By POLITICO StaffPolitics The GOP has a plan to repeal and replace the Affordable Care Act and replace it with something more conservative.
It’s a strategy Republicans and some in the Senate are hoping to sell to their conservative base.
But it’s unclear whether any of the key House GOP moderates, who have been pushing for the plan, will join them in a vote next week.
And the Republican leadership is not ruling out the possibility that any of its GOP defectors will defect to Democrats to back the GOP plan, which has the backing of just a handful of House Republicans and the White House.
The strategy is being put forward by Sens.
Bill Cassidy, R-La., and Lindsey Graham, R of South Carolina, who will be the bill’s top Senate defenders and hold the gavel.
They are pushing for a plan that would preserve a key component of the ACA — the Medicaid expansion — while leaving out some of the more contentious elements of the law.
The proposal is the culmination of months of work between the two lawmakers and their aides and their colleagues in the House.
The Senate is expected to begin passing the bill this week, although it is unclear whether Cassidy and Graham will be able to make it through the full chamber.
The Cassidy-Graham plan would create a state-run health insurance exchange, which would offer subsidized health insurance to low-income Americans.
They would also make significant changes to the Medicaid program, including expanding coverage for children up to age 26 and requiring private insurance companies to cover preventive care and maternity care.
The plan also would cut back on the Medicaid funding that states receive to cover health care providers, such as doctors and hospitals.
“We want to get rid of the Obamacare elements and bring the rest of it into the private marketplace,” Cassidy said during a news conference last week.
“We want people to have access to the private market.”
Sen. Tom Cotton, R.I., the first South Carolina Republican to join the Senate Budget Committee, also backed Cassidy-Cotton’s bill last week, but he didn’t go as far as Cassidy-Graham in calling for the repeal of the Medicaid expansions.
“This is not an attack on Medicaid, it’s a repeal of Obamacare,” Cotton said on “Fox News Sunday.”
“We don’t want to take away coverage from the most vulnerable in our society.”
Cotton added that he was concerned about the bill not fully repealing the Medicaid changes.
“I’m concerned about whether it will provide the coverage that we all want, or whether it does not,” Cotton told ABC News.
“If we don’t get it right, it could be a disaster.”
Senators Mike Lee, R.-Utah, and Lindsey O. Graham, a fellow Republican from South Carolina who will serve as a vice chairman on the Senate Finance Committee, were the only two senators to vote against the Cassidy-Lee bill last year, saying it didn’t meet their priorities.
“The Cassidy and Lee plan is not a plan I believe in,” Lee said on CNN last week of the plan.
“I think it will make the country less secure.
And I think it’s going to be a bad plan for the economy and for the health care system.”
The GOP leaders plan for a repeal bill is likely to face hurdles from the right.
In an interview last week with the Financial Times, White House press secretary Sarah Sanders said the GOP would not support the bill because it does “not reflect the priorities” of the president.
“He is open to the idea of repealing and replacing Obamacare,” Sanders said.
“But the Cassidy and Kayl Graham plan is a fundamentally different approach to health care reform.
The Graham plan would end Medicaid expansion, leave out Medicaid funding for preventive care, end Medicare Advantage and eliminate insurance subsidies for the elderly.”
But Sen. Rand Paul, R., who has been pushing to repeal the ACA, said he and other senators would support the plan because of the GOP’s “moral obligation to repeal Obamacare.”
“There is a moral obligation to do something that works,” Paul said during an interview on Fox News Sunday.
“And the Graham plan that’s been proposed by Senator Cassidy and Senator Graham does work, but it’s not the same as Obamacare.”
Sen.(R-Ky.), who has also pushed for the ACA repeal, said the Cassidy plan would “make Medicaid less affordable” for people with preexisting conditions.
“In fact, in the Cassidy bill, the Medicaid would be cut to $600 billion,” he said on Fox.
“So it would make Medicaid less accessible to those people, to those who are very low income, to children, to people with pre-existing conditions.”
Senates Republicans will have to work with Democrats on the House bill to pass it.
And Democrats are likely to oppose the bill, saying its Medicaid cuts are too much, particularly for lower-income people.
But if Republicans want to pass the bill without any Republican defections, they may be able get enough support from the moderate House GOP to pass.
On the House side