How the new health care bill sweetens the deal for Republican holdouts

July 13, 2017, 11:40am

The new version of the Senate bill to replace Obamacare is chock full of handouts to secure the votes of reluctant Republicans.

When the initial vote on the legislation was tabled in late June, the thinking was that Senate Majority Leader Mitch McConnell still had about $188 billion in savings he could dip into in order to assuage the concerns of Republicans who felt the bill was either too cruel or not business-friendly enough.

The bones of the bill are still largely the same, according to a summary of the legislation, and there are still a number of mostly moderate Republican senators on the fence about the bill. For instance, the bill would still change Medicaid from an entitlement with no budget limitation to specific payments made to states. This is partly why people like Nevada Sen. Dean Heller, who was the first Republican to come out hard against the bill, said on Wednesday that he did not support the revised version.

But that’s old news. Here are the carrots that McConnell and the bill’s authors have put in to get more Republicans behind the legislation:

The opioid crisis gets tens of billions in dedicated funding

Ohio’s Rob Portman and West Virginia’s Shelley Moore Capito, whose states are being ravaged by the opioid and prescription drug epidemic, successfully got $45 billion in extra money for “treatment and recovery” options related to the national crisis. Under Obamacare, coverage for addiction treatment was made mandatory for insurers.

A Zika fund for swampland senators

“Public health emergencies” would not count toward states’ fixed Medicaid payments from the federal government, which was a key concern of Florida’s Marco Rubio, and could entice Louisiana’s Bill Cassidy, who would have to contend with another wave of Zika cases in their swampy states.

Ditching the investment tax cut

The previous bill included a tax cut son investment income, a Medicare tax, and other taxes that largely affect the wealthy. Deciding that perhaps cutting taxes on the rich while gutting medical assistance programs for the poor might be a bad look, Republicans have now scrapped that provision — something aimed at winning over more moderate members like Maine’s Susan Collins and Alaska’s Lisa Murkowski.

Tea Party favors

The new bill would, for the first time, subsidize the purchase of low-premium, high-deductible “catastrophic” health insurance plans, and allow people to set up health savings accounts with tax benefits to pay for health care costs. These are policy prescriptions favored by conservative think tank types, as well as Tea Party hardliners such as Ted Cruz and Utah’s Mike Lee.

Alex Thompson contributed to this report.