Alex Brandon / AP
Majority Leader Mitch McConnell is trying to wrangle members from opposite ends of the Republican caucus together to support some revised version of the Senate health care bill, offering both moderates and conservatives new policies to shore up support for the bill.
On the table: More funding to fight the opioid epidemic, revised health savings account policies, potentially getting rid of the repeal of the net investment tax on the wealthy.
Off the table: Undermining pre-existing conditions protections, which could happen indirectly under a plan Sen. Ted Cruz is pushing,
What we're hearing:
- There's a push to include as much as $45 billion in funding for the opioid crisis, up from $2 billion under last week's bill. This would be a win for moderates like Sens. Rob Portman and Shelley Moore Capito.
- There's also an effort to add more funding to the state stabilization fund, and to make the funding available sooner to states.
- There will likely be a provision allowing health savings accounts to be used for premiums. This is a win for conservatives, and could help middle-class people afford their premiums. One aide said the price tag could be around $60 billion, as it would result in lost tax revenue. (HSA contributions aren't taxed.)
- There's chatter about removing a repeal of the Affordable Care Act's 3.8 percent investment tax, which benefits wealthy people. This would free up some extra funding to help coverage levels, and would also help combat the narrative that the bill cuts coverage for the poor to give money to the wealthy.
What's becoming a big problem: Cruz is pushing to allow insurers offering ACA-compliant plans to also offer non-compliant plans, which wouldn't be required to meet the ACA's pre-existing conditions protections or other insurance regulations. Cruz wants to include that in the revised bill to cut the cost of individual insurance, and says sick people could still get subsidies that would protect them from premium hikes.
But that's off the table, senior GOP aides say, because most Republican senators have already decided they don't want to undermine the ACA's pre-existing condition protections in any way.