GOP senators unveiled their new plan to repeal and replace the Affordable Care Act on Thursday after spending nearly two weeks making revisions, but it’s already teetering on the edge of collapse.
If just three Republicans oppose the procedural vote scheduled for next week, the GOP’s seven-year effort to repeal the Affordable Care Act would come to an end.
Two Republican senators have already said they plan to vote "no" on the procedural vote next week: Sens. Susan Collins of Maine and Rand Paul of Kentucky.
"As a conservative, I won’t support the new federal spending or entitlements or bailouts," Paul told reporters shortly after the revised draft was released Thursday.
For Collins, who is known as a moderate on health care, the issue comes down to the deep cuts to Medicaid funding proposed in the revised draft.
"My strong inclination and current intention is to vote ‘no’ on the motion to proceed," Collins said Thursday.
Several Republicans have said they remain undecided.
"I look forward to reviewing the revised Senate health care legislation and forthcoming CBO report to determine the impact on West Virginians, but continue to have serious concerns about the Medicaid provisions," Sen. Shelley Moore Capito, R-WV, said Thursday in a statement.
Sen. Rob Portman of Ohio, who also expressed serious concerns about Medicaid cuts said he is undecided.
"It’s 172 pages guys, so I’ve got a weekend of reading," Sen. Dean Heller of Arizona told reporters on his way out of the U.S. Capitol.
But with or without his party’s support, Senate Majority Leader Mitch McConnell has vowed to take up the procedural vote, in order to open debate on the Senate floor.
President Donald Trump weighed in Friday morning, tweeting: "Republicans Senators are working hard to get their failed ObamaCare replacement approved. I will be at my desk, pen in hand!"
Some of the revisions in this version of the bill include: maintaining some Obamacare taxes for the wealthy, allowing people to pay for insurance with pre-tax money and providing financial support to help low-income people purchase healthcare.
In an effort to address some concerns voiced by moderates, the revised bill also includes a $45 billion dollar sweetener to fight the opioid epidemic.
To address some conservative concerns, the new version includes an amendment that Sen. Ted Cruz of Texas introduced, which would allow insurers to offer cheaper bare-bones plans that don’t cover essential health benefits. This addition could bring down costs for some, but has caused contention with some moderate senators because it could hurt those with pre-existing conditions.
The Congressional Budget Office (CBO) plans to release it’s analysis of the revised plan’s potential effect on the budget early next week. They are analyzing two versions of the bill, one with the "bare-bones" amendment and one without.
If the procedural vote is successful, an amendment process will begin, meaning the bill will be a work-in-progress until the final vote.