GOP releases revised health care bill, adding pressure on Heller

WASHINGTON — A revised Republican bill to replace Obamacare was unveiled Thursday by Senate leaders who scrambled to round up the votes to pass the legislation next week.

The GOP tweaked the bill, keeping Obamacare taxes on high-income wage earners that Republicans had earlier hoped to eliminate, adding more funds for subsidies, and allowing insurers to offer bare-bones coverage plans.

But the revised bill retains the deep cuts to Medicaid and defunds Planned Parenthood, which prompted Sen. Susan Collins, R-Maine, to announce she would vote against a procedural measure to bring the bill to the floor next week.

Conservative Sen. Rand Paul, R-Ky., also said he would vote against taking up the bill because it fails to fully repeal mandates and taxes imposed by the Affordable Care Act, commonly known as Obamacare.

Those defections immediately placed the legislation in peril and put more pressure on Sen. Dean Heller, R-Nev.

Heller, who opposed the first draft of the GOP legislation over the Medicaid cuts, was non-committal about his vote to bring the bill to the floor for debate next week and about changes in the legislation.

Heller met with Senate Majority Leader Mitch McConnell, R-Ky., and several other centrist lawmakers behind closed doors after the bill was unveiled on Thursday.

“Conversations are continuing and I’m going to read the new bill and weigh its impact on Nevada,” Heller said.

The most vulnerable GOP senator up for reelection in 2018, Heller has drawn a high-profile Democratic challenger, Rep. Jacky Rosen, D-Nev.

“I’m disappointed that once again Senator Heller refuses to oppose the Republican health care plan,” Rosen said in a statement released by her campaign. “Instead of fixing the Affordable Care Act, he still wants to get to yes on passing a partisan repeal that will increase costs and strip coverage from Nevadans.”

Rep. Dina Titus, a Las Vegas Democrat also eyeing the Senate race, said on her Twitter account that Heller should “man up” and vote against the motion to bring the bill to the floor for debate next week.

Making good on a promise

McConnell remained hopeful that Republican leaders would be able to debate the bill next week, after an analysis of the legislation is completed by the nonpartisan Congressional Budget Office.

“This is our chance to bring about changes we’ve been talking about since Obamacare was forced on the American people,” he said.

The CBO report on the first draft said the Senate bill would leave 22 million people without insurance after 10 years.

McConnell said the revisions to the bill would help hold down escalating costs of insurance for consumers.

“It aims to make insurance more affordable and more flexible,” he said.

But Senate Minority Leader Charles Schumer, D-N.Y., said the bill would be a “devastating blow” for older Americans, working families, rural hospitals and those in nursing homes because of Medicaid cuts and rising costs.

“It appears that little has changed at the core of the bill,” Schumer said, adding that the revised plan was “every bit as mean as the old one.”

Sen. Catherine Cortez Masto, D-Nev., called the revised bill a “sham” and said if passed, “thousands of Nevadans and millions of Americans across the country would lose access to quality, affordable health care.”

“This is simply unacceptable,” Cortez Masto said.

Democrats are united in their opposition to repeal the ACA, which was enacted in 2010.

A struggle to craft bill

Although Republicans have vowed to repeal the bill for the past seven years, the GOP has struggled to craft legislation that pleases conservatives and centrists alike. The House passed its version of the bill in May.

Republicans from Nevada and other states that expanded Medicaid under the ACA to take advantage of federal funding have opposed the GOP bill and cuts of $772 billion to the program.

Nevada Gov. Brian Sandoval said the new Senate bill hasn’t changed much from the earlier version. His reaction: “great concern.”

A Republican, Sandoval said his principal concern remains that the GOP bill would phase out financing for the Medicaid expansion. About 200,000 Nevadans received coverage under the expansion.

“They’re living healthier and happier lives as a result of their receiving coverage,” Sandoval said. “And for them to lose that … would be very hurtful for them.”

Conservatives also have groused about the bill, particularly taxes imposed under the ACA that remain in the Senate GOP replacement bill.

Paul said he would oppose the bill because it did not fully repeal Obamacare.

With a slim 52-48 majority, McConnell can afford only two Republican defections to pass the bill, with Vice President Mike Pence serving as the tie-breaking vote.

The first test will come next week when the Senate is expected to vote on a procedural motion to take up the bill. If more than two GOP senators vote “no,” the bill would be doomed, denying President Donald Trump his first majority legislative victory.

Paul and Collins announced they would vote against the motion, Sen. Rob Portman, R-Ohio, and Sen. Shelley Moore Capito, R-W.V., said they, like Heller, are concerned with the Medicaid cuts but remained uncommitted on the motion to proceed.

Trump on Wednesday declared that failure of the Senate to pass a health care bill would make him “very angry.” But talking with reporters aboard Air Force One en route to France, the president acknowledged the challenges lawmakers face.

“I’d say the only thing more difficult than peace between Israel and the Palestinians is health care,” Trump said.

Contact Gary Martin at 202-662-7390 or gmartin@reviewjournal.com. Follow @garymartindc on Twitter. The Associated Press contributed to this story.