As of 2017, 31 states and Washington, D.C. adopted the Medicaid expansion. Yet it still would force those states to figure out what to do about the millions of lower-income Americans who used it to gain health coverage.
The Senate's plan, like one passed by the House of Representatives, rolls back numerous provisions of Obamacare, including taking deep cuts from Medicaid program. The conclusion is that this plan would have an impact on thousands of CT residents, for some, increasing their health care costs and for others, ending their health care coverage.
Obama law: Raised taxes on upper-income people and health care companies to finance coverage expansion.
Shortly after the Senate bill was released on Thursday, the challenges that lie ahead in the Senate came into view.
Both the House's AHCA and the Senate's "Better Choice Reconciliation Act of 2017" (BCRA) are meant to be components of a much larger process called budget reconciliation.
Senate GOP bill: Stretches phase-out of Medicaid expansion financing. State government pays over $2 billion a year to cover Medicaid.
U.S. President Donald Trump acknowledged that a lack of support from four Senate Republicans leaves the party's healthcare overhaul on a "very, very narrow path" to win passage, but signaled a willingness to work with them to make changes. Income-based subsidies help with premiums and with out-of-pocket costs such as deductibles and copayments. It disregards women's reproductive health and other special health care needs. But more important, like Collins, Heller set out conditions for getting his support that it's unlikely Mitch McConnell could meet without blowing up his entire coalition.
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Critics say most of the benefits of the tax breaks will go to affluent Americans. Beginning in 2020, under the Republican proposals, the feds for the first time would put a cap on how much funding they'd offer states on a per enrollee basis (with the option for states to instead take a lump sum payment, known as a block grant).
In Montana, 20 percent of residents didn't have medical insurance in 2013. Several of them felt his lash during last year's campaign or, like Portman and Susan Collins of ME, have kept their distance from Trump.
"None of these will be easy choices to make, but states will be forced to make them", Rudowitz said.
The White House said it is hopeful a final bill will be finished before lawmakers leave Washington later this summer.
Brewer said cutting Medicaid eventually will cause private insurance premiums to rise because people losing coverage will seek treatment in hospital emergency rooms.
"And so if you say the federal government's going to pay for it, it's very easy, because the federal government has a printing press, you know, down at the Federal Reserve - they'll just crank out, we'll add to our debt".
A spokesman for Arizona's current governor, Republican Doug Ducey, said the governor was studying the GOP bill.
"I am deeply concerned about the potential effects of a one-size-fits-all approach", he said. Contributing were AP reporters Becky Bohrer in Juneau, Alaska; Bobby Caina Calvan in Helena, Montana; Bob Christie in Phoenix; Kristena Hansen in Salem, Oregon; Marc Levy in Harrisburg, Pennsylvania; Alison Noon in Carson City, Nevada; Bob Salsberg in Boston; Sophia Tareen in Springfield, Illinois; and Kristen Wyatt in Denver.
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