Conservatives seek changes to Senate healthcare bill

Conservative senators seeking changes to the chamber’s ObamaCare repeal-and-replace legislation met Thursday with GOP leaders and the Senate parliamentarian.

Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah) are pushing for a change to the bill that would allow insurers to sell plans that do not comply with ObamaCare’s insurance regulations if they also sell plans that do meet those rules.

They say that change would help win their votes for the legislation, which they currently oppose.

But the proposal has drawn resistance from other Republicans who want to maintain ObamaCare’s protections for people with pre-existing conditions and worry that the change would allow plans to be sold without those protections.

{mosads}What to do about the proposed change is a major stumbling block as the GOP tries to get enough votes for their repeal bill to pass.

Another problem? It’s not clear that the change advocated by Cruz and Lee would meet the standards of Senate rules allowing the GOP to prevent Democrats from filibustering the legislation. Those rules are of crucial importance since Republicans don’t have the 60 votes needed to break a filibuster.

“The meeting we had this morning had to do with the technical issues regarding the parliamentarian, and so we’re trying to help figure it out because there’s a lot of support for what he’s trying to do,” Senate Majority Whip John Cornyn (R-Texas) told reporters Thursday, referring to Cruz’s proposal.

Aside from the issue of Senate rules, there are also serious policy objections to the conservative proposal from more moderate members of the conference, which flared up in the Senate lunch on Wednesday.

“It hasn’t been fleshed out yet, so I believe pre-existing conditions ought to be covered and we shouldn’t deny people coverage with pre-existing conditions, so that would have to be worked out,” Sen. Rob Portman (R-Ohio) said Thursday of Cruz’s proposal. “There are a lot of moving parts.”

Many Republican lawmakers are concerned that healthy people would flock to the cheaper plans without ObamaCare protections, while only sicker people would be left in the plans that remained under the ObamaCare regulations, driving up costs among that pool of people.

The ObamaCare regulations in question include preventing people from being charged more based on their health and requiring that insurance plans cover a certain range of health services.

Sen. John Thune (R-S.D.), the No. 3 Senate Republican, said Cruz’s change “could” be included, but “it has to be structured in a way that ensures that the pools aren’t adversely affected.”

Thune pointed to changes that Sen. Mike Rounds (R-S.D.) is proposing.

Rounds said he’s discussed the amendment with Cruz, adding that “it has potential.”

“I think he’s onto something and I think with some modifications he could be very successful,” said Rounds, a former insurance executive.

One option to avoid pricey plans for the sick is to essentially create ratios for how much consumers in each group can be charged, according to Rounds. That means there would be a ratio limiting how much more people could be charged in the sicker pool compared to those in the healthier pool.

For example, he said, if the least expensive plan in the new group was $100 a month, the most expensive plan in the other group could be $250.

This concept is nothing new in the insurance industry, he said, and was discussed “very, very briefly” in the closed-door Senate GOP lunch Thursday. He added, “Some other people have got some really good ideas of how to address it as well.”