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Senate GOP adds penalty for lapsed coverage to health care bill

28 June 2017

To succeed in gutting health coverage for millions of Americans, Senate Republican leaders need to get a series of lies accepted as truth.

With the bill opposed immediately by all Democrats and more than a a dozen Republicans either stating they are now a "no" or have reservations, the legislation would appear to have an uphill mountain to passage.

The original Senate bill, unveiled last week, required insurance companies to offer coverage to everyone, including people with pre-existing medical conditions. Obamacare used the individual mandate to level tax penalties on people who could afford insurance but did not buy it. Insurers need healthy customers who are affordable to cover to help pay the costs of people with medical conditions that are costly to treat.

Already five Republican senators have said they can not vote for their party's plan as it stands now, with four them saying it does not go far enough to curb provisions under the Obama law and one saying the cuts in healthcare payments for the poor go too far.

This first lie is important because it rationalizes the Republican claim that the bill has to be draconian because it can't pass without support from the party's most right-wing legislators.

All appear ready to negotiate changes before the expected vote ahead of the week-long congressional recess around the July 4th holiday celebrating the U.S.'s 18th century independence from England. But they won't, because the tax cuts are the thing that matters to them. Look no further than how laser eye surgery went from exotic to affordable during the years it was not covered by most insurance. Ron Johnson, an ardent Obamacare critic, who said he finds it hard to see how he can vote yes on the bill by this week. In Ohio, he said, the strategy is to mobilize constituents in an effort to sway Mr. Portman with a flood of calls and emails.

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McConnell drafted the plan behind closed doors after numerous meetings among GOP senators. Heller faces a competitive re-election race next year.

Medicaid is by far the largest program of federal grants to the states, and state officials are always trying to tweak the formula for distributing that money to their advantage.

Next would come a "vote-a-rama", which allows senators to introduce any number of amendments.

The Congressional Budget Office's initial review of the Senate's draft bill is expected to be released Monday.

Mr Johnson also on Monday published an op-ed in the New York Times arguing his case against the legislation. And on CNN's "State of the Union", Kellyanne Conway, counselor to the president, said Trump "is working the phones, he's having personal meetings, and he's engaging with leaders". "All they do is delay and complain.They own ObamaCare!" Lisa Murkowski, Maine's Susan Collins, and Nevada's Dean Heller had already mentioned some skepticism about the health bill (and the largely secretive process that went into crafting it) before its unveiling last Thursday, particularly over provisions that would fundamentally restructure the Medicaid program for low-income Americans on top of dismantling other Obamacare provisions.

Democrat Senator Bernie Sanders has criticised the proposed bill and said that lives were at stake if it passes.

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Senate Republicans are facing down an increasingly daunting challenge to secure the votes necessary to pass legislation to dramatically change President Barack Obama's signature health care law, and several senators said they would like more time to debate and tweak the plan as GOP leaders push for a vote this week.

"It's not going to get any easier", Senate Majority Whip John Cornyn, R-Texas, told reporters on the sidelines of a three-day seminar organized by billionaire industrialist Charles Koch in Colorado Springs.

It would also phase out extra federal money that law is providing to 31 states to expand Medicaid to additional low-income earners. The others are Ted Cruz of Texas, Rand Paul of Kentucky and Mike Lee of Utah. And it would put annual caps on overall Medicaid money the government until now has automatically paid states, whatever the costs.

Imagine you are negotiating with two creditors who say you owe them $1,000 and you insist you owe nothing.

Trump tells "Fox and Friends" that "we've a very good plan".

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