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Senate Republicans Promise Health Bill on Thursday 

click to enlarge A car carrying Sen. Pat Toomey, who helped draft the Republican health care bill, passes demonstrators in Harrisburg, Pa., July 5, 2017. With Republican health care legislation hanging in the balance, activists feeling betrayed by leaders they helped elect have turned their focus to other issues. - NOAH SCIALOM/THE NEW YORK TIMES
  • Noah Scialom/The New York Times
  • A car carrying Sen. Pat Toomey, who helped draft the Republican health care bill, passes demonstrators in Harrisburg, Pa., July 5, 2017. With Republican health care legislation hanging in the balance, activists feeling betrayed by leaders they helped elect have turned their focus to other issues.

By THOMAS KAPLAN and ROBERT PEAR
© 2017 New York Times News Service

WASHINGTON — Senate Republican leaders, facing their restive colleagues after the Fourth of July recess, vowed on Tuesday to press ahead with their effort to repeal and replace the Affordable Care Act, with a new version of their bill Thursday and a vote next week — regardless of the deep divisions in the party.

The weeklong recess only seemed to generate more doubts about the Senate bill, but Sen. Mitch McConnell, R-Ky., the majority leader, signaled that he was not ready to give up on his party’s 7-year-old promise to gut President Barack Obama’s signature domestic achievement. Accusing Democrats of obstructionism, he announced he would delay the Senate’s scheduled August recess by two weeks so that senators could keep working.

But pessimism among Republicans still pervaded the Capitol on Tuesday after a week in their home states that did little to resolve the disputes that thwarted a vote last month.

Sen. Charles E. Grassley, R-Iowa, said Tuesday that he was “very pessimistic” about passing a bill, while Sen. John McCain, R-Ariz., said it was “very possible, very probable” that the Senate bill was dead.

Changes are coming, but none that are likely to radically alter the estimate by the Congressional Budget Office that 22 million fewer people would have health insurance in 2026 under the Senate health care bill than under the Affordable Care Act. A new estimate is expected from the budget office early next week.

The revised bill is expected to include a $45 billion fund to help combat the opioid epidemic, as well as a provision allowing consumers to use health savings accounts to pay for premiums.

Senate Republicans are also likely to keep a pair of taxes imposed by the Affordable Care Act on people with high incomes. Keeping those taxes would undercut a major argument against the bill by Democrats, who have branded it as a tax cut for the rich disguised as a health bill.

But the largest changes to the health care system are likely to remain in the bill.

About two-thirds of the increase in the projected number of uninsured Americans would result from deep cuts in expected Medicaid spending, the budget office said.


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