KHN Morning Briefing

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With Clock Ticking, Senators Tweak Health Plan To Shift Money To Reluctant Senators’ States

The changes would send money to Alaska and Maine, homes of Republican Sens. Lisa Murkowski and Susan Collins. Both women will be crucial if the Graham-Cassidy replacement bill is brought to the floor for a vote.

The New York Times: Senators Revise Health Bill In Last-Ditch Effort To Win Votes
With time running short, the authors of the latest plan to repeal and replace the Affordable Care Act shifted money in the bill to Alaska and Maine, which are represented by Republican senators who appear reluctant to support it. The revised version of the bill, written by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, would provide extra money for an unnamed “high-spending low-density state,” a last-minute change seemingly aimed at Alaska and its holdout Republican senator, Lisa Murkowski, who has yet to say how she will vote. It would also send money toward Maine, whose Republican senator, Susan Collins, had said earlier on Sunday that she would almost certainly vote no. (Pear and Kaplan, 9/24)

The Washington Post: A Closer Look At How The Revised Health Bill Would Benefit Key Senators’ States
The revised Republican health-care bill that senators plan to unveil Monday would partly even out wide gaps between states that would win and lose financially, providing more generous funding to states of some reluctant GOP lawmakers, but would give states less freedom to unwind federal health insurance rules. The new version of the Cassidy-Graham legislation eliminates what had been one of the measure’s most controversial features, which would have enabled states to get federal permission to let insurers charge higher prices to customers with preexisting medical conditions. In addition, states now would not be able to allow health plans to impose annual or lifetime limits on coverage, as the original bill would have done. (Goldstein and Eilperin, 9/25)

The Washington Post: New Version Of Health-Care Bill Will Help Alaska And Maine — Home Of Two Holdout Senators
The plan was distributed among Republicans late Sunday, with party leaders just one “no” vote away from defeat and as Republican senators from across the political spectrum were distancing themselves from the prior draft. Aides to Murkowski and Collins did not immediately comment late Sunday. Some Republicans close to the process have long counted Collins as an eventual “no,” predicting that little could be done to the bill to change her mind. On Sunday night, some were once again privately pessimistic the changes would convince her to vote yes. (Sullivan, Cunningham and Phillip, 9/24)

Politico: Graham, Cassidy Revise Obamacare Repeal Bill, Appealing To Holdouts
Under the revised text, the bill's authors now project increases in federal funding for Arizona (14 percent), Kentucky (4 percent) and Alaska (3 percent), which would have seen declines under the previous version, according to a leaked analysis from Trump's health department. In particular, Murkowski's home state would uniquely benefit from Sec. 129, which allows the state with the highest separate poverty guideline — Alaska — to receive a 25 percent hike in federal matching funds for Medicaid. (Pradhan and Diamond, 9/24)

The Wall Street Journal: GOP Health Push Hits More Snags
The bill by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina would set “block grants” of federal funding for each state to use for health care, including the Medicaid program for the poor. The revised text of the bill gives states broad authority to make changes to coverage mandated under the ACA, and they no longer must seek a waiver to roll back some of those requirements, which was in the earlier text of the bill, health analysts reviewing the new bill said. (Radnofsky and Peterson, 9/24)

The Hill: GOP Changes Graham-Cassidy Bill To Win Over Wary Senators 
“Despite an attempt to appear to add money for a select few states, this bill is just as bad for those states and the rest of the states because it still contains a massive cut to Medicaid, and would throw our health insurance system into chaos while raising premiums," Senate Democratic Leader Chuck Schumer (N.Y.) said in a statement. "It still takes away protections for those with preexisting conditions and further weakens consumer protections." (Sullivan, 9/24)

Los Angeles Times: Senate Republicans Unsure What Their Healthcare Bill Would Do, Even As They Push Ahead On It
With a vote expected as soon as Wednesday, according to the White House, and backers still talking about potentially major changes, the legislation will get its first and only congressional hearing Monday afternoon. The independent Congressional Budget Office, which lawmakers rely on to assess major legislation, already has said it won’t have time to analyze the bill’s effect on health coverage and insurance premiums. “This is like legislating blind,” said University of North Carolina political scientist Jonathan Oberlander, who has written extensively on the history of major healthcare legislation.“It is really hard to find an example of something where Congress was this reckless.” (Levey, 9/25)

Bloomberg: GOP Revises Obamacare Repeal With Bill Headed To Likely Defeat
If Republicans can’t get the votes -- or decide to scrap this bill altogether -- it would mark another reminder of the party’s inability to deliver on seven years of promises to repeal the 2010 law. The GOP could still try to resurrect a proposal later in the year, but the repeal effort’s collapse would seed doubts about the party’s ability to deliver any significant legislative victories. (Litvan, Tracer and Dennis, 9/25)

The Hill: Republicans Struggle To Keep ObamaCare Repeal Alive
"It’s not dead,” Marc Short, the White House director of legislative affairs, told “Fox News Sunday." "Here we are, just days away from a final vote and we’ve trying to win over the support of the last couple senators to get there." Short added that he anticipated a vote on the healthcare legislation to come up on Wednesday. Senate Majority Leader Mitch McConnell (R-Ky.) hasn't formally scheduled a vote but said last week that he "intends" to bring up ObamaCare repeal. (Carney, 9/24)

CQ: Byrd Rule Issues Could Dampen Repeal Efforts
Congress has just a few days to act on the Republican health care repeal bill through the shortcut budget reconciliation process, but the bill’s abortion restrictions could create problems under those rules. The draft bill from Sens. Lindsey Graham, R-S.C.; Bill Cassidy, R- La.; Dean Heller, R-Nev.; and Ron Johnson, R-Wis., retains several of the anti-abortion provisions from previous efforts to repeal the 2010 health care law. Those include language defunding Planned Parenthood for one year and banning individuals from using tax credits to buy insurance that covers abortion. Both provisions were both deemed violations by the parliamentarian in July. (Raman, 9/22)

The Hill: Graham: Budget Resolution Must Keep ObamaCare Repeal Debate Alive 
Sen. Lindsey Graham (R-S.C.) said on Sunday he would not vote for a budget resolution that did not allow the health care debate to continue. "We're not going to vote for a budget resolution that doesn't allow the health care debate to continue," Graham, who sits on the Senate Budget Committee, said on ABC's "This Week." (Carney and Manchester, 9/24)

The Hill: Graham Pushes Back On Working With Democrats On Health Care Reform
Sen. Lindsey Graham (R-S.C.) on Sunday pushed back on the possibility of working with Democrats on heath care reform, saying ObamaCare is a placeholder for "BernieCare" for Democrats. “I’ve come to conclude that ObamaCare is a placeholder for BernieCare in the Democratic world," Graham said on ABC's "This Week," adding that there is no bipartisan process at this point for moving forward on health care reform. (Manchester, 9/24)

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