What's In The New GOP Health Care Bill

We sort through the revised GOP health care bill, which includes provisions to cater to more conservative lawmakers as well as moderates.

DAVID GREENE, HOST:

Well, it is round two for health care in the United States Senate. Senate Majority Leader Mitch McConnell released an updated bill yesterday. He's hoping to get the support of 50 Republicans. The party is hoping to fulfill its promise to repeal the Affordable Care Act or Obamacare.

This latest proposal seems to cater to more conservative Republicans by letting insurance companies sell policies that don't meet all Obamacare rules. The bill also tries to bring in moderate senators with a fund that can help low income people get coverage. NPR's Alison Kodjak is here. And, Alison, you love nothing more than digging into a wonky piece of legislation, right?

ALISON KODJAK, BYLINE: (Laughter) Nothing like it. I'll try to dewonk (ph) it for you this morning.

GREENE: Dewonk - that is an official term. Well, help us understand what's in this bill.

KODJAK: So the bill actually - you know, broad outlines are very similar to the previous bill. It gets rid of the individual mandate, so people are no longer required to own insurance, and they won't get fined if they don't buy it. And it makes major cuts and restructures Medicaid. But there's this new compromise. It was proposed by Ted Cruz, the senator from Texas. And it allows insurance companies to offer these stripped-down policies that don't cover as much but don't cost as much. They can only do that as long as they also offer these comprehensive policies that meet all the Obamacare rules. So that's sort of this compromise to try to bring in the conservative members who want more freedom and still allow people with pre-existing conditions to get good insurance.

GREENE: OK, so we're going to watch to see whether that compromise, other compromises, actually make a difference here. Let me ask you just sort of a step-back question. I mean, Republicans made this promise. It's one reason that a lot of Americans supported them in their effort to get rid of Obamacare. They said they want more insurance policy options for consumers, and also they promised to lower premiums. Do they accomplish that here?

KODJAK: Well, it's possible they accomplish it because they can sell these cut-rate policies. They won't have as much coverage, but they will probably be cheaper. But the problem is that then you have people who actually need health care, people with pre-existing conditions, who are going to be buying the more comprehensive policies. And those policies' prices are likely to go up. So if you cut prices for some people you're probably going to be raising prices for other people.

And, you know, in addition they've created this big fund - billions and billions of dollars - to help those people with pre-existing conditions be able to buy insurance cheaper. But it's not clear how that fund will be used. It's going to go to the states, and the states can use it however they want.

GREENE: Well, let me ask you about Medicaid because one of the things that Senator McConnell really had to do was try and bring in some of the moderates who were worried that the earlier bill just cut Medicaid too much. What is in Medicaid in terms of this bill?

KODJAK: Well, that's a big issue here. This bill doesn't actually change anything from the previous bill on Medicaid. So the bill rolls back the Medicaid expansion, which offered coverage to about 10 million additional people. And it changes the whole structure of Medicaid, which over time, over about 20 years, cuts Medicaid funding from the current law by more than 30 percent.

People are very worried about this. And many state governors are worried, and a lot of Republican senators said they couldn't vote for this bill based on that Medicaid issue. So it's unclear how those same senators are now going to say they can vote for this version because Medicaid hasn't really changed.

GREENE: And finally, let me just ask you about the number of people covered. I mean, this - the Congressional Budget Office comes out - it came out the last few times we've gone through this with a number that a lot of people would be dropped from their insurance. Does this revised bill cover more people than the earlier bill?

KODJAK: Well, we haven't seen a CBO score yet, but with the no changes in Medicaid it's unclear that - those people probably still will not be covered. And that was about 14 million people in the last CBO score. So it depends on whether or not they think these cut-rate policies are coverage and whether a lot of people will buy them. If a lot of people buy those insurance policies and that the Congressional Budget Office calls them coverage, then it could be a little bit better than the last bill.

GREENE: All right, dewonking (ph) the health care debate for us (laughter) and updating us on this new Republican proposal, NPR's Alison Kodjak. Thanks, Alison.

KODJAK: Thanks, David.

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