Senate Majority Leader Mitch McConnell said today in Washington that the Senate will definitely vote next week on a motion to proceed with debate on the Better Care Reconciliation Act bill.
"Next week, we'll get on the bill," McConnell said at a press conference that was streamed live on C-SPAN's website. "I have every expectation that we'll be able to get on the bill."
If the Senate approves the motion, the Senate would consider the bill under budget reconciliation rules. Budget reconciliation rules would give each senator a chance to propose amendments to the bill, McConnell said.
McConnell said the Senate would start by considering two main alternatives: voting on something like the version of the Better Care act bill that was unveiled earlier this month, or voting on an amendment that would create a completely new version of the bill. The "amendment in the nature of a substitute" would simply repeal many Affordable Care Act revenue and spending provisions, with a two-year delay before the changes would take effect.
"It's pretty obvious we've had difficulty getting 50 votes to proceed," McConnell said.
McConnell said proceeding with debate would give senators who have concerns about the Better Care bill an opportunity to improve it.
The McConnell Amendment
The proposed McConnell amendment would create a stripped-down version of the Better Care bill. The amendment would immediately:
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Eliminate the individual coverage mandate and employer coverage offer mandate.
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Increase funding for community health centers and state substance abuse program grants.
Starting in 2020, the McConnell amendment would:
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Repeal the Affordable Care Act Medicaid expansion program.
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Repeal individual health insurance premium subsidies.
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Repeal many of the Affordable Care Act tax provisions.
- End extra federal support for a program that provides personal care services for people with severe disabilities.
The amendment would also push the start date for the Cadillac plan excise tax on high-cost health plans back to 2026.
CBO
The Congressional Budget Office (CBO) has estimated in the past that the Senate's Better Care bill and the House health insurance bill, the American Health Care bill, would lead to the United States having about 22 million more uninsured people in 2026 than it would have if the current Affordable Care Act system stays in place and works as expected.
In a new forecast released today, the CBO predicts that, by 2026, the McConnell amendment could increase the number of uninsured people by about 32 million when compared with how many people might be uninsured if the current rules stay in effect.
The McConnell amendment could lead average individual major medical premiums to be about twice as high in 2026 as they would be under the current rules, according to the CBO analysts.
Adopting the McConnell amendment could increase premiums about 25% in 2018, the CBO says.
The CBO has posted a copy of the analysis here.
Budget Measures v. Full Repeal
Republicans have 52 seats in the Senate. Vice President Mike Pence presides over the Senate and can cast a vote to break a tie.
Under traditional Senate rules, supporters of budget reconciliation bill, with provisions that the Senate parliamentarian classifies as germane to the federal budget, need just 51 votes to get to a vote on the Senate floor.
Supporters of an ordinary bill need 60 votes to have a bill come up for a vote on the Senate floor.
