz
        CQ Roll Call  Getty Images

Sens. John Cornyn and Ted Cruz CQ Roll Call Getty Images

It is obvious to most Ohioans and Americans that the major goal of our Republican friends in Columbus and Washington, D.C.is making the rich more comfortable.

U.S. Sen. Joni Ernst, R-Iowa, said during Senate floor debate Wednesday that former President Barack Obama's signature health care law is "not affordable for Iowans" but hasn't declared how she will vote on the proposed legislation.

McConnell, eager to approve the legislation next week, indicated he was open to changes before it reaches the Senate floor, but he said it was time to act.

Senate Majority Leader Mitch McConnell, R-Kentucky, said he hopes to bring the GOP bill to a vote before Congress breaks for its Fourth of July recess. By making the change in 2025, moderate Republicans wary of how the cuts will affect their states might be willing to sign on.

The Senate version makes only modest changes - and makes deep cuts to Medicaid, which 79 percent of those surveyed oppose. That includes phasing out extra money Obama's statute gives states that have expanded the program, a step Nevada has taken, adding 200,000 additional people.

Many Republicans say privately that they are eager to work with Democrats on fixes to the current law to keep the insurance exchanges from imploding.

And Obama called on Americans to lobby their senators, in order to slow down the Republican bill's consideration and pressure GOP lawmakers into negotiating with Democrats on the proposal. The entire Medicaid program as Americans know it could end, and for many Republicans, that's the entire idea.

Asked about the bill's impact on Medicaid insurance coverage for lower-income Iowans, Ernst said, "I wouldn't say they are losing it".

The tax credits would be tied to income - similar to the Affordable Care Act, but different from the House bill that would link the funding to a person's age.

"No argument against Trumpcare is more eloquent than the grave consequences it means in people's lives", she wrote colleagues.

It would also repeal most of the tax increases imposed by the Affordable Care Act to help pay for expanded coverage, in effect handing a broad tax cut to the affluent in a measure that would also slice billions of dollars from Medicaid, a program that serves 1 in 5 Americans, not only the poor but also nearly two-thirds of people in nursing homes. Americans in their 50s and early 60s benefited from Obamacare because insurers could only charge them three times more than younger policyholders.

Just hours after McConnell released the 142-page legislation on Thursday, four conservatives said they opposed it. "But in a separate statement, Cruz says he wants to help make "real improvements" so it "provides the relief from Obamacare that Republicans have repeatedly promised the last seven years" - especially in reducing health insurance premiums". But he said "it's going to be very hard to get me to a "yes" on the bill. "We'll have to see".

A disappointing CBO score for the Senate bill would only compound the pressure facing wary Republicans such as Rand Paul of Kentucky, Shelley Moore Capito of West Virginia, Rob Portman of Ohio, Susan Collins of ME and Lisa Murkowski of Alaska.

It halts federal funding to Planned Parenthood for one year, and stipulates that any health plan that covers abortions wouldn't qualify for federal subsidies. The bill has not yet been scored by the non-partisan Congressional Budget Office on its possible effects.

Heller said that to win his vote, GOP leaders would have to "protect Medicaid expansion states" from the bill's current cuts. The Senate bill also calls for a tighter cap on federal spending in Medicaid overall than the House bill did.

The measure largely uses people's incomes as the yardstick for helping those without workplace coverage to buy private insurance. A single person would no longer qualify for subsidies if he or she earned about $42,000 per year, under the Senate bill, leaving them on the hook for thousands more in premium costs.

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