Senate health care vote repeal and replace or repeal bills


Alex
Wong/Getty Images

The Senate’s expected to vote on a health care bill this week,
though which bill they will vote on is still unknown. 

They’ve got three options:

1) The Senate’s plan to repeal and replace the
Affordable Care Act (better known as Obamacare).

2) A plan to strictly repeal Obamacare.

3) The
House of Representative’s plan
to repeal and replace
Obamacare. 

It’ll start with a motion to proceed on Tuesday, that will open
up 20 hours of debate before the Senate begins to vote.

Here’s how Republican Senator Susan Collins put
it on Face the Nation on Sunday: 

“It appears that we will have a vote on Tuesday. But
we don’t whether we’re going to be voting on the House bill, the
first version of the Senate bill, the second version of the
Senate bill, a new version of the Senate bill, or a 2015 bill
that would have repealed the Affordable Care Act now, and then
said that somehow we will figure out a
replacement over the next two years.”

“I don’t think that’s a good approach to facing the legislation
that affects millions of people and one-sixth of
our economy.”

Here’s what you need to know about the bills the Senate
could consider. 

Better Care Reconciliation Act, or repeal and replace (with or
without the Cruz amendment)


ted cruz mike lee
Senators Ted Cruz and Mike
Lee.

AP

On Thursday, Republicans in the Senate just released
another update to the Better
Care Reconciliation Act
, or BCRA, their plan
to repeal and replace Obamacare.

This is the effort that ran into trouble last week after Senator
John McCain fell ill and some other Republicans declined to go
along with the vote.  

The latest draft of this bill includes more funds to tackle
the opioid crisis, and a change to allow people to pay for
premiums using health savings accounts. The bill also still
includes deep
cuts to Medicaid
, with an estimated $756 billion cuts by 2026
according to the Congressional Budget Office. 

But notably absent is an amendment from Senators Ted Cruz and
Mike Lee that critics said could make plans with adequate
coverage
unaffordable to those who have certain medical conditions
.

The amendment titled the “Consumer Freedom Amendment,” would have
allowed plans to exist that don’t comply with two regulations set
up under the Affordable Care Act: community rating and essential
health benefits. The latter could have had a big impact on people
with pre-existing conditions.

Key parts subject to Byrd rule: On Friday,
the Senate parliamentarian said that
major parts of the BCRA
would be subject to the Byrd rule, an
obscure piece of legislation that requires the bill to have 60
votes in its favor to avoid a filibuster. Any other legislation
would simply need 50 votes. Included in the list of provisions
subject to the Byrd rule are defunding Planned
Parenthood, restricting the use of tax credits for
abortions, and getting rid of the essential health benefits for
Medicaid in 2020. 

CBO’s conclusion: The bill, without the Cruz
amendment, would leave 22 million more Americans
without
insurance by 2026 compared with the current law, in line with

their estimates for the original bill
. That number likely
would have been inflated if the CFA was included. The CBO
also said the bill would have an unexpected
effect on deductibles
they could get so
high they’re actually more than the poorest Americans earn.
The bill would cut $756 billion from Medicaid through 2026. 

The Obamacare Repeal Reconciliation Act or straight repeal

Senate Republicans are also mulling over a plan to simply
repeal the Affordable Care Act. Titled the Obamacare Repeal
Reconciliation Act (ORRA), it is
nearly identical
to the bill that was vetoed by President
Barack Obama in 2015. The bill would repeal all the provisions
put in place by the ACA, including key taxes, the Medicaid
expansion some states opted into and getting rid of mandates for
employers and individuals to provide and have insurance. 

The repeal would begin in 2020.

CBO’s conclusion:  According to the agency, 17
million fewer Americans would have health insurance in 2018, a
number that would grow to 32 million by 2026. By 2026, health
insurance premiums are expected to double. Cuts to Medicaid would
hit $842
billion
by 2026.  


Donald Trump Paul Ryan AHCA rose garden white house
President
Donald Trump (C) congratulates House Republicans after they
passed legislation aimed at repealing and replacing Obamacare,
during an event in the Rose Garden at the White House, on May 4,
2017 in Washington, DC.

Mark
Wilson/Getty Images


The American Health Care Act

There’s also still the chance that the Senate could decide to
vote on the AHCA, the version of
repeal and replace that the House of Representatives passed in
May

Among
other provisions
, the bill included a change called
the

 MacArthur
amendment

 which can allow s
tates to
avoid some of the regulations. It raised concerns that people
with 

preexisting
conditions
won’t be able to access health insurance if it
becomes law.

CBO’s conclusion: 24 million
fewer Americans
would be insured by 2026, with roughly $880

billion in cuts to Medicaid
 through 2026. 

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