Though Senate Republicans are planning a procedural vote Tuesday on healthcare legislation, GOP leaders haven’t yet divulged which measure they’ll be voting on.
There are now three different versions of the Better Care Reconciliation Act (BCRA), which would repeal and replace the Affordable Care Act. Also in play is the House-passed healthcare bill, the American Health Care Act, and a repeal-and-delay bill, the Obamacare Repeal Reconciliation Act (ORRA).
A spokesman for McConnell said Thursday afternoon that the Senate majority leader wasn’t prepared to say which bill lawmakers would vote on next week, the Los Angeles Times reports.
And John Cornyn, the Senate’s No. 2 Republican, said Thursday that knowing what the healthcare bill will be before the procedural vote is "a luxury we don't have,” according to The Hill. A Cornyn spokesman, though, said the senator was referring to the fact that the final bill could be altered through an open amendment process.
Indeed, the draft bills being considered would all likely have to eliminate some provisions after being evaluated by the Senate’s parliamentarian, the New York Times notes, in order to ensure they comply with the “Byrd Rule” that dictates what can be included in a budget reconciliation bill.
In addition to the various bills already on the table, some Republicans and Centers for Medicare & Medicaid Administrator Seema Verma on Thursday offered up another idea aimed at easing GOP moderates’ concerns, per The Wall Street Journal. Their plan would use up to $200 billion from the ACA’s taxes to cut out-of-pocket costs for people who would lose Medicaid coverage under a Republican healthcare bill.
Yet at least one moderate GOP holdout wasn’t impressed. “If you’re still going to take more than $700 billion out of the Medicaid program, you still have significant problems,” said Maine Sen. Susan Collins.
To Sen. Bob Corker, R-Tenn., the confusion over which measure he’ll be voting on is becoming unsettling, according to the Associated Press.
“It’s almost becoming a bidding process—let’s throw $50 billion here, let’s throw $100 billion there,” he said
The week of the CBO
Regardless of which measure Republican senators vote on next week, two scores issued this week from the Congressional Budget Office offer some clarity about what their current options entail.
For the ORRA, the CBO estimated that the measure would result in even greater losses in insurance coverage—32 million by 2026. That figure was of little surprise, though, since the CBO made the same estimate for a version of the bill passed—and vetoed—while President Barack Obama was in office.
Then the CBO estimated that BCRA 3.0—which is basically the same as version 2.0, minus the controversial Cruz amendment—would increase the number of uninsured by 22 million within 10 years. That’s the same finding it made for the original version of the BCRA, though the CBO also predicted the latest version would offer greater budgetary savings—mostly because it kept certain ACA taxes the original version repealed.
The Cruz amendment hasn’t yet received a score from the CBO, but a draft of an HHS analysis of it that leaked this week raised eyebrows among some policy experts, who questioned its methodology.
Meanwhile, a group of former CBO directors published an open letter to House and Senate leaders on Friday that condemns the recent "recent attacks on the integrity and professionalism of the agency and on the agency’s role in the legislative process.”
“As the House and Senate consider potential policy changes this year and in the years ahead, we urge you to maintain and respect the Congress’s decades-long reliance on CBO’s estimates in developing and scoring bills,” they wrote.