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Death Knell Sounds For Senate's GOP Health Care Bill

DAVID GREENE, HOST:

The latest effort by Senate Republicans to repeal and replace the Affordable Care Act is done. Two more senators declared they would vote against the bill yesterday. That left Majority Leader Mitch McConnell without the support he needed from fellow Republicans to pass the legislation. Let's talk through what happened here with NPR's Alison Kodjak. Good morning, Alison.

ALISON KODJAK, BYLINE: Hi, David.

GREENE: So we had two senators last night essentially killing the bill. Why'd they make that decision?

KODJAK: Yeah, so this was Senator Mike Lee from Utah and Jerry Moran from Kansas. They're both conservative senators. And they said that the bill doesn't go far enough. It doesn't repeal enough of the Obamacare taxes and it doesn't lower insurance premiums enough. And it really sort of showed the major divide. They want a bolder repeal, more of Obamacare taken away.

And this bill left a lot of it in place as an effort to protect people who have insurance through Obamacare.

GREENE: But wasn't the leadership seeing some positive signs, hoping that Senator Lee of Utah was working with him? He proposed an amendment that was included in the draft for Mitch McConnell. So why did he ultimately jump ship?

KODJAK: You know, it's not clear exactly why. He and Ted Cruz, the senator from Texas, did propose this amendment that would allow insurance companies to sell these sort of stripped-down policies that don't offer a lot of coverage but don't cost a lot of money. So last weekend, the insurance industry wrote a really, really strongly worded letter saying basically that that proposal would, quote, "make coverage unaffordable for millions of people."

So it was going to have the opposite effect of what he was going for, which was to lower premiums. So he didn't say that was why, but that could be a reason.

GREENE: OK, so we have two senators who felt like this bill did not go far enough. But that was only one of Mitch McConnell's problems.

KODJAK: (Laughter) It sure was. There were a lot of things that people couldn't agree on in this bill. The biggest one was Medicaid. That was a, like, elephant in the middle of the nation. This bill, like the one passed in the House, had a huge Medicaid rollback. It ended up kicking millions of people off the program over a few years. And then it went even further and cut the funding for Medicaid over the long-term.

So most states thought they would have to offer fewer benefits, maybe pay hospitals less or make it harder for people to qualify. And that was really worrisome to the more moderate people who didn't want to see their low-income citizens losing their health care coverage.

GREENE: OK, NPR's Alison Kodjak, who's been covering every twist and turn in this health care debate. Alison, thanks a lot.

KODJAK: Thank you, David. Transcript provided by NPR, Copyright NPR.

Alison Fitzgerald Kodjak is a health policy correspondent on NPR's Science Desk.