Republicans in the U.S. Senate released the initial draft of a healthcare bill Thursday that will reduce Medicaid spending, cut taxes for the wealthy, limit subsidies to private insurance companies, remove health insurance mandates, lower taxes for companies in the healthcare industry and enact other changes.
Those with pre-existing conditions will be able to keep their coverage without a price hike directly tied to the condition. Those who want to allow their children to remain on their health insurance plan until they are 26-years old will still have that option. The cuts to Medicaid could impact thousands of Arkansans. U.S. Sen John Boozman, R-Ark., and U.S. Sen. Tom Cotton, R-Ark., would not say on Thursday if they will vote for or against the bill.
Cotton’s Director of Communications Caroline Rabbitt told Talk Business & Politics the senator will review the bill before answering any questions about it. How long it will take him to review it wasn’t released. Cotton was among 13 senators who gave input for the bill to U.S. Senate Majority Leader Mitch McConnell, R-Kentucky. Cotton wasn’t privy to the final draft of the bill until it was officially released Thursday morning. A protest rally by UltraViolet, a national women’s advocacy group, is slated for 11 a.m. Friday outside Cotton’s Little Rock office.
Gov. Asa Hutchinson contacted Cotton earlier this week and expressed concerns about how the cost of maintaining the Medicaid expansion in the state under the Affordable Care Act, or Obamacare, would be shifted from the federal government to the states. Hutchinson did not say if he supports or opposes the bill.
“I have started reviewing the Senate bill, but a great deal more time and thought is required before we understand the changes completely. I look forward to discussing the proposal with Sen. Boozman and Sen. Cotton. There are significant positive changes in the Senate bill, including increased flexibility for the states, but I will need more analysis on potential cost impacts on Arkansas,” he said.
Boozman plans a complete review of the bill before he comments, his spokesman Patrick Creamer said. The senator had a jam-packed schedule on Thursday and couldn’t answer questions about the bill. When his review of the bill would be completed was not released.
AARP released a statement opposing the plan.
“This bill will raise costs for older Americans. It will decimate protections for people with pre-existing conditions like cancer and asthma. It will weaken Medicare, increasing premiums and opening the door to costly vouchers. And it will cut Medicaid, leaving many with fewer services or without coverage altogether, especially the 17 million poor seniors and disabled adults and children who rely on the program.”
The bill hasn’t been scored by the Congressional Budget Office. How many will lose health coverage is unknown if the bill remains intact, which is unlikely. Republicans can only lose two senators from their caucus to get the bill approved, and at least four senators have already said they will not support the bill. U.S. Sen. Rand Paul, R-Kentucky, U.S. Sen. Ted Cruz, R-Texas, U.S. Sen. Mike Lee, R-Utah, and U.S. Sen. Ron Johnson, R-Wis., released statements saying they will not vote for the bill in its current form. If changes are made, the four senators said they would be open to voting for the bill.
Two glaring problems with healthcare costs were not addressed by the bill. Premium costs and prescription drug prices have skyrocketed in recent years and no remedy for those problems was included in the legislation. It was also unclear how the program will be paid for if the mandates are removed. GOP leaders had hoped to vote on the bill late next week before the body adjourns for the Fourth of July recess.
The House has already passed a controversial repeal and replace bill. If the Senate does pass a bill, it will have to be reconciled with the House version before it can be presented to President Donald Trump for signature or veto. The president has publicly praised the House bill, but behind closed doors has reportedly called it “mean” due to the fact it drastically cuts Medicaid coverage for millions of poor and lower middle class workers. He’s asked lawmakers to craft legislation with “heart.”
Democratic senators are unified in their opposition to the bill. Republicans have been under fire for crafting the bill in secret. GOP leaders in 2009, including McConnell, complained that Democrats wrote the ACA without involving them.
Health and Human Services Secretary Tom Price, a doctor and former member of Congress, supports the proposal. He said it protects patients, will bring down insurance coverage costs, and expand healthcare choices.
“We welcome the Senate’s proposal to provide Americans with much needed relief from Obamacare. The Senate’s proposal is built on patient-centered reforms that put the American people in charge of their healthcare decisions, not government, protecting patients, bringing down the cost of coverage, and expanding choices,” he said.
Gov. Hutchinson changed the “Private Option” system of Medicaid expansion under former Gov. Mike Beebe to “Arkansas Works.” Arkansas Works uses federal Medicaid dollars under the ACA to purchase private health insurance for individuals with incomes up to 138% of the federal poverty level. It was created in 2013 after the U.S. Supreme Court ruled states had the option of expanding their Medicaid populations. Instead of doing that, Arkansas received a waiver from the Obama administration allowing it to purchase through the private markets. It has been funded almost entirely by the federal government until this year when the state began picking up 5% of the tab. That number grows over time to 10% by 2020.
Under “Arkansas Works,” Hutchinson and Arkansas health officials have asked the Trump administration to put a work requirement for able-bodied recipients in effect. They have also requested a waiver to limit the program eligibility to qualified applicants that make up to 100% of the federal poverty level. The current program expands eligibility to those making up to 138% of the federal poverty level.
Editor’s note: Talk Business & Politics writer Wes Brown contributed to this re