Senators seek assurance that House won't pass the bill McConnell may ask them to pass; they want to keep talks goingHealthy Care

A stripped-down version of a health-insurance bill won't pass the Senate unless House Speaker Paul Ryan guarantees that the House will take the issue to a House-Senate conference committee and not pass the so-called "skinny repeal" into law.

That became clear late Thursday afternoon, when Republican Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Ron Johnson of Wisconsin said they would not vote for the limited bill without such a guarantee. Since Democrats are solidly against such a bill and 52 of the 100 senators are Republicans, three "no" votes would kill the measure.

"The skinny bill as policy is a disaster," Graham told reporters. "The skinny bill as a replacement for Obamacare is a fraud."

Senate Majority Leader Mitch McConnell is expected to offer an amendment that would repeal the individual and employer mandates and the medical-device tax of the Patient Protection and Affordable Care Act, because he has been unable to get 50 votes to pass a more comprehensive bill. Vice President Mike Pence's tie-breaking vote earlier this week was only to put a bill on the floor and start debate.

Republicans "could try to salvage a bigger repeal-and-replace bill in House-Senate negotiations," Dylan Scott of Vox writes. "That would put Medicaid back on the table for cuts and surely lead to bigger coverage losses than skinny repeal alone. The uncomfortable truth for these Republican senators is they've been trying to do the latter for the past two months and they haven't been able to do it. It's not clear how adding the House to the mix could possibly help."

Any bill reported by a House-Senate conference committee would go back to both houses for approval and would not be subject to amendment.

"So in a matter of hours, we could be heading into drawn-out conference negotiations — or skinny repeal could be the law of the land," Scott writes. To show how divided Republicans are, he relates what Johnson and Sen. Rand Paul of Kentucky told him in the past two days. "Paul supports skinny repeal and wants the repeal-and-replace bill to stay dead. Johnson feels very differently."

Here's what Paul said about the idea of passing skinny repeal in order to take the issue a conference committee:

"I'm gonna advocate that if we can get some repeal, that we just send it to the House for approval because I think if it goes to conference committee, it's gonna get built back up into the monstrosity that we just voted down. If we end up with a $300 billion insurance subsidy fund, I think conservatives will vote against that also. . . . If it goes to conference committee and it explodes in its breadth and expense, they're gonna have trouble getting the votes."

And here are Scott's quotes from Johnson, who was the last senator to vote to start debate:

"It's sad. It's very sad. It's very sad." Asked if it is better than nothing, he replied, "If I vote yes, it's certainly saying it's better than the status quo, which is awful. You keep coming back to that. No matter how disappointing this is, how frustrating it is, you come back to the fact that these markets are collapsing."

Johnson said one Wisconsin family had to repay $15,000 in ACA subsidies because their income ended up being higher than they expected. "I don't see anything in any of these bills that really addresses those forgotten men and women," he said.

Here is Vox's chart of the Congressional Budget Office estimates of annual growth in the uninsured population as potential results of each major bill that has been debated:



from Kentucky Health News http://ift.tt/2uHlE0T Senators seek assurance that House won't pass the bill McConnell may ask them to pass; they want to keep talks goingHealthy Care

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