A new healthcare proposal is gathering steam in the Senate. It’s dubbed the “skinny” bill. It would not repeal Obamacare, but it would end requirements that many employers provide health coverage and a mandate that most people without health coverage must pay a penalty.

I do not have a definition of “many” and there are a lot of other unknowns in the bill. Senator Rand Paul said he could support it and Trump is Tweeting about the “big day”.

Yet, it’s unclear if the Republicans have the votes, and we still do not know what’s actually in the bill. Shhh. It’s a secret, but supposedly we find out later today. Well, maybe.

The Wall Street Journal reports Senate Poised for First Vote in Obamacare Repeal Effort.

Nearly a month after Senate Majority Leader Mitch McConnell halted a vote on a GOP plan to dismantle and replace much of the Affordable Care Act, the Kentucky Republican said the chamber would vote Tuesday on whether to bring the bill up for consideration. Republican leaders delayed the vote earlier when it became clear that GOP defections would prevent the Senate from beginning debate on it through a so-called motion to proceed.

A sustained campaign from Mr. McConnell and, in the last week, President Donald Trump, will be tested for its effectiveness in winning over enough GOP votes to at least clear the first procedural hurdle. The next step will be to see if there are 50 votes to pass any legislation.

This scaled-down measure would repeal ACA requirements that many employers provide health coverage and a mandate that most people without health coverage must pay a penalty, Senate GOP aides said Tuesday. The bill would also repeal a medical device tax, they said. If that passes, then it would set up negotiations to secure a compromise between the “skinny repeal” plan passed by the Senate and the broader bill passed by the House in May.

The proposal that waters down a more robust repeal of the current health law has been closely guarded by Mr. McConnell, but will be discussed today at a lunch with GOP Senate lawmakers.

“We are potentially one or two days away from a vote on a bill that would reorganize one sixth of the American economy, impacting tens of millions of American lives—and no one knows what it is!” Senate Minority Leader Chuck Schumer (D., N.Y.) said Monday. “It’s sort of like ‘Alice in Wonderland’ around here.”

As of Tuesday morning, only one Republican senator, Susan Collins of Maine, was a firm opponent of beginning debate on the bill. Whether the bill advances Tuesday will depend on a handful of other GOP senators who remain undecided, including Mike Lee of Utah, Rob Portman of Ohio, Lisa Murkowski of Alaska, Rand Paul of Kentucky, Shelley Moore Capito of West Virginia, Dean Heller of Nevada and Ron Johnson of Wisconsin.

The Congressional Budget Office has estimated that such a plan would leave 32 million more people without insurance coverage by 2026.

Mr. Paul said he would vote to begin debate if the 2015 repeal bill comes to the floor first but not if the procedural vote leads to consideration of the Senate GOP bill.

“I really hate their bill,” Mr. Paul said Monday night of the Senate-drafted legislation. “Their bill is not repeal at all, and so I just don’t support their bill.”

The Republican health plan gets rid of the requirement that most people have health coverage or pay a penalty and ends the enhanced federal money to the 31 states that expanded Medicaid, a program for the low-income and disabled that has grown by about 16 million people since expansion provisions kicked in in 2014. It also imposes steep cuts to federal funding for the program.

The proposal provides tax credits similar to those provided under the ACA, but it expands eligibility and makes the credits smaller. Insurers could again sell cheaper health plans with fewer benefits than under the ACA, and states could obtain waivers enabling them to roll back the current health law’s regulation. Insurers could also charge older people more than they currently can under the law.

Paul is mistaken. The 2015 clean repeal bill would take 60 votes to pass. The trick is to come up with a bill that only requires 50 votes with vice president Pence breaking the tie.

Skinny Bill Problems

  1. A huge number of loose ends. We do not know what is in the bill.
  2. No incentives to reduce costs.
  3. No provisions for hospitals to turn people away who do not have insurance.
  4. Rising costs of insurance. Premiums are expected to rise 20% if this passes, but no one really knows since details are scant.

Many Republicans are still on the fence. The Skinny bill will pick up support from Rand Paul and I presume Ted Cruz, but will it cause any other defections?

As per the “Rule of Nothing”,  the best thing to do may be nothing.

Obamacare is too flawed to fix.

Mike “Mish” Shedlock