With Republicans' latest attempt to repeal and replace the Affordable Care Act hanging by a thread, GOP Senators Bill Cassidy and Lindsey Graham have tweaked their bill in hopes of moving holdout senators from a no to a yes.
The new draft (PDF) began circulating Sunday night and was posted online by Cassidy, R-La., on Monday. Perhaps most notably, an analysis (PDF) of the bill released by Cassidy shows increases in federal funding for Alaska, Arizona and Kentucky, which all saw decreases under the previous version, according to Politico.
Those three states are also home to Senators Lisa Murkowski, R-Alaska, Sen. John McCain, R-Ariz., and Sen. Rand Paul, R-Ky.—all crucial swing votes on the legislation. Murkowski hadn’t said whether she would support the original bill, and both McCain and Paul have signaled they would vote against it.
And Maine, home to Republican Sen. Susan Collins—who has said she is leaning against voting for the bill—would see a 43% increase in funding relative to current law, per the analysis.
Even President Donald Trump championed the bill’s impact on those four states:
Alaska, Arizona, Maine and Kentucky are big winners in the Healthcare proposal. 7 years of Repeal & Replace and some Senators not there.— Donald J. Trump (@realDonaldTrump) September 24, 2017
Experts like the Center on Budget and Policy Priorities’ Jason Liebenluft, however, were dubious about the analysts’ claims, noting that they leave out the effect of some Medicaid cuts:
Seriously, folks: these #'s floating around don't even include the cap to Medicaid program (was $1 trillion cut from '20-'36 in prior draft)— Jacob Leibenluft (@jleibenluft) September 25, 2017
Meanwhile, Sen. Ted Cruz, R-Tex., has signaled he’s not on board with the bill either, according to the Texas Tribune.
“Right now, they don't have my vote—and I don't think they have Mike Lee's, either,” Cruz said during a festival in Austin, Texas, referring to his fellow conservative from Utah.
In what is likely a bid to sway conservatives, though, the revised Graham-Cassidy bill gives states even more authority to loosen federal rules for insurance plans. The Kaiser Family Foundation’s Larry Levitt described the changes in a series of tweets:
States no longer have to submit waivers of insurance rules under the revised Graham-Cassidy bill. They just have to describe their plans.— Larry Levitt (@larry_levitt) September 25, 2017
Under the revised Graham-Cassidy bill, states decide how much insurers can charge people who are sick, required benefits, and cost-sharing.— Larry Levitt (@larry_levitt) September 25, 2017
Under the revised Graham-Cassidy bill, states can alter the federal cap on patient out-of-pocket costs, allowing for bare bones insurance.— Larry Levitt (@larry_levitt) September 25, 2017
Those changes could appeal to Paul, however. He said Sunday that he might consider an ACA repeal bill that both constricts the block grants as outlined in the original version of Graham Cassidy, waives many of the federal regulations for insurance plans, according to The Washington Post.
AHIP, provider groups turn up heat on Graham-Cassidy
America’s Health Insurance Plans, which has already come out in opposition to the Graham-Cassidy bill, is not backing down in its criticism.
The trade group joined with the Blue Cross Blue Shield Association, Federation of American Hospitals, American Hospital Association, American Medical Association and the American Academy of Family Physicians to release a joint statement (PDF) this weekend opposing the bill.
"While we sometimes disagree on important issues in healthcare, we are in total agreement that Americans deserve a stable healthcare market that provides access to high-quality care and affordable coverage for all,” they wrote. “The Graham-Cassidy-Heller-Johnson bill does not move us closer to that goal. The Senate should reject it.”
Murray wants to restart ACA stabilization talks
In the statement McCain issued Friday outline his opposition to the Graham-Cassidy bill, he said he hoped that the Senate HELP Committee would continue its work on repairing the ACA.
Sen. Patty Murray, D-Wash.,—who had expressed disappointment when her talks with Alexander stalled as the Graham-Cassidy bill gained steam—was quick to back up McCain’s calls for bipartisanship.
“I agree with Senator McCain that the right way to get things done in the Senate—especially on an issue as important to families as their healthcare—is through regular order and working together to find common ground,” she said in a statement. “I’m still at the table ready to keep working, and I remain confident that we can reach a bipartisan agreement as soon as this latest partisan approach by Republican leaders is finally set aside.”
However, it’s unclear if Alexander—who chairs the HELP Committee—feels the same way. As of press time, his office provided no comment on whether he shares Murray’s desire to move forward with bipartisan healthcare talks.