Republican senators have already been pushing back against their own party's Better Care Reconciliation Act (BCRA) -- which is the Senate's version of the Houses' American Health Care Act (AHCA) -- that many of the same senators have been working on in secret. Senate Majority Leader Mitch McConnell (R-Ky.) finally revealed the secret bill last Thursday, a week before he tries to put it to a vote. But there is growing doubt that he will be able to get a vote this week before they break for their July 4 recess. Some of the issues facing the bill were already creating problems with the more outspoken senators who have already said they would not vote for it.
New tweaks to the bill that took place on Monday could end up making more Republicans who do not want to vote "yes" for a bill that even remotely looks like Obamacare -- a.k.a. Affordable Care Act (ACA) -- definite. These tweaks suggest that they're bringing back an individual mandate that has become scripture among Republicans, one of the main reasons they've said that they have been wanting to get rid of the ACA.
The reason for this is because they would need to find a way to fund the market to keep the insurers interested in the program by having healthy people pay into it instead of sick people. They also have to penalize those who don't, so Senate Republicans plan for a 30 percent raise on premiums for those who didn't buy healthcare last year to enter the new market.
Republicans could change vote on bad bill
Even with McConnell adjusting the majority vote rules in order to pass their bill, Republicans could only afford to lose two defections. But a report by The Hill titled: "Rocky rollout for the Senate healthcare bill" suggests that they may lose more senators along the way. The article points to Sen.
Rand Paul (R-Ky.) and Mike Lee (Utah) as well as Ted Cruz (Texas) and Ron Johnson (Wis.) who said in a statement on Thursday that they don't support the bill. Nonetheless, they also said they would be willing to negotiate, but with the new adjustment, Republicans could be even more divided on what they are voting for.
It should be noted that Sen.
Paul has said once before when it was suggested that President Trump should be investigated, that Republicans should not investigate their own. With that type of sentiment, it's likely that it's the same kind of room he is leaving to negotiation on the healthcare bill too despite the appearance that he refuses to vote for it. This was also the case when House Republicans voted for the AHCA just to pass the bill despite rejection from their constituents. With the recent news that threatens to make the BCRA more like Obamacare, Republicans can vote for their own defeat by passing it or test the ideologues to defeat it by not passing it at all.
Concerns over ending Medicaid expansion
Moderate Republicans have said that they have issues with how the bill would treat constituents who are enrolled in Medicaid.
For instance, the Hill article points to Sen. Dean Heller (R-Nev.) and Susan Collins (R-Maine.). Collins referred to the bill's attempt to rein in Medicaid costs that is imposed by indexing to a lower measure of inflation starting in 2025. The measure would be lower than what House Republicans had in their version of the bill. The House version of the bill was initially "rejected" by the Senate, who said they would rewrite their own, which has resulted in the BCRA.
Since then, Senate Republicans have been working behind closed doors without revealing what is in their bill until Thursday. Another centrist Republican, Sen. Rob Portman (R-Ohio) also shared his concerns with the Medicaid policies, specifically those that would target drug treatment while his state was facing an opiod epidemic.
At best, centrist Republicans are looking to do more research before they're due to vote on this bill but with little time left, they're unsure if they would be able to vote "yes."
The bill's issues with Medicaid are gargantuan in how states would already be able to qualify for it. For instance, states already have a statutory funding structure that they would need to reintroduce new Medicaid legislation to, which would become expensive and force states to pay for it, much like Obamacare already does. Here's footage from CBS News where protesters staging a "die-in" outside of Mitch McConnell's office are being taken away by Capitol Police.
