24 June, 2017
McConnell stitched it together behind closed doors, potentially moving President Donald Trump and the GOP toward achieving perhaps their fondest goal - repealing former President Obama's 2010 statute, his proudest domestic legacy.
But the measure landed in rough seas ahead of a vote that Sen. But Senate Majority Leader Mitch McConnell, R-Ky., indicated he was open to discussion and seemed determined to muscle the measure through his chamber next week.
Nonetheless, Heller's announcement underscores the scant margin of error Republican leaders must deal with.
Sen. Joe Donnelly, D-Ind., criticized Republicans for coming up with the draft bill after weeks of secret discussions involving only a few GOP senators and then planning to rush it through the Senate without a single public hearing on the details.
And there are plenty of moderates who haven't weighed in yet.
"Assuming that 15 million fewer people would have coverage in 2026, we estimate that the coverage losses from the Senate bill would result in 18,100 additional deaths in 2026", the Center for American Progress explained, assuming coverage loss based on the previous Congressional Budget Office score. "The consumer will shop, and when the consumer shops, competition works", said the senator. For instance, states can now opt out of requiring insurance to cover things like maternity care. This is a budget gimmick to ensure that the bill complies with Senate rules that forbid the legislation from adding to the federal government's long-term debt.
The Senate bill would phase out extra money Obama's law provides to 31 states that agreed to expand coverage under the federal-state Medicaid program.
It would also cut spending and thus reduce the federal deficit.
"I don't believe that the president has specifically weighed in that it's right to cut Medicaid", Sanders said, adding that Trump will continue to negotiate with the Congress "until we get the best bill that we can".
Trump has spoken favorably about both the House-passed bill and the Senate version unveiled this week, though he declared several times as he ramped up his campaign for the presidency that he would not cut Medicaid.
Collins has taken a series of small but important steps that have helped guide the process in a positive direction, starting with her 2015 vote against an Obamacare repeal bill because it called for the defunding of Planned Parenthood.
"It's going to be very hard to get me to a yes", he said, noting that conservative Republican senators would likely be reluctant to add spending back to the measure.
Alaska Gov. Bill Walker, a Republican-turned-independent, said in a statement Thursday that he is still reviewing the Senate plan, but had some worries about how it might affect his vast and sparsely populated state, where health care costs are high.
States would have more flexibility in determining the essential health benefits that all insurance companies must provide, such as prescription drug coverage, preventive health screenings, and coverage of mental health services.
Paul, speaking only for himself, said the bill did not repeal enough of Obamacare, pointing to core elements of the GOP bill such as its tax credits and stabilization fund as "new entitlements".
Trump took an active role as the House of Representatives worked on its own healthcare bill, holding regular meetings with representatives at the White House as it made its way through numerous committees.
Of the four conservatives, Paul has always been seen as the least likely to end up voting for the bill.
However Obama, whose best-known domestic policy achievement stands to crumble, offered a scathing critique of the new bill just hours after its release.
Asked about the bill's impact on Medicaid insurance coverage for lower-income Iowans, Ernst said, "I wouldn't say they are losing it". The Senate parliamentarian will make that decision.
The legislation also provides more generous tax subsidies than the House Bill to help low-income people buy private insurance.
Former Arizona Gov. Jan Brewer, a Republican who surprised her party when she chose to expand Medicaid four years ago, is urging Congress to save the expansion, which has provided coverage to 400,000 Arizonans. Bernie Sanders, I-Vt., and MoveOn.org were planning weekend rallies in Pennsylvania, Ohio and West Virginia.
AP writer Regina Garcia Cano reported from Las Vegas.