Sen. Rand Paul Randal (Rand) Howard PaulSecond GOP senator to quarantine after exposure to coronavirus GOP senator to quarantine after coronavirus exposure The Hill's Morning Report - Sponsored by National Industries for the Blind - Trump seeks to flip 'Rage' narrative; Dems block COVID-19 bill MORE (R-Ky.) is outlining a list of demands to win his support for the GOP's latest ObamaCare replacement bill that would require major changes to the legislation.

Paul's primary demand, according to his office, is to substantially reduce the central component of the bill sponsored by GOP Sens. Lindsey Graham Lindsey Olin GrahamMcConnell locks down key GOP votes in Supreme Court fight Will Republicans' rank hypocrisy hinder their rush to replace Ginsburg? Momentum growing among Republicans for Supreme Court vote before Election Day MORE (S.C.) and Bill Cassidy William (Bill) Morgan CassidyCoushatta tribe begins long road to recovery after Hurricane Laura Senators offer disaster tax relief bill Bottom line MORE (La.): block grants to states with money to spend on health care.

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"Graham/Cassidy keeps and redistributes/spends over a trillion dollars," Paul says in a document provided by his office.

"My promise to the voters was to repeal Obamacare - not block grant and keep Obamacare," he adds. "If Obamacare were truly repealed, this entire trillion dollars would not be spent. This is the primary obstacle to my support, and only a significant reassessment of this trillion-dollar spending regime would get my support."

A "significant reassessment" of the spending, though, is likely to cost the GOP other votes, most notably Sen. Lisa Murkowski Lisa Ann MurkowskiMcConnell locks down key GOP votes in Supreme Court fight Most Americans think winner of election should pick next Supreme Court justice: poll Murkowski: Supreme Court nominee should not be taken up before election MORE (R-Alaska), who is already focused on whether the bill does enough to help people afford coverage.

Finding some way to win Paul's vote, however unlikely, is crucial for GOP leaders, given that they can only lose two votes. Sen. John McCain John Sidney McCainMomentum growing among Republicans for Supreme Court vote before Election Day McConnell urges GOP senators to 'keep your powder dry' on Supreme Court vacancy McSally says current Senate should vote on Trump nominee MORE (R-Ariz.) is also against the bill, and Sen. Susan Collins Susan Margaret CollinsMcConnell locks down key GOP votes in Supreme Court fight Most Americans think winner of election should pick next Supreme Court justice: poll Murkowski: Supreme Court nominee should not be taken up before election MORE (R-Maine) said Sunday that it's "very difficult" for her to imagine supporting the measure.

Paul, who has repeatedly bashed the bill in television interviews and on Twitter, also wants states to have even more freedom to repeal ObamaCare regulations. The "default," he says, should be that all its regulations are repealed, and states can opt in to keep some regulations if they choose.

Further action to repeal those regulations is politically fraught, though, given that they include protections for people with pre-existing conditions.

Finally, Paul wants both executive action from the Trump administration and committee time to consider legislative action on a favored cause of his, known as Association Health Plans, which allow businesses and individuals to band together to buy health insurance as a group.