WASHINGTON — Senate Republicans scrambled Monday to salvage their push to roll back the Affordable Care Act, making a series of last-minute changes to their sweeping repeal bill in a bid to woo GOP holdouts.
But the changes — which funnel more money to the states of several key GOP lawmakers while further loosening patient protections in the current law — drew only more criticism from across the nation’s health care system.
And consumer advocates stepped up warnings that the bill — written by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana — would be devastating to sick Americans.
“This bill is an even harsher version of the previous failed proposals that were overwhelmingly rejected by Americans,” said Betsy Imholz, special projects director for Consumers Union. “It is not only a repeal of the Affordable Care Act — threatening key consumer protections and coverage requirements that ensure those with pre-existing conditions have access to meaningful care — but also a historic undercutting of the Medicaid program.”
Cassidy and Graham have said Americans will not lose vital insurance protections, including the guarantee that they could get insurance even if they are sick.
“This plan protects those with pre-existing conditions and gives states resources and flexibility to lower premiums and increase the number of Americans insured,” Cassidy said on Monday after releasing his latest proposal.
But those claims have been refuted by nearly every major voice in the U.S. health care system, including leading hospitals, physician groups and patient advocates.
On Monday, 36 current and former state insurance commissioners sent a strongly worded letter to congressional leaders urging them to reject the latest proposal.
“The Cassidy-Graham bill would increase the number of people without health coverage and severely disrupt states’ individual insurance markets, with sharp premium increases and insurer exits likely to occur in the short term and over time,” wrote the commissioners.
Senate Republican leaders are trying to woo key Republican senators who have expressed strong doubts about the bill, which appears to remain at least a vote or two short of what GOP leaders need for passage.
Sen. Susan Collins of Maine said in an interview on CNN on Sunday that “it’s very difficult for me to envision a scenario where I would end up voting for this bill.”
Sen. John McCain of Arizona previously said he would oppose the bill, and Sen. Lisa Murkowski of Alaska has said she remains undecided.
On the right, Sen. Rand Paul of Kentucky has previously said several times that he opposes the bill. And Sen. Ted Cruz, speaking in his home state of Texas, said “right now they don’t have my vote.” Cruz said he did not think Sen. Mike Lee was supporting the bill either.
With 52 Republicans in the Senate and no Democrats supporting the repeal effort, sponsors of the bill can afford to lose only two GOP votes.
The revised version would send more money to Alaska, Arizona and Maine in a clear effort to win over Murkowski, McCain and Collins.
Graham and Cassidy also appear to have weakened consumer protections, giving states more authority to waive requirements like the prohibition on insurers charging sick people more for coverage.
The full impact of the changes will be difficult to assess as the nonpartisan Congressional Budget Office, which lawmakers rely on to analyze major legislation, will not have time to issue a full report on the new proposal.
Senate Republicans must vote this week before a Sept. 30 deadline, after which they can no longer use a special rule that allows them to advance repeal legislation with only 50 votes instead of the 60 normally required to pass controversial bills in the Senate.
That would require them to vote on one of the most sweeping pieces of domestic legislation in at least half a century with almost no time for study and debate.
The GOP proposal would roll back government programs created by the current law to guarantee Americans’ health coverage and completely restructure state Medicaid programs that currently cover approximately 70 million people.