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Koch chief says health care bill insufficiently conservative

He urged Republicans to work with Democrats by "stop sabotaging Obamacare" and giving up the effort to repeal the Affordable Care Act. Republicans previously slammed those cuts as robbing the program to pay for Obamacare.

Gov. John Bel Edwards, a Democrat, said his first review of the Senate legislation "raises several red flags for the state".

One thing the Senate plan would do would be to make subsidized coverage through the exchange markets available to people now in what is called a "coverage gap" - those who make too much to qualify for traditional Medicaid, but not enough to qualify for subsidized policies on the exchange markets.

Following the vote-a-rama, the vote on the full bill would come either Thursday or Friday.

One possibility is that McConnell is anxious the provision runs afoul of the procedural rules allowing Republicans to pass the bill with a simple majority vote. But it would repeal the individual and employer mandates, along with the taxes and fees that have supported the ACA, and it would phase out the Medicaid expansion program, which has extended coverage to an estimated 11 million people in the states that chose to take part in that program. That represents roughly 23 percent of all Americans. But any replacement should cover more people, not fewer.

In both plans, states could keep coverage for the newly eligible adults, but federal taxpayers would not continue to pay a larger share of the bill. However, the Senate plan also contains what he called a "complete, fundamental rewriting of how Medicaid is paid for between the states and the federal government". But if they are able to get it done, the rest of the Trump agenda could click into place, with tax cuts and regulatory reform following.

And the measure would permanently transition Medicaid into a block grant arrangement or put strict caps on how much money each state receives, shrinking the program far beyond its pre-Affordable Care Act size.

He pulled out the Senate Republican bill. President George W. Bush made a similar attempt that never gained traction. "We believe we'll get more individuals covered than are covered right now".

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"There's two issues here", said Charles Blahous, a conservative health policy expert who served as a federal trustee for the Social Security and Medicare trust funds from 2010 until 2015. It would roll back the expansion of Medicaid that has allowed millions of people to get health insurance, then change Medicaid's structure and reduce its funding going forward.

He said the party leadership's claim that the bill would lower health costs is "a lie". "No one wins on health care policy", observed Holtz-Eakin. For decades, Medicaid spending growth has been out of control.

The Senate bill, which GOP leaders unveiled Thursday, looks an bad lot like the bill that the House passed in May. "And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, can not change the fundamental meanness at the core of this legislation".

"Only in Washington is giving more each year considered a cut", said Barrasso, who also said the new health care plan will provide subsidies for insurance for those who don't qualify for Medicaid.

When Trump suggested on Twitter in late May that Republicans should change the Senate rules to a simple majority vote to speed up the process, McConnell told the president to leave Senate business to him, according to three people familiar with the conversation.

As one of five Republican senators that announced opposition to the bill in its current form, Paul said he would consider voting for partial repeal of Obamacare, if there's a stalemate, but argued the Senate bill "isn't anywhere close to repeal".

The significance of the Senate bill's changes to the private insurance market are similarly easy to miss, particularly when it comes to the financial assistance available to people buying coverage on their own.

Former Arizona Gov. Jan Brewer, a Republican who surprised her party when she chose to expand Medicaid four years ago, is urging Congress to save the expansion, which has provided coverage to 400,000 Arizonans.

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