Senate Republicans have started writing their bill to repeal and replace the Affordable Care Act and are expected to continue work on a draft this weekend—though some appear uncertain that a final deal will be reached.
Senate Budget Committee Chair Mike Enzi (R-Wyo.) said the GOP has made enough policy decisions "in some areas" to begin the writing process. He said he is working on the bill's language with Senate GOP leaders and Senate Committee on Health, Education, Labor and Pensions Chair Lamar Alexander (R-Tenn.) and Senate Finance Committee Chair Orrin Hatch (R-Utah).
Enzi declined to give a timeline for the legislation, but said he "hope(s)" to have a bill after the end of the one-week Memorial Day recess, which began Thursday.
Senators still face challenges
Republican senators have yet to reach agreements on key policy issues, including federal Medicaid funding, whether to allow states to opt out of certain ACA regulations, and how to structure tax credits that would replace the ACA's federal subsidies, the Washington Post's "PowerPost" reports.
Senators are working to find middle ground between conservatives, who feel the House-approved American Health Care Act does not go far enough to repeal the ACA, and moderates, who say the House's changes would result in fewer benefits and could put individuals with pre-existing conditions at risk.
Another concern, according to Politico, is the American Health Care Act's latest Congressional Budget Office score, which projected 23 million fewer people will have insurance under the bill.
Sen. Dean Heller (R-Nev.) said the CBO score "makes everything harder." And one Republican senator who remained unnamed told Politico, "If I had to bet my house, I'd bet we don't get it done."
If Senate Republicans are able to coalesce around a bill and secure the 51 votes needed to pass it via reconciliation, they still would need to wait for another CBO score and get the OK from the Senate parliamentarian before they could hold a vote. And from there, the House would need to sign off on any changes.
According to "PowerPost," that process could take a minimum of several weeks, meaning it could be difficult for the Senate to vote on their bill before they adjourn for their August recess (Sullivan et al., "PowerPost," Washington Post, 5/26; Everett/Haberkorn, Politico, 5/25; Haberkorn, Politico, 5/25).
What does health care reform beyond the ACA look like? Join our new webconference series
Couldn't attend our 2016-2017 Health Care Advisory Board National Meeting, need a refresher, or want to share our content with your team? Across this eight-part series, we'll recap the key insights and top case studies from our new research presentations, focusing in on how to position hospitals and health systems for long-term success amid political uncertainty.