but the bill's fate was quickly thrown into question as several senators voiced skepticism.
Four
conservative lawmakers said they could not support it in its current form,
leaving Republicans short of the votes they need for passage. Democrats are
united in opposition.
The 142-page
proposal, worked out in secret by a group led Senate Majority Leader Mitch
McConnell, aims to deliver on a central campaign promise of President Donald
Trump by rolling back former President Barack Obama's signature healthcare law,
which has provided coverage to millions of Americans since it was passed in
2010.
Republicans
view the law, formally known as the Affordable Care Act, as a costly government
intrusion into the private marketplace.
Trump
welcomed the bill but indicated that changes may be in store.
"I am
very supportive of the Senate #Healthcarebill. Look forward to making it really
special!" he wrote on Twitter.
Trump urged
the House of Representatives to pass a similar bill in May, only to criticize
it in private as "mean" once it passed. He said on Wednesday he
wanted a health plan "with heart."
Democrats
immediately attacked the legislation as a callous giveaway to the rich that
would leave millions without coverage.
"The
president said the House bill was mean," said Senate Democratic leader
Chuck Schumer. "The Senate bill may be even meaner."
Obama
weighed in on Facebook. "If there’s a chance you might get sick, get old,
or start a family – this bill will do you harm," he wrote.
The Senate's
most conservative members said the plan did not do enough to scale back the
U.S. government's role.
"This
current bill does not repeal Obamacare. It does not keep our promises to the
American people," said Senator Rand Paul, who along with fellow Republican
Senators Ted Cruz, Mike Lee and Ron Johnson said they could not support it in
its current form.
Shares of
hospital companies and health insurers rose on the bill's release, with the
overall S&P 500 healthcare sector closing up 1.1 percent at an all-time
high.
"The
initial proposal I think is more generous and more positive to the industry
than expected," said Jeff Jonas, a portfolio manager with Gabelli Funds.
SHARPER CUTS
TO MEDICAID
Over months
of often bitter debate, Republicans have struggled to craft legislation that
lowers costs and reduces government involvement, while minimizing the
inevitable disruptions that would come with a revamp of a sector that accounts
for one-sixth of the world's largest economy.
The
nonpartisan Congressional Budget Office found that the House bill would kick 23
million Americans off their health plans, and the legislation is unpopular with
the public. Fewer than one in 3 Americans supports it, according to
Reuters/Ipsos polling.
The Senate
measure maintains much of the structure of the House bill, but differs in
several key ways.
The Senate
bill would phase out Obamacare's expansion of the Medicaid program for the poor
more gradually than the House version, waiting until after the next
presidential election in 2020, but would enact deeper cuts starting in 2025. It
would also allow states to add work requirements for some of the 70 million
Americans who depend on the program.
The
legislation also provides more generous tax subsidies than the House bill to
help low-income people buy private insurance.
Those
subsidies would be based on income, rather than the age-based subsidies
contained in the House bill - a "major improvement," according to
Republican Senator Susan Collins, a key moderate who has expressed concern over
the bill's impact on the poor.
The Senate
legislation provides less money, however, for the opioid epidemic, allocating
$2 billion in 2018, compared with $45 billion over 10 years in the House
version.
Both
versions would repeal the 3.8 percent net investment income tax on high
earners, a key target for Republicans.
They also
would repeal a penalty imposed on large employers that do not provide insurance
to their workers, and remove the fine that Obamacare imposes on those who
choose to go uninsured
Policy
experts said that would keep more young, healthy people out of the market and
likely create a sicker patient pool.
The Senate
bill would provide money to stabilize the individual insurance market,
allotting $15 billion a year in 2018 and 2019 and $10 billion a year in 2020
and 2021.
It proposes
defunding Planned Parenthood for a year, but abortion-related restrictions are
less stringent than the House version because of uncertainty over whether they
would comply with Senate rules. They could be included in another Senate bill.
McConnell said
Democrats chose not to help frame the bill, which Republicans say would fix a
collapsing health marketplace.
"Republicans
believe we have a responsibility to act, and we are," he said.
Democrats
say they offered to help fix Obamacare but were rebuffed.
The bill's
real-world impact is not yet known, but the CBO is expected to provide an
estimate early next week.
As lawmakers
spoke about the legislation on the Senate floor, a protest erupted outside
McConnell's personal office, with many people in wheelchairs blocking a
hallway, holding signs and chanting: "No cuts to Medicaid." U.S.
Capitol Police said 43 protesters were arrested and charged with obstruction.
Aside from
the quartet of conservatives, none of the other 48 Republican senators appeared
to reject the bill out of hand. But several said they would check with
home-state constituents before taking a position.
"I
expect there's going to be a number of changes between now and the final
vote," said Senator John Barrasso of Wyoming.
REUTERS*
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