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Senate GOP Releases Bill To Cut Medicaid, Alter Obama's Affordable Care Act

Senate Majority Leader Mitch McConnell is flanked by Sen. John Barrasso, R-Wyo., (left) and Senate Majority Whip John Cornyn of Texas (right).  They are three of the 13 senators in the health care working group.
Jacquelyn Martin AP
Senate Majority Leader Mitch McConnell is flanked by Sen. John Barrasso, R-Wyo., (left) and Senate Majority Whip John Cornyn of Texas (right). They are three of the 13 senators in the health care working group.

UPDATE: 9:35 a.m., June 22, 2017

Senate Republicans released their long-awaited bill Thursday to dismantle much of Barack Obama's health care law, proposing to cut Medicaid for low-income Americans and erase tax boosts that Obama imposed on high-earners and medical companies to finance his expansion of coverage.

The bill would provide tax credits to help people buy insurance. It would also let states get waivers to ignore some coverage standards that "Obamacare" requires of insurers.

RELATED: Republicans’ Proposed Medicaid Cuts Would Hit Rural Patients Hard

The measure represents the Senate GOP's effort to achieve a top tier priority for President Donald Trump and virtually all Republican members of Congress. Senate Majority Leader Mitch McConnell, R-Ky., hopes to push it through his chamber next week.

Senate GOP Releases Bill To Cut Medicaid, Alter Obama's Affordable Care Act
Senate GOP Releases Bill To Cut Medicaid, Alter Obama's Affordable Care Act GUEST:Kenny Goldberg, reporter, KPBS News

Our top story, the healthcare bill is revealed today after weeks of speculation already a number of Republican senators have said they do not supported in his current form. Kenny Goldberg has been watching the whole process carefully and if here to help us understand what we know so far. Thank you for joining us. Let's talk about how this could affect California specifically. The new bill would be the end of the insurance mandate. How could that affects the health insurance marketplace in California? When you eliminate the mandate that everyone has to have insurance you will find that young and healthier people will not bother to get insurance. That is until they are fake or show up in emergency rooms. Those people who do have insurance will tend to be thicker and the kind of people that need more frequent care. That would really affect the insurance market in a bad way. It will be tougher financially for insurance companies to keep these plans vibrant and I naturally found. One of the fundamental differences is the new bill would hand more of the responsibility for deciding how much healthcare people get, leave it up to the states. Could this put a huge burden on California, which is committed to keeping a stronger safety net than others? It could be in that under the Republican Senate bill, insurance companies will no longer be required to offer all of the 10 essential Obamacare benefits. If plants wanted to they could remove certain benefits they did not want to cover like pregnancy, maternity care, preventative services and those kinds of things. California insisted that its plans covered all those things by state law, then it might be a little tougher for insurance companies here as opposed to other states. Under the affordable care act, California along with others expanded their Medicaid programs. How could the Senate GOP healthcare bill affect that? It would roll back and eventually sunset all love the federal expansion dollars in the last two years California has added more than 3 million people to the MediCal role. Under the Senate bill, after 2021 California would have to pick up most of that tab. It would be extremely expensive for California to cover that without federal help. The only way that they could do it would be to raise taxes significantly. That is unlikely to happen. In other words, if the Senate bill were to pass as is, probably 4-5 million Californians would lose health insurance. How will that affect ran recipients in San Diego? Was a 900,000 are on Medi-Cal, it would have a dramatic effect in San Diego and will be even more dramatic in some other counties where MediCal recipients make up one quarter or even higher of the population. This initiative will cut taxes for some, who would benefit? The wealthy, people who are more than $200,000 per year. The tax cuts what amount to about $350 billion over 10 years. That has been the fundamental way the federal government funded Obamacare. If you eliminate those taxes, you will be there is very little revenue left to try to support some of these assistants program -- assistance programs. So the house bill to repeal the affordable care act based tax credit on age, what about the Senate bill? It keeps the subsidies based on income. However, it is a little more stingier than the Obama care subsidies. Undercover California become a point would be a little lower. Some people would not be eligible for subsidies who get them now. How does Planned Parenthood bear under the Senate bill? The house bill took federal funding away from them. The Senate bill does the same thing. It will prevent Planned Parenthood from getting any Medicaid money for treating people for one year. That would have a big effect in states like California, where there are hundreds of Planned Parenthood clinics. In some areas of the state the clinic is one of the only healthcare operators around. So, they would not be able to build for their services when they are treating Medi-Cal patients. How are Democrats in the Senate reacting? Harrison Feinstein, how is he taking it? They are both blasting the bill. Feinstein set the idea that Obamacare is in a death spiral is false. She said California's healthcare market is very robust and no state has embraced Obamacare more than California. She also said there is really no justification giving millionaires a tax break and in effect cutting subsidies to the poor. Pamela Harris said almost the same thing, that the Republican healthcare bill care for millions of people in need and instead give tax cuts to millionaires. They both are absolutely blasting the fact. That is Kenny Goldberg our KPBS health reporter.

Yet it faces an uncertain fate in the Senate.

At least a half-dozen GOP senators — conservatives as well as moderates — have complained about the proposal, the secrecy with which McConnell drafted it and the speed with which he'd like to whisk it to passage. Facing unanimous Democratic opposition, the bill would fail if just three of the Senate's 52 GOP senators oppose it.

The measure would provide $50 billion over the next four years that states could use in an effort to shore up insurance markets around the country.

For the next two years, it would also provide money that insurers use to help lower out-of-pocket costs for millions of lower income people. Trump has been threatening to discontinue those payments, and some insurance companies have cited uncertainty over those funds as reasons why they are abandoning some markets and boosting premiums.

RELATED: Here's What We Know About The Senate GOP Health Care Bill

The House approved its version of the bill last month. Though he lauded its passage in a Rose Garden ceremony, Trump last week privately called the House measure "mean" and called on senators to make their version more "generous."

Democrats say GOP characterizations of Obama's law as failing are wrong and say the Republican plan would boot millions off coverage and leave others facing higher out-of-pocket costs.

The nonpartisan Congressional Budget Office said the House bill would cause 23 million people to lose coverage by 2026. The budget office's analysis of the Senate measure is expected in the next few days.