Governors wary of Medicaid cost shift in Senate health bill

If either version is signed into law by President Trump, it will unshakably fix into place only one thing - the perception that the Republican Party simply doesn't care whether millions of Americans are healthy or hurting, breathing or wheezing, getting better or worse.

"At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not ideal, nor could it be the end of our efforts", Obama wrote.

But some Republican senators, as well as all the Senate's Democrats, have complained about McConnell's proposal, the secrecy with which he drafted it and the speed with which he'd like to whisk it to passage.

Mr McConnell stitched it together behind closed doors, potentially moving Mr Trump and the GOP toward achieving perhaps their fondest goal - repealing former Mr Obama's 2010 statute, his proudest domestic legacy. "We need much more than that", says Mendell, who founded the nonprofit Shatterproof after his son Brian's opioid addiction sent him into a depression and he took his own life. "If Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it".

Some conservative and moderate GOP senators have their doubts, too.

Sens. Dean Heller of Nevada, facing a competitive 2018 re-election battle, Rob Portman of OH and Shelley Moore Capito of West Virginia expressed concerns about the bill's cuts to Medicaid and drug addiction efforts. Only 50 votes are needed to pass it, and Republicans hold 52 seats and the tiebreaker in Vice President Mike Pence.

The Senate Republican health care bill would guarantee immediate assistance for insurance markets that are struggling in many states.

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"ObamaCare is dead and we're putting a plan out today that is going to be negotiated", Trump said at a White House technology event earlier in the day.

But like the House bill, the proposed Senate bill also would phase out extra financial incentives provided to states by the federal government to expand eligibility for Medicaid.

The Senate proposal would also impose annual limits on the federal Medicaid funds that would go to each state, which would tighten even further beginning in 2025. The program now gives states all the money needed to cover eligible recipients and procedures.

"There is a huge tax cut for the richest people in our country, with both the House and the Senate versions of these bills, and this tax cut is on the backs of the poorest, sickest, oldest people in our country", Sen.

Pearson said those subsidies will be smaller than under current law. In practice, that would mean many plans would have higher deductibles and out-of-pocket costs. However, the credits would require people to purchase a less comprehensive plan, and would not be available to as many low-income people, according to published reports. Almost a third of Ohioans getting coverage under the health care program have a substance abuse or dependence problem, the state says.

The bill would also let states apply waivers to disregard some mandates of the Affordable Care Act, like the law's ban on insurance companies charging higher premiums for people with pre-existing medical conditions. But the Senate bill begins phasing out this increased funding starting in 2021 and restoring it to pre-Obamacare levels by 2024. Many Republicans have long fought that organization because it provides abortions.

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