Skip to Content

Here’s Everything That’s Different in the New GOP Health Care Bill

Senate Republican leaders on Thursday unveiled a reworked version of their health care bill, following party infighting that threatened to torpedo their effort to replace the Affordable Care Act, also known as Obamacare.

After Senate Majority Leader Mitch McConnell unveiled his first health care bill on June 22, it was almost immediately clear it would not pass without compromises between the Republican Party’s various factions. Conservative Republicans, like Sens. Rand Paul, Ted Cruz, and Mike Lee, were unhappy that the first bill did not fully repeal the ACA. More moderate lawmakers, like Sens. Susan Collins and Lisa Murkowski, opposed the bill’s proposed Medicaid reductions.

That left Sen. McConnell in the tough position of having to craft a compromise bill that would satisfy both sides. Whether his latest effort will succeed at that task remains to be seen. Collins, for instance, has already come out against the new bill.

For now, here are the major differences (and similarities) between the latest bill and the original effort.

What’s Different:

“The Cruz Amendment” — More Options for Cheaper Plans

In a clear effort to woo the conservative wing of the Republican Party, the new bill includes an amendment similar to one proposed by Sen. Ted Cruz that would allow anyone to purchase a cheaper health insurance plan with fewer offerings, even if they want to use federal tax credits to do so.

Currently, insurance plans need to meet minimum standards and cover essential benefits as part of their plans under the Affordable Care Act. The new plan would include three primary care visits per year and would limit out-of-pocket costs.

More Money for Out-of-Pocket Expenses

The bill adds an additional $70 billion in federal funding to help pay for out-of-pocket costs, or costs that fall outside the realm of coverage. That’s on top of the original bill’s $112 billion, bringing the total funding to $182 billion. The new version would also allow people to use their health savings accounts to pay for premiums.

More Money For Opioid Funding

The new bill adds an additional $45 billion in funding for substance abuse recovery and treatment, on top of the original bill’s $2 billion. That may appease Sens. Rob Portman and Shelley Moore Capito, both of whom opposed the first bill in part because of their lack of funding to support recovering opioid addicts. Neither lawmaker immediately returned Fortune’s request for comment on the new legislation. Portman’s Communications Director said on Twitter that the Senator is reading the text and will review the analysis from the Congressional Budget Office before making any decisions.

What’s the Same:

Medicaid Reduction

The original bill aimed to phase out the state Medicaid expansion to be implemented under the ACA from 2020 through 2024. It would also have slowed the growth rate of federal spending for Medicaid. The new version of the bill retains both of these measures.

McConnell’s new bill makes some tweaks to Medicaid spending compared to first bill, but they are minor. For instance, it includes a provision allowing states to apply for a waiver to continue improving services for aging, blind, and disabled citizens.

Planned Parenthood Defunding

The new bill retains a provision that strips Planned Parenthood of federal funding for one year and prohibits people from using Medicaid services at Planned Parenthood clinics.

This provision was a sticking point with Sen. Collins, who said last month it makes “no sense” to eliminate federal funding for the organization. Sen. Murkowski, considered another swing vote, has also said she opposes the elimination of federal funding for Planned Parenthood.