Final Details of Senate Health Bill a Mystery Days Before Vote

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By Colleen Murphy

Republican senators say they don’t know what is in the final version of the chamber’s health care bill—though a draft that will restructure health care tax credits is expected to be released June 22.

The Senate is likely to vote on the bill as soon as the week of June 26, Senate Majority Leader Mitch McConnell (R-Ky.) said during a June 20 news conference, although the vote can’t take place until the Congressional Budget Office releases a revenue score of the bill and an estimate of how many individuals it would cover. Many Republican senators dodged questions about specific pieces of the bill June 20, saying they needed to see a more final version.

“We haven’t seen a bill. It would be impossible for anybody to answer any of these questions until a bill comes out,” Sen. Bob Corker (R-Tenn.) said.

Moving ahead on a vote puts the Senate on a tight timeline, with eight days in session before a week-long July recess. Senators are in touch with the CBO about “various options” as they shape a bill, but nothing is finalized, said Sen. John Thune (R-S.D.), the third-ranking Republican.

“Right now nobody has a finalized health care bill, nobody has seen any kind of finalized text,” he said. Thune has for months been in talks about how to make the tax credits in the House-passed health bill larger for low-income and older individuals.

As he left a health-care working group meeting June 20, Senate Finance Committee Chairman Orrin G. Hatch (R-Utah) was asked if senators were close to wrapping up the bill. “Didn’t seem like it to me,” he said.

Some Agreement

Republican senators have generally been in consensus since before the House passed the American Health Care Act ( H.R. 1628) on May 4 that the measure didn’t put enough money toward credits for older and low-income individuals. An amendment to the House health bill set aside $85 billion for the Senate to rework the bill’s refundable tax credits.

A 64-year-old earning $26,500 would pay $1,700 in premiums annually under the Affordable Care Act, the law that the House bill would dismantle. That individual could face a premium up to nine times as large—$16,100—under the House health bill, according to a May 24 CBO estimate.

“I’m for low-income people having enough money to purchase health care and I think leadership knows that, and there are many people that feel that way,” Corker said.

The Senate is also expected to keep some of the ACA’s taxes in place in order to make their legislation more generous.

The Holdup

Senators haven’t yet made final decisions on how to rework the House bill’s tax credits. A ban on using tax credits to pay for health care plans that cover abortion—included in the House-passed bill—is bogging down bill negotiations in the Senate, Sen. Bill Cassidy (R-La.) said June 20.

Because the ban could break Senate rules, senators may need to find a way to work within an existing structure that already includes the language, such as Medicaid or the tax credit structure of the ACA—though under that law individuals can use the credits to help pay for plans that cover abortion in some cases. While senators have been grappling with that complication for weeks, finding a solution is increasingly important as a vote nears.

Cassidy said senators are running into issues on how to structure the tax credits while keeping the language, which follows the provision known as the Hyde Amendment, a ban on using federal funds to pay for abortions.

“We’re still awaiting more detail on the tax credits,” he said.

House Ways and Means Committee Chairman Kevin Brady (R-Texas) reiterated to reporters June 15 that keeping the restriction was important to him “as a pro-life legislator,” and to other House Republicans.

“Those tax credits should not be used to purchase plans that offer elective abortions; the House was very clear in that as a priority, so I hope the Senate takes that into consideration,” he said.

With assistance from Laura Davison in Washington.

To contact the reporter on this story: Colleen Murphy in Washington at cmurphy@bna.com

To contact the editor responsible for this story: Meg Shreve at mshreve@bna.com

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