Senate Republicans to unveil ‘discussion draft’ of health care bill

Seven weeks after the House of Representatives passed the American Health Care Act, Senate Republicans unveiled their version of the health care bill Thursday. Senate Majority Leader Mitch McConnell of Kentucky released a “discussion draft” at an all-members meeting at 9:30 a.m.

Democratic outrage

The bill’s release follows months of speculation and contentious debate. Ever the dominant issue, health care remains a critical focus for many, as worried Americans swarmed congressional town hall meetings in recent months to voice their outrage.

Some Republican representatives were willing to face their constituents on the issues, while others shunned the events. Senate Democrats have criticized their Republican counterparts for working on the bill behind closed doors.

Democrats have voiced pessimism about the substance of the bill. On Tuesday, Senate Minority Leader Chuck Schumer, D-N.Y., said he agreed with President Donald Trump, who reportedly called the House bill “mean.”

McConnell has disagreed, saying, “It’s going to have a profound, positive improvement over the status quo. The status quo is simply unsustainable.”

But when ABC News’ Mary Bruce asked McConnell if Americans have a right to see the negotiations process, he did not provide an answer.

What does the bill look like?

The Senate bill would repeal the individual and employer mandates that require the purchase of insurance or face a penalty for not doing so. Unlike the House bill, however, it would not penalize people, via a surcharge, who let their coverage lapse.

It also provides tax credits to help individuals purchase insurance, but unlike the House bill, which linked the amount of the credits to age, the Senate bill considers income, age and geography.

The upper chamber’s draft would also keep the Obamacare-era Medicaid expansion intact until the end of 2020 and then gradually phase it out over four years before it arrives at the level of federal support all states were receiving before the Affordable Care Act expanded the program.

Beginning that year, Medicaid will also be allocated differently, with states being able to choose between receiving a block grant or an amount of support linked to the number of people enrolled in the program, as opposed to the amount of spending per Medicaid beneficiary .

During that transition time, the Senate bill would also provide, for two years, Affordable Care Act-era payments to insurance companies meant to defray the cost of keeping sick people on their rolls. Trump has repeatedly threatened to eliminate this funding, and House Republicans are engaged in a lawsuit against the payments, so this measure seeks to provide a level of stability and prevent more insurers from leaving the marketplace.

It would also provide an additional $50 billion over four years to “help balance premium costs and promote more choice in insurance markets” via a “short-term stabilization fund.”

The bill does keep at least one popular feature of the Affordable Care Act: the ability for children to stay on their parents’ plans through the age of 26.

Although the bill is a wholly Republican-crafted piece of legislation, not all Republicans are on board. GOP leaders want a vote next week, but with health care for millions on the line, some Republican members are asking, What’s the hurry?

Sen. Ron Johnson, R-Wis., explained, “The public needs time to digest it. I need time to digest it. We need to gather genuine input from our constituencies. That’s going to take longer than a week.”

This means the Senate bill released today could be very different from the one eventually voted on. Sen. Al Franken, D-Minn., appearing on ABC News’ “Powerhouse Politics” podcast, noted that when crafting the Affordable Care Act, Republicans had a chance to offer changes.

“In the Health Committee, I think 160 Republican amendments were accepted into the bill,” he said. “It was debated for 25 straight days before it was voted on. It was scored well in advance. This is a sham.”

Going forward

The Congressional Budget Office, which provides nonpartisan, quantitative analyses to Congress, will evaluate the bill. Republican leaders expect the new CBO score on Monday but are hopeful it could come as soon as Friday.

The CBO estimated that the version of the American Health Care Act passed by the House would leave 24 million more Americans uninsured by 2026 than under the Affordable Care Act. The office also estimated the bill would reduce federal deficits by $337 billion from 2017 to 2026.

ABC News’ Mary Bruce contributed to this report.
J. Scott Applewhite/AP