GOP Plans Health Vote With `No Idea' Which Bill It'll Consider

One change under discussion, which has attracted interest from pivotal Republicans like Bill Cassidy of Louisiana, would provide extra funds to states to help move some low-income people from Medicaid to private insurance plans. Seema Verma, the head of the Centers for Medicare and Medicaid Services, proposed that idea to some GOP senators on Wednesday, Alaska Sen. Dan Sullivan said. Sullivan said Verma called it a "wraparound" plan to provide extra help on the individual market for poor people.

Her plan seeks to partially replace the Affordable Care Act cost-sharing reduction subsidies that lower out-of-pocket costs for people making between 100% and 250% of the poverty level. The current GOP health bill would end the Affordable Care Act subsidies. Details of Verma's plan haven't been made public, and it isn't clear that there'd be enough funding in the bill to help all the low-income people who would leave Medicaid maintain similar coverage to what the Affordable Care Act exchange system provides.

Cassidy told reporters Thursday that "empirically it works," and that his understanding is that as much as $200 billion may be allocated to fund that.

Possible Revolt

Even as some moderates examine the idea, Republican leaders still risk a revolt by Ted Cruz of Texas and some other conservatives. They're insisting on the inclusion of Cruz's proposal to allow private insurers to offer policies free of the Affordable Care Act consumer protections alongside plans that comply. It remains unclear whether the provision will be allowed under expedited procedures Republicans are using, or whether it will be removed by opponents who say its promise of cheaper plans would pull too many healthy people out of the exchanges.

Some lawmakers are changing positions frequently, making the outcome of next week's votes hard to gauge.

Paul shifted course and told reporters Thursday that he would vote with his party to allow the health care debate to begin when a critical procedural vote comes as early as Tuesday, so long as he's guaranteed a vote on a full repeal. He made clear he still doesn't back the GOP's leadership replacement legislation.

"If they want my vote, they have to at least agree that we will have a vote on clean repeal," he said. He said that as long as that proposal gets "equal billing" with other alternatives on the first day of debate, he'll help let the leaders bring their bill to the floor.

Sen. Bob Corker, a Tennessee Republican, on Thursday for the first time said he would support a repeal of the Affordable Care Act "after a reasonable transition period." It is a marked shift for a senator who has called for a clear replacement, and who successfully lobbied Republican leaders to keep the Affordable Care Act tax increases for the wealthy in their replacement plan.

Republican leaders, who have said they want to begin work on a tax overhaul rather than prolong the health debate, say they're determined to hold their vote next week, regardless of the outcome.

Sen. John Cornyn of Texas, the No. 2 Republican leader, told reporters Thursday that if the measure fails and McCain is absent, the legislation can be reconsidered when he returns.

"If we fail by one vote, we can come back to it when he is available," Cornyn said. "There is some benefit to going forward next week to see where we are, and that may be the outcome."

—With assistance from Anna Edney, Zachary Tracer, Terrence Dopp and Arit John. 

— Read GOP Health Bill's $13,000 Deductibles Would Be Illegal, CBO Says on ThinkAdvisor