July 13 (UPI) -- The U.S. Senate released a revised healthcare plan Thursday that maintains some taxes on the wealthy but allows health insurers to offer skimpier plans.
Because all Democrats oppose replacing the Affordable Care Act, known as Obamacare, Republicans can only lose two of their 52 votes. But at least nine Senate Republicans -- including conservatives and moderates -- have publicly opposed the original version of the bill, according to CBS News.
The new bill includes a controversial amendment from conservative Sen. Ted Cruz of Texas that allows the sale of cheap, deregulated insurance plans as long as Obamacare-compliant plans are still sold. A conservative aide told Politico it is a "good step forward but there's a lot more work to do."
A leading health insurance lobbying group says the bare-bones plans would lead to higher premiums for sick people interested in buying less coverage than they need.
The bill also includes $70 billion more than the first draft of $112 billion for state-based health care initiatives to drive down premiums. This includes $45 billion for fighting drug addiction.
The legislation also allows people to pay for insurance with pre-tax money.
In addition, the proposal will give states new flexibility on Medicaid funding if a public health emergency takes place.
Retained would be two taxes on the wealthy under Obamacare: a 3.8 percent net investment tax and a 0.9 percent payroll tax that helps finance Medicare to individuals with incomes above $200,000 and married couples making more than $250,000. That would save them about $172 billion over the next decade.
Sen. Rand Paul of Kentucky said including the Cruz proposal would not be enough to get his support. He wants more of Obamacare to be thrown out.
"If you vote 'no' on this bill, it essentially is a vote for Obamacare because that's what we're going to be left with," Texas Sen. John Cornyn, the majority whip, said on Fox News on Thursday morning. "If Sen. Paul can show me 49 other votes for his bill, then I would be all for it. But, unfortunately, the practicality is we have to pass a bill."
Several moderates, including Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, are concerned that the bill would hurt people with pre-existing conditions and others who got coverage under Obamacare. They are worried about spending reductions to Medicaid for low-income families, people with disabilities and seniors.
On June 26, the Congressional Budget Office said 22 million more people will be uninsured by 2026 under the Senate's first attempt to replace the ACA, the Better Care Reconciliation Act. In the American Health Care Act approved by the U.S. House, the figure is 23 million.
The new bill was sent to the Congressional Budget Office for analysis and a score. The analysis for the rest of the draft is expected Monday.
Murkowski, one of the moderates opposed to the original bill, told CNN she was unhappy that reporters saw a summary distributed to lobbyists before she had seen the bill.
"I think that as a courtesy to those of us who are actually making the decisions that we would actually have an opportunity to see it first," she added.
On Tuesday, McConnell announced the annual August recess will be delayed three weeks to deal with healthcare, taxes, the budget and presidential nominations.
Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana are working on an alternative approach to replacing Obamacare. They want to send the extra taxes on the wealthy to the states to control.
Like the revised plan, their proposal would scrap the financial penalty for individuals who don't comply with the mandate to have insurance and for employers to provide affordable coverage.