Republicans unveil revised health care bill

Michael Mathes

Washington (AFP) - Republican leaders unveiled a revamped health care bill Thursday aimed at salvaging Donald Trump's top legislative priority, after the US president warned he'll be "very angry" if party divisions scupper his drive to dismantle Obamacare.

The new Senate bill is intended to woo Republicans from both conservative and moderate factions, and reassure those who fear repealing Barack Obama's Affordable Care Act -- a longstanding goal for the party -- could adversely impact millions of Americans.

With Democrats united in opposition, Senate Majority Leader Mitch McConnell needs support from at least 50 out of 52 Republicans to pass the measure in the 100-member chamber.

Ten Republicans have said they will not support the previous version of the bill. The test is whether leadership can convince most of them to get on board.

Like the previous version, the new draft eliminates a fundamental principle of Obamacare, the requirement that almost all individuals either obtain health insurance or pay a fine, according to a summary of the bill released by the Senate Budget Committee.

It still includes plans to slash by more than $700 billion the Medicaid federal health care program for the poor and disabled, a move that Republican centrists fear could devastate millions of families.

But key changes include the provision of an extra $70 billion to stabilize the health insurance exchanges created under Obamacare, on top of the $112 billion earmarked under the previous version.

In a nod to moderate Republicans, the revamped bill jettisons plans to repeal two taxes on wealthy Americans that are used to help pay for Obamacare, and scraps repeal of a tax on health insurance executives.

It also provides $45 billion to support opioid abuse treatment programs and individuals with mental disorders.

Concessions to conservatives include giving states flexibility to let insurance companies offer cheap, no-frills plans alongside those that include certain health benefits mandated by Obamacare.

Some Republicans warn that move could end up abolishing protections for people with pre-existing conditions and send costs soaring for children and older insurance holders in the individual market.

The chamber's 52 Republicans entered a closed-door meeting Thursday where McConnell unveiled the much-anticipated measure.

With opposition growing, and McConnell postponing the Senate's August recess by two weeks to allow time to bring skeptical lawmakers on board, the president used his bully pulpit to urge fellow Republicans to rally round the effort.

- 'Get it done' -

Trump warned Wednesday he would be "very angry" if Congress failed to pass legislation to replace large parts of Obamacare.

"For years, they've been talking about repeal-replace, repeal-replace," Trump told the Christian Broadcasting Network. "They have to get together and get it done.... I will be very angry about it" if they fail.

But Senator Rand Paul, a longtime critic of the bill, said Thursday he still has serious doubts.

"I don't know that this is better than Obamacare," Paul told Fox News.

"The new plan actually doesn't repeal Obamacare. It keeps about half of the Obamacare taxes. Keeps most of the Obamacare regulations, keeps most of the Obamacare subsidies and it creates a giant insurance bailout super fund," he warned.

McConnell has been criticized for crafting the initial bill in secret and rushing the process, leaving lawmakers with little time to analyze the legislation and consider changes.

"We're just kind of throwing stuff up against the wall -- concepts, policies, things that we think will work -- but we haven't given outside groups... the time" to analyze the plan, said Republican Senator Ron Johnson.

Polls show the previous version to be widely unpopular. An analysis by the non-profit Congressional Budget Office forecast that under the bill, ranks of the uninsured would swell by 22 million people by 2026 compared to current law.

McConnell wants to receive a CBO score on the new version as early as next Monday, and hold a vote to begin debate on the bill next week.