Could bare-bones health care plans save the Senate bill?

USA TODAY

WASHINGTON — As Senate Republicans scramble to get their health care bill back on track, a controversial proposal floated by a band of hard-line conservatives is gaining ground.

Sen. Ted Cruz walks outside the Senate chamber on Capitol Hill on June 22, 2017.

Sens. Ted Cruz of Texas and Mike Lee of Utah are pushing a provision that would allow insurance companies to offer health plans that don’t cover services that are mandatory for insurance plans under Obamacare, such as maternity care or substance abuse. The theory is if insurance plans cover less, they'll cost less. Cruz and Lee are part of a group of four conservatives who came out against an earlier version of the GOP bill, saying it did not do enough to repeal Obamacare.

In a nod to moderate Republicans, the Cruz-Lee proposal would also require insurance companies to offer plans that do cover all the minimum benefits required by the Affordable Care Act.

“There’s a lot of appeal to that idea," Sen. Pat Toomey, R-Pa., told reporters Thursday. "Anybody that likes Obamacare so much they’d have their Obamacare plan. And then they would also have the freedom to buy anything they like."

“I like it,” Sen. Lindsey Graham, R-S.C., told USA TODAY. “My hope is that people who are young and healthy will have an option that fits their needs. And when you get 45 with three kids you can buy a different plan. And when you get 62, you can buy a different plan. I like the idea of buying plans consistent with the needs of your life at the time.”

While the proposal would offer consumers more choices, it could also prompt healthy people to drop the more expensive regulated plans and opt for cheaper, bare-bones coverage. That would drive up the cost of more comprehensive plans that older and sicker Americans need.

“I think it could (be added to the bill). It has to be structured in a way that ensures that the pools aren’t adversely affected,” Sen. John Thune, R-S.D., told reporters. Thune, a member of GOP leadership, has a leading role in crafting the health care bill.

Sen. Mike Rounds, R-S.D., said he was working on a way to make that idea work, saying there needed to be a reasonable ratio of the costs of the two options. “Otherwise you’ll run everybody out of that plan that’s healthy and into the less expensive plans," he said. "And then you’d end up with the federal government subsidizing that (more costly) plan."

But not everyone thinks it’s a good idea.

Maine Sen. Susan Collins, one of the most moderate Senate Republicans, said she is worried about limited coverage and higher premiums.

Collins also such a proposal could hamper "the important consumer protection” under Obamacare that stops insurance companies from capping how much they’ll spend for a patient's health costs.

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Senate Majority Leader Mitch McConnell, R-Ky., was forced to scrap a planned vote on a draft health care bill earlier this week, after it became clear Republicans did not have enough votes for a procedural motion to open debate on the bill. Republicans can lose just two votes and still see their legislation pass; so far, at least eight senators have expressed outright opposition to the bill and a handful of others have said they are skeptical.

The nonpartisan Congressional Budget Office released an analysis earlier this week that found the current draft bill would lead to 22 million fewer people having health coverage by 2026 than under current law.

The CBO report did find that the Republican health care plan would also reduce the federal deficit by $321 billion over the next decade. Some Republicans are saying some of that savings could be used to fund programs that would gain support from wary lawmakers.

For example, senators are discussing adding extra money to help combat opioid addiction to help bring Sens. Rob Portman, R-Ohio, and Shelley Moore Capito, R-W.Va., onboard. Both Portman and Capito come from states ravaged by addiction and have said the bill's reduction in Medicaid spending will hurt their constituents who use the program to get help.

An analysis by the CBO released Thursday found that Medicaid spending would be 26% lower in 2026 than it would be if Obamacare was left in place. That number would increase to a 35% reduction in spending by 2036.

“I do think the opioid fund is progress … It’s a step in the right direction,” Portman told reporters Thursday.

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