Senate GOP's Plan To Repeal, Replace May Be In Trouble

Doing so becomes even more hard if you also try to write a bill that will get enough votes from your legislative colleagues.

GOP Senate leaders can only lose two members of their 52-senator caucus in support of the bill in order for it to pass. Heller said he spoke with Senate Republican leaders and Vice President Mike Pence on Friday morning.

Passage would move President Donald Trump and the GOP closer to one of their marquee pledges - erasing Obama's 2010 statute.

Against fast-moving developments, here's a look at some major issues for consumers. He argued that some Republicans were anxious about reining in Obamacare's vast expansion of federally subsidized health care.

Other Republicans appeared more willing to embrace it.

The GOP's biggest Medicaid change involves limiting future federal financing. Medicaid would operate on a fixed budget rather than as an open-ended program. Instead, Republicans propose a per-beneficiary cap. Iowa opted to expand, and has added more than 150,000 people to its rolls since 2014. About 11 million are covered by the expansion. The federal share drops to 90 percent after 2020.

The main course is meant to be big cuts in individual and corporate tax rates that would benefit the rich. The idea was a relatively late addition to Trump's talking points.

Heller, facing a competitive re-election battle next year, said he was opposing the legislation because of the cuts it would make in Medicaid.

Economist Douglas Holtz-Eakin, a longtime GOP adviser, says the Republican approach is "180 degrees different in its economic and budgetary philosophy", from the course steered by Obama.

Heller said that he, too, was against the bill as it is drafted, leaving himself just enough wiggle room to continue his practice of being the senator in the middle, the man who wants to see the Medicaid program phased out, except when he decides he doesn't. Those are exactly the people the Republicans have been complaining about. Consumer organizations like AARP are also opposed.

The Senate plan significantly scales back Medicaid - a healthcare programme for the poor - and repeals Obamacare's taxes on the wealthy.

It "would have a profoundly negative impact on Americans", said John Meigs, president of the American Academy of Family Physicians.

Dr. Mott Blair of Wallace, N.C., recalls a patient who got a colonoscopy that found a polyp, which undetected could have led to colon cancer.

"This bill takes away the No. 1 tool we have in the fight against opioids - Medicaid treatment", he said. "They're not going to have a disastrous complication like a stroke or a heart attack, at least not for the foreseeable future". Everyone expects changes to be made.

- Eliminates most of the Obamacare tax increases. The situation varies from state to state, with healthy markets in some and others struggling to hang on to insurers.

The Senate measure maintains much of the structure of a House bill passed in May but differs in several key ways. The House and Senate formulas for subsidies differ.

Over the long run, premiums for younger people are expected to come down.

Toomey said there are a lot of misconceptions with the bill that he wants to clear up. Or as one economist described it, they'll face a choice between paying a premium they can't afford or paying a deductible they can't afford.

  • Salvatore Jensen