(Rob Portman at The Wall Street Journal's CEO Council meeting in Washington.Thomson Reuters)
Senate Republicans late Tuesday were unable to pass the latest version of their plan to overhaul the US healthcare system, paving the way for what appears to be a more modest attempt at undoing the Affordable Care Act, the healthcare law better known as Obamacare.
An amended version of the Better Care Reconciliation Act failed 57-43, as nine Republican senators joined all Democrats in opposing it. It needed 60 votes to advance.
The latest version of the BCRA — which Democratic Sen. Ron Wyden of Oregon nicknamed "Trumpcare 3.0" — reinserted an amendment that experts argued could have had a big impact on people with preexisting medical conditions.
The revised version of the bill proposed that more funds would be set aside for the opioid crisis and that people would be able to pay for premiums using a health savings account. It also proposed deep cuts to Medicaid.
Here's the quick summary of what was in the new bill:
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The Consumer Freedom Amendment, proposed by Sen. Ted Cruz of Texas.
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The Portman Amendment, which provided $100 billion in funding designed to stabilize states.
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It also changed a section that would have made out-of-pocket maximums technically higher than what's allowed by the law.
The Portman Amendment
The amendment from Sen. Rob Portman of Ohio called for $100 billion in new funding designed to stabilize states. It would accomplish this by increasing funding to $30.2 billion a year from $19.2 billion. Portman has expressed concerns that the BCRA doesn’t provide enough funding for Medicaid tackling the opioid crisis.
The Consumer Freedom Amendment
Unlike the version of the Senate bill scored last week by the nonpartisan Congressional Budget Office, this bill included an amendment from Cruz that critics said could make plans with adequate coverage unaffordable to those who have certain medical conditions.
The amendment would have allowed plans to exist that don't comply with two regulations set up under Obamacare: community rating and essential health benefits. Under the Cruz amendment, titled the Consumer Freedom Amendment, health plans that do adhere to the regulations would receive $70 billion in funding to offset the higher premiums that would result relative to the plans that don't cover the regulations. Whether that funding would be enough to make the plans affordable was uncertain.
On July 15, the Department of Health and Human Services released a report on the Consumer Freedom Amendment, taking a look at what it would do in the context of the ACA — not the BCRA bill. The report concluded that Cruz's amendment would lower premiums in both the traditional ACA plans and the less regulated ones.