Senate Majority Leader Mitch McConnell. Reuters

Senate Republican leadership released the updated version of its healthcare bill on Thursday, but continued pushback from its own conference most likely puts the legislation in the same perilous position as previous iterations.

The details of the bill outline a variety of edits but indicate that much of the original BCRA remains intact.

Here's a rundown of the changes in the new version of the BCRA:

Some of Obamacare's taxes are kept: The new version could preserve the 3.8% investment-income tax on people making over $200,000 a year, a huge source of revenue introduced by the Affordable Care Act and one of the biggest reasons Republicans wanted to repeal the law, better known as Obamacare. Other taxes including one on health-insurance executives and a Medicare health-insurance tax would no longer be repealed in this version. Numerous smaller taxes, like one on tanning salons, would still be repealed. This move would not sit well with conservatives and tax opponents.

The new version could preserve the 3.8% investment-income tax on people making over $200,000 a year, a huge source of revenue introduced by the Affordable Care Act and one of the biggest reasons Republicans wanted to repeal the law, better known as Obamacare. Other taxes including one on health-insurance executives and a Medicare health-insurance tax would no longer be repealed in this version. Numerous smaller taxes, like one on tanning salons, would still be repealed. This move would not sit well with conservatives and tax opponents. Increased funding for the opioid crisis: The original bill had $2 billion in funding to combat the opioid crisis. The new version is expected to increase that number to about $45 billion.

The original bill had $2 billion in funding to combat the opioid crisis. The new version is expected to increase that number to about $45 billion. A modified Cruz amendment: A modified version of Sen. Ted Cruz's amendment will be in the bill. According to the talking points, if an insurer offers a plan on the individual insurance exchanges that qualifies with all of Obamacare's regulations, it can also offer plans off the exchanges that do not adhere to those regulations. Additionally, the bill will include a $70 billion fund designed to offset costs for insurers that sign up "high risk individuals" to the off-exchange, deregulated plans.

A modified version of Sen. Ted Cruz's amendment will be in the bill. According to the talking points, if an insurer offers a plan on the individual insurance exchanges that qualifies with all of Obamacare's regulations, it can also offer plans off the exchanges that do not adhere to those regulations. Additionally, the bill will include a $70 billion fund designed to offset costs for insurers that sign up "high risk individuals" to the off-exchange, deregulated plans. Allow people to use tax credits on catastrophic health plans: These high-deductible plans provide skinny coverage similar to a bronze-level plan under Obamacare. Under Obamacare, tax credits from the federal government were not allowed to be used on these plans since they did not adhere to the minimum standards for coverage.

These high-deductible plans provide skinny coverage similar to a bronze-level plan under Obamacare. Under Obamacare, tax credits from the federal government were not allowed to be used on these plans since they did not adhere to the minimum standards for coverage. Increased funding for the state stability fund: This fund is distributed to states to help bring down premiums and start programs that lower costs for insurers and consumers. According to reports, there will be $70 billion of new money for this fund in the new version of the BCRA in addition to the $112 billion in the first version.



The bill includes a provision that holds back 1% of the stability fund for a state "where the cost of insurance premiums are at least 75 percent higher than the national average." That appears to be aimed at placating Sen. Lisa Murkowski, of Alaska, a moderate skeptic of the legislation. Alaska typically has much higher premiums than the rest of the US.

This fund is distributed to states to help bring down premiums and start programs that lower costs for insurers and consumers. According to reports, there will be $70 billion of new money for this fund in the new version of the BCRA in addition to the $112 billion in the first version. The bill includes a provision that holds back 1% of the stability fund for a state "where the cost of insurance premiums are at least 75 percent higher than the national average." That appears to be aimed at placating Sen. Lisa Murkowski, of Alaska, a moderate skeptic of the legislation. Alaska typically has much higher premiums than the rest of the US. Allow people to spend money from health savings accounts on premiums: HSAs, which are not taxed, can be spent on a variety of medical care costs. A new provision would allow it to go toward insurance costs.

While many of these changes address some concerns of GOP members, they most likely won't have a big imprint on the projected effects of the legislation, experts said.

"This is still a bill that will result in very large reductions in insurance coverage and reductions in the quality and affordability of the insurance coverage for many people who retain coverage," Matthew Fiedler, a fellow at the Brookings Institution's Center for Health Policy, told Business Insider.

The score from the nonpartisan Congressional Budget Office estimated that the first version of the BCRA would result in 22 million more uninsured Americans by 2026 than the current system would.

"We're still likely to see many millions of people losing or going without coverage as a result of this bill. Although some of the taxes on wealthy people are retained, the bill doesn't appear to use much of that to cover low-income people," Cynthia Cox, the associate director at the Kaiser Family Foundation, a nonpartisan healthcare think tank, told Business Insider.

The new version may not win over Republican holdouts

The biggest issue of concern: The new legislation does not address an approximated $772 billion in cuts to the Medicaid program through 2026. For many moderate detractors in states with large Medicaid populations, that could be a make-or-break issue.

Murkowski has blasted the cuts, which would roll back Obamacare's Medicaid expansion and cap the amount of funding the federal government provides.

"The ACA allowed for Medicaid expansion. The ACA didn't address traditional Medicaid … Why do we not focus on the urgency of the concerns with the ACA?" Murkowski told reporters Wednesday, according to Politico.

Other moderate senators like Susan Collins of Maine, Shelley Moore Capito of West Virginia, and Dean Heller of Nevada also expressed concerns about the new version preserving most of the Medicaid cuts.

On the other end of the GOP spectrum, conservative-leaning members have remained on the fence about their intentions.

Sen. Rand Paul of Kentucky told reporters during a conference call Wednesday that he would not support the bill even after the changes. Paul criticized what he called a "kitchen sink" approach by McConnell to try to win over members by adding spending to the legislation.

Paul said the GOP should instead "narrow" the bill to a slim partial repeal of Obamacare, addressing the parts on which the conference could agree.

And the amendment offered by Cruz, which would allow insurers to dodge certain regulations created by Obamacare, will be tentatively added to the bill. That will most likely help the legislation earn the support of Cruz and Sen. Mike Lee, but it could also help push moderates to oppose the legislation. On Wednesday, a group featuring some of the US's largest insurers blasted the Cruz amendment, highlighting its potential effects on protections for people with preexisting conditions.

Majority Whip John Cornyn, the No. 2 Republican in the Senate, told reporters on Wednesday night that the bill did not have enough votes to pass. It can lose only two Republican votes. As of now, none of the 10 senators who came out publicly against the original version of the bill have said they moved into the "yes" column.