Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana have revised their draft of the Senate Republican plan to repeal Obamacare. The draft includes new funding provisions and regulatory changes aimed at securing support from GOP senators who have opposed or expressed concerns with the bill. More changes aimed at undecided senators could come — but with three GOP senators now against the bill, the road to repeal is looking less likely.
The GOP Sweetheart Deals
There are six GOP senators being heavily courted who said they don't support or are undecided about the bill. Republicans need 50 votes to pass the plan and can’t afford to lose the support of three GOP senators. Three senators have now said they won’t support the bill, but they could change their minds.
Five 
they’re trying to flip
Sens. Rand Paul, John McCain and Susan Collins said they won't vote for the bill, but additional funding for Kentucky and Arizona was added over the weekend in the hopes of winning them over. Sen. Ted Cruz of Texas also doesn’t support the bill and indicated fellow conservative Mike Lee of Utah might also oppose it.
4% increase in funding for Kentucky
14% increase in funding for Arizona
No increased funding for Maine
No increased funding for Texas
No increased funding for Utah
No additional funding was allocated for Texas or Utah, but the revised bill does make it easier for states to eliminate Obamacare insurance regulations, which would allow health plans to offer catastrophic insurance policies, a provision Cruz and other conservative Republicans strongly support. No concessions were made for Maine, as securing Collins’s vote was thought unlikely.
One ? they’re trying to appease
Sen. Lisa Murkowski of Alaska voted against the GOP’s previous three attempts to repeal Obamacare and says she is still undecided. Murkowski is a pivotal vote to get the bill through Congress — a 3 percent federal funding boost for Alaska was included in the latest Graham-Cassidy draft.
3% increase in funding for Alaska
How Graham-Cassidy would alter federal funding
The bill would overhaul or eliminate major sections of the health care law, including its subsidized insurance coverage and Medicaid expansion. Instead, states would receive block grants, or a lump sum of money from the federal government, which they could use largely as they see fit.
But states would receive less funding
Avalere Health, a health consulting firm, released estimates of how federal funding would change if the bill became law. The analysis found federal funding to states would be reduced by $120 billion from 2020 to 2026. States that expanded Medicaid would be hardest hit, with California losing $78 billion in funding.
SOURCE: Estimated federal funding change from 2020 - 2026 (in billions)
But Republicans are up against a tight deadline. Their budget reconciliation bill, which allows them to overhaul Obamacare with a simple majority, expires on Sept. 30. The urgency of the deadline could work to Graham’s and Cassidy’s advantage, however, by spurring hesitant Republicans to seize what may be their last opportunity to deliver on their seven-year promise to repeal Obamacare.
What Graham-Cassidy would do to Obamacare
| Medicaid expansion |  eliminated |
| Cost-sharing subsidies | eliminated |
| Tax Credits | eliminated |
| Individual and employer mandate | eliminated |
| Traditional Medicaid |  changed |
| Taxes | changed |
| Essential health benefits | changed |
| Price restrictions on older Americans | changed |
| Health savings account | changed |
What would be eliminated from Obamacare
Medicaid expansion
States were encouraged to expand their Medicaid programs to include individuals and families earning up to 138 percent of the federal poverty level, with the federal government subsidizing at least 90 percent of costs for new beneficiaries. Thirty-one states and Washington, D.C., expanded their programs.
Federal funding for Medicaid expansion would be eliminated and reallocated in the form of a lump sum that states could spend however they chose. This funding would expire in 2027.
Cost-sharing subsidies
The law provided payments to insurers to cover out-of-pocket medical costs for low-income customers on Obamacare’s marketplaces.
Current subsidy payments would expire in 2020. States could use a portion of their block grant to fund cost-sharing subsidies, but funding decisions would be made on a state-by-state basis.
Tax Credits
The ACA provided tax credits based on income and cost of coverage to low- and middle-income Americans to help defray the cost of insurance premiums.
Federal tax credits would expire in 2020, but states might choose to use a portion of their block grants to fund them.
Individual and employer mandate
Companies with 50 or more employees were required to offer affordable health insurance and virtually all Americans were required to have health insurance or pay a fine.
Fines for both the individual and employer mandate would disappear.
What would be changed from Obamacare
Traditional Medicaid
There is no corresponding provision in the ACA.
Ends Medicaid as an open ended entitlement and turns it into a capped program. Medicaid funding for states will be per capita starting in 2020.
Taxes
The ACA established a number of taxes on the health care industry and the wealthy to help fund the law’s coverage expansion.
The medical device tax would be repealed but most other Obamacare taxes would remain untouched.
Essential health benefits
Insurers were required to provide coverage for 10 essential health benefits, including access to maternity care, prescription drugs and mental health services.
States would be allowed to apply for waivers that could change what qualifies as an essential health benefit. Waivers changing the status of what is — and isn’t — an essential health benefit could also affect people with pre-existing conditions and undermine prohibitions on annual and lifetime limits for insurance coverage.
Price restrictions on older Americans
Insurers were prohibited from selling policies that charged older Americans more than three times what they charged younger individuals.
The restriction is not eliminated but states could now apply for waivers that let insurers charge different premiums based on age.
Health savings account
In 2017, an individual could set aside $3,400 and a family $6,750 in a pretax health savings account (HSA).
Individuals and families would be eligible to contribute more to their HSAs. Plus, HSAs could be used to pay insurance premiums, which is not currently allowed.
