Republican leadership in the U.S. Senate has revised its Obamacare “repeal and replace” measure, but its fate for passage remains tenuous. Two GOP senators – Susan Collins of Maine and Rand Paul of Kentucky – said they opposed allowing the debate to start. Several other Republican senators said they are undecided on a procedural vote that would ignite a floor discussion next week.
The latest bill keeps some Affordable Care Act taxes, including a net investment income tax and an additional Medicare Health Insurance Tax, and it scraps a tax break for high-earning health insurance executives contained in an earlier version. It also directs more than $100 billion in new spending for low-income coverage and funding to fight the rising opioid epidemic.
In a nod to conservative senators, the “repeal and replace” plan allows insurers to sell bare-bones plans aimed at healthier individuals if those insurance companies sell ACA-compliant plans. Moderate Republican senators and governors are likely to still be troubled by the Medicaid provisions in the bill. While there is an increase in funding for Medicaid from the first bill that was floated, the overall potential ramifications are still uncertain. Another provision added would allow for Medicaid expansion money to come to the states in the form of block grants.
The new Senate health insurance plan is expected to receive a Congressional Budget Office (CBO) score on Monday.
Arkansas’ two U.S. Senators have remained quiet over the past three weeks regarding their positions on the entire healthcare debate. Talk Business & Politics has made repeated efforts to interview both senators for their thoughts on the current debate over the past three weeks, but those requests have been declined. In response to fresh inquiries from Talk Business & Politics, a spokesman for U.S. Sen. Tom Cotton, R-Ark., said on Thursday (July 13) the senator “is still reviewing the legislation released today.”
U.S. Sen. John Boozman, R-Ark., released a statement late Thursday.
“We need a health care system that ensures access to affordable, quality care for every American. Obamacare failed to establish this. In fact, it made the situation worse for millions of Americans. We are trying to determine whether or not this revised Senate bill will be able to accomplish our goal of improving health care for all Americans. I have the text and will be evaluating it. We will be talking about it as a caucus over the next few days. I also want to see what the CBO has to say about it. I do think it is a positive development that the Majority Leader is trying to find ways to bring the different sides of our caucus together. The good news is we all want to get to ‘yes.’”
Gov. Asa Hutchinson, R-Ark., who is attending a National Governors Association conference in Rhode Island, spoke with TB&P and said he has reviewed some early analysis of the bill. He likes three specific changes to the measure, but still has concerns about Medicaid funding.
“I applaud our Senate delegation because they have been successful, it appears to me, in accomplishing a number of things that I said would be good for Arkansas,” Hutchinson said.
“I had asked for the block grant option for the states to include the expanded Medicaid population. The revised bill does that. Secondly, I asked that we needed to have more funding for the tax credits – particularly the low-income as they move off of Medicaid onto the marketplace. That additional funding is in the bill. Thirdly, I noticed that there’s a better formula for the DISH payments, which are payments to hospitals for the uninsured,” the governor said.
“I’m still very concerned about the shift of costs to the states on the Medicaid funding, both for traditional and the expanded population. That reduced spending is still a part of this Senate bill. While we have to curtail the cost increase, a steep reduction would still adversely affect Arkansas. That’s something I hope they’ll continue to work on. It is a work in progress as you can see. Sen. Graham (R-South Carolina) talked like he was going to offer amendments to the bill, and so I think we just continue to watch it and I’m grateful for the changes they’ve made so far.”
When asked if he supports the measure or would advocate Arkansas’ senators supporting the current revised bill, Hutchinson said it’s too early to make that call.
“It’s too early to make that judgment because it’s still a changing dynamic. I want to continue to be a voice for the concerns I have for our healthcare delivery in Arkansas and the impact it will have,” Hutchinson said. “I don’t think we can make a final judgment yet.”