WASHINGTON -- In a high-stakes bid for conservative support, Senate Majority Leader Mitch McConnell has agreed to demands from Republican Sen. Ted Cruz of Texas to allow insurers to sell low-cost, skimpier plans as part of a new but still-reeling health care bill being released Thursday, two GOP aides said.
However, including that provision seems likely to alienate moderates and perhaps other conservatives. Sen. Mike Lee of Utah, who'd partnered with Cruz, tweeted that the version they crafted wasn't in the bill, adding, "Something based on it has, but I have not seen it or agreed to it."
The manoeuvring by McConnell, R-Ky., came as party leaders laboured to prevent losing a showdown vote next week on their plan for repealing much of President Barack Obama's health care law, a vote in which they have no margin for error. Since Democrats uniformly oppose the effort, McConnell needs the votes of 50 of the 52 GOP senators to prevail, and two already seem certain to vote "no" -- conservative Sen. Rand Paul of Kentucky and moderate Sen. Susan Collins of Maine.
McConnell also faced pressure from U.S. President Donald Trump, who has warned he will be "very angry" if the majority leader doesn't deliver.
Details on the Cruz amendment were not clear, but its inclusion was confirmed by two Senate GOP aides who weren't authorized to be quoted speaking about the legislation before its release and spoke on condition of anonymity.
His original proposal would let insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by Obama's 2010 statute. Moderate Republicans have objected to the idea, arguing it would make policies excessively costly for people with serious illnesses because healthy people would flock to the cheaper coverage.
One aide said McConnell's revised bill would also allow people who use tax-favoured health savings accounts to pay health insurance premiums, another favourite proposal of conservatives.
President Donald Trump heaped additional pressure on party leaders Wednesday. In an interview with the Christian Broadcasting Network's "The 700 Club," he said he will be "very angry" if the Senate fails to pass the health care measure and said McConnell must "pull it off."
McConnell's new bill was expected to offer only modest departures from the original version, which he yanked off the Senate floor two weeks ago to avoid certain defeat at the hands of a broad range of unhappy Republicans.
The reworked measure's key elements remain easing Obama's requirements that insurers cover specified services like hospital care and cutting the Medicaid health care program for the poor, disabled and nursing home patients. Obama's penalties on people who don't buy coverage would be eliminated and federal health care subsidies would be less generous.
The new package would keep most of the original bill's Medicaid reductions and eliminate tax increases Obama's statute imposes on the health care industry. But it would retain Obama tax boosts on upper-income people, and use the revenue to help some lower earners afford coverage, provide $45 billion to help states combat drug abuse and give extra money to some hospitals in states that didn't use Obama's law to expand Medicaid.
Paul told reporters the revised measure has nothing "remotely resembling repeal."
Collins has long complained the measure will toss millions off coverage. Spokeswoman Annie Clarke said Collins would vote no next week "if the Medicaid cuts remain the same" as those that have been discussed.
Besides Paul and Collins, other Republican senators have also been noncommittal on whether they will back McConnell's bill next week, including Tim Scott of South Carolina and Rob Portman of Ohio.
"If there are not meaningful protections for consumer freedom that will significantly lower premiums then the bill will not have the votes to go forward," Cruz told reporters Wednesday.
Lee has said he wants their proposal in the bill, or something else relaxing Obama's coverage requirements, for him to support it.
Their proposal endured a blow when the insurance industry's largest trade group, America's Health Insurance Plans, said it would lead to "unstable health insurance markets" and said people with serious pre-existing medical conditions could "lose access" to comprehensive or reasonably priced coverage.
Scott said he was still trying to determine if the legislation would help families and consumers with pre-existing medical problems. has fought to ease the bill's Medicaid reductions, has also yet to commit to back the measure next week.
McConnell withdrew an initial package two weeks ago in the face of Republican discord that would have spelled certain defeat.
AP reporters Erica Werner, Jill Colvin, Matthew Daly and Ricardo Alonso-Zaldivar contributed to this report
