Here’s What Senate Republicans Want to Do with Healthcare

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Can Republican leadership get both the Senate’s conservative and moderate wings behind its new healthcare plan?

Senate Republicans released a draft of their new healthcare bill Thursday. The long-awaited bill serves as the counterpart to the House’s American Healthcare Act.

Known as the Better Care Reconciliation Act of 2017, the bill has come under intense scrutiny in recent weeks. The controversial decision by Senate Majority Leader Mitch McConnell to draft the bill behind closed doors has left many Americans and lawmakers frustrated. McConnell pursued this strategy to ensure the bill would receive input from thirteen Senate colleagues before it reached the floor.

Having undergone this process will prove pivotal in the next few weeks as McConnell tries to keep the Republican majority from turning its back on the bill. While the Senate version of the bill is similar to the House version, there are some key differences that were made to appease conservatives and moderates alike.

Much like its House counterpart, the Senate bill aims to repeal Obamacare’s individual mandate, cut back on federal support of Medicaid, and eliminate the Affordable Care Act’s (ACA) taxes on insurers and the wealthy. Additionally, the bill would end ACA taxes on over-the-counter drugs, tanning, flexible spending accounts, and health savings accounts.

The bill differs from the American Healthcare Act by providing tax credits based on income level rather than age. This would make it so anyone earning up to 350% of the poverty level would be eligible for credits. Cost sharing subsidies are also included in the bill. These are subsidies that aim to bring down premium costs by helping insurers offer coverage to low-income Americans. The House bill was heavily criticized for its stance on preexisting conditions. The Senate iteration of the bill ends this controversy by mandating that states cover preexisting conditions. Lastly, the new bill phases out Medicaid funding until 2025 and decreases funding drastically.

While these additions were to be expected, the bill also has some surprising features that may prove difficult to pass. Most notably, the bill includes a provision that would defund Planned Parenthood and restricts federal funds for healthcare plans that cover abortion. This will surely be the portion of the bill Democrats and some moderates will be opposed to most. The opioid epidemic will also feature as some Senators will likely support an expansion of the current $2 billion allocated by the bill.

The path to 50 votes already looks incredibly rocky and whether the bill will survive the upcoming process of amendments and hearings is in question. Some of the more conservative members of the Senate such as Rand Paul (R-Ky.) and Ted Cruz (R-Tx.) have referred to the bill as “Obamacare Lite” and have voiced their displeasure with the bill in its current form. Unless major changes are made to make the bill less like Obamacare, these Senators are unlikely to support it.

Conversely, Senators Murkowski (R-Ak.) and Collins (R-Me.) believe the bill might go too far and would rather the Republicans take a more moderate approach. The outlier may be Senator Portman (R-Oh.), who is unlikely to support the bill unless serious changes are made regarding its stance on the opioid epidemic, an issue that deeply affects his state.

Senator Mitch McConnell and the Republican party are going to have their hands full trying to pass this bill in light of negative approval ratings. Whether this will change now that Americans understand the bill’s content and specifics remains unseen. Only one thing is for sure: everyone in D.C. is going to be busy until the July 4th recess.

Joel Gillison is a student the University of North Carolina - Chapel Hill studying public policy.

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