Senate Republicans Reveal Obamacare Replacement Bill

Aides and lobbyists get first peek at discussion draft

A seven-year push by Republicans to dismantle the Patient Protection and Affordable Care Act (PPACA) has finally reached a critical phase as Senate GOP leaders unveiled a draft bill that they aim to put to a vote, possibly as early as next week, according to a Reuters report.

The draft proposes repealing a 3.8% net investment income tax on high earners retroactively to the start of 2017, not at some point in the future, as some analysts had speculated. The tax, affecting high-income Americans and imposed by Democrats to help pay for the PPACA, has been a key target for Republicans.

U.S. hospital stocks traded sharply higher after the bill was released, Reuters said. Health insurers also traded broadly higher, with large players Aetna and UnitedHealth Group each up more than 1.5%.

Earlier, the Washington Post reported that, as Senate leaders were putting the final touches on their bill, a draft document circulating among aides and lobbyists proposed to roll back the PPACA’s taxes, phase down its Medicaid expansion, rework its subsidies, give states wider latitude in opting out of its regulations, and eliminate federal funding for Planned Parenthood.

The bill presented in the discussion draft largely mirrored the House measure that narrowly passed last month, but with some significant changes aimed at pleasing moderate Republicans, the Post said. While the House legislation tied federal insurance subsidies to age, the Senate bill would link them to income. The Senate proposal cuts off Medicaid expansion more gradually than the House bill did, while at the same time enacting deeper long-term cuts to program. The Senate bill also removes language restricting federally subsidized health plans from covering abortions, which may have run afoul of complex budget rules.

Under the Senate draft, federal Medicaid spending would remain “as is” for three years. Then, in 2021, it would be transformed from an open-ended entitlement to a system based on per-capita enrolment, according to the Post. Starting in 2025, the measure would tie federal spending on the program to a slower growth index.

Senate Majority Leader Mitch McConnell (R-Kentucky) has vowed to hold a vote before senators go home for the July 4 recess, but he is still trying to corral the 50 votes needed to pass the Senate’s repeal measure.

Sources: Reuters; June 22, 2017; and The Washington Post; June 21, 2017.