What's inside the Senate Republican health care bill

7/17/2017, 6 a.m.
This story has been updated to reflect the changes made to the Senate health care bill, as of July 13.

— This story has been updated to reflect the changes made to the Senate health care bill, as of July 13.

Senate GOP lawmakers announced changes to their health care bill Thursday in hopes of securing more moderate and conservative votes.

The new bill includes several changes to the original, which was released in June. One of the most significant was the inclusion of an amendment by Texas Senator Ted Cruz, which would allow insurers offering Obamacare plans to also offer cheaper, bare-bones policies.

Overall, though, the Senate legislation largely mirrors the House bill, making sweeping changes to much of the nation's health care system. But it also keeps more of Obamacare's structure in place.

Like the House version, the bill would drastically cut back on federal support of Medicaid, which will likely force states to shrink their programs and people to lose coverage. However, the Senate bill would maintain much of Obamacare's subsidy structure to help people pay for individual coverage, but make it less generous, particularly for older enrollees.

As in the House bill, senators would repeal the mandates that require most Americans to obtain insurance and most employers to offer it. While it would keep Obamacare's taxes on the wealthy, it would eliminate them on insurers, medical device manufacturers and others.

But the Senate version also provides funds to stabilize the Obamacare market over the next few years, including allocating money for a key set of subsidies that insurers receive.

The Republican effort to repeal Obamacare has had a lot of critics, ranging from conservative lawmakers to moderate ones to insurers to the AARP. The Senate bill would lead to 22 million fewer people having coverage by 2026, according to the non-partisan Congressional Budget Office. And President Trump called the House version "mean."

Proponents of the bill say it would save the individual health market from collapse. The legislation would provide Americans more choice, greater control and lower costs, they argued.

But opponents said it could reverse the gains in coverage that have been made since the Affordable Care Act was enacted in 2010.

What the bill calls for

Allow insurers to sell skimpier, less expensive plans: The so-called Consumer Freedom amendment being pushed by Cruz would let insurers that offer Obamacare plans on the exchanges to also sell policies that are exempt from certain of the law's mandates. That could allow carriers to provide less comprehensive plans with lower premiums, which would likely attract younger and healthier Americans.

But that would leave the sicker, more expensive consumers in the Obamacare plans, causing their premiums to spike.

Offering Obamacare plans will also make insurers eligible for new federal funding aimed at helping them pay for high-cost enrollees.

Revamp Medicaid funding. Just as in the House bill, the Senate version would send the states a fixed amount of money per Medicaid enrollee, known as a per-capita cap.

States could also opt to receive federal Medicaid funding as a block grant. Under the latter, states would get a set amount of federal funding each year, regardless of how many participants are in the program. Block grants wouldn't apply to funding for the elderly, disabled or children.