As soon as the revised health care bill was introduced yesterday, criticism began and the margin for passage may already be compromised. Two Republican senators, moderate Susan Collins of Maine and conservative Rand Paul of Kentucky, have already announced they were not swayed by the revised bill. Republicans must have 50 out of 52 Republican Senators voting for the bill. As mentioned in my blog yesterday, the revised bill includes an amendment from Senator Ted Cruz (R., Tx.) which would allow insurers to sell “skimpy” plans, as long as they also offer at least one which meets the Affordable Care Act (ACA)’s requirements. The new version preserves the ACA taxes on the wealthy and earmarks an extra $45 billion for opioid treatment. The revised bill would for the first time permit people to use tax-advantaged health savings accounts to pay for their premiums.

A key moment will come early next week when the Congressional Budget Office releases its estimate of the bill’s impact on cost and coverage. Many senators have stated that they are going to wait for the CBO’s assessment before deciding how to vote. The Senate procedural vote could come shortly after the CBO report, probably by the middle of next week. Senate Majority Leader Mitch McConnell (R., Ky.) implored his fellow Republican Senators to at least support this vote to allow debate to begin on the bill. If the bill survives, a debate on the underlying measure would follow, including the offering of numerous amendments.

Republicans, including President Donald Trump, acknowledged it was hard to bridge the gap between conservatives and centrists. According to Senate Majority Whip John Cornyn (R. Tx.), voting against the ACA repeal bill is essentially voting for the ACA. No Democrats are expected to support the bill. Stay tuned for further updates.

For more information on this topic, contact your Health Care counsel at Smith, Gambrell & Russell, LLP.