What we know:
It would eliminate Obamacares subsidy program and replace it with a different structure to help low-income people afford insurance. But Republicans are still trying to craft an alternative that would prohibit coverage of abortion without violating the strict reconciliation rules enabling them to pass the bill without a Democratic filibuster.
Republicans plan to offer states a waiver to opt out of major parts of Obamacare and create their own health care rules. The bill would alter a waiver that was part of Obamacare known as 1332 waivers and make them easier to obtain.
States would be able to waive Obamacares insurance requirements, including one requiring states to have an exchange, as well as rules for what benefits insurers must cover, what qualifies as a health plan, and the actuarial value of the plans.
It is not expected to allow states to waive Obamacare requirements that insurers accept everyone and charge the same rates, with few exceptions. The House waived the latter requirement, triggering a storm of criticism that it was abandoning people with pre-existing conditions. Keeping the Obamacare requirements would mark a victory for GOP moderates but prompt pushback from conservatives, who want the waiver to be broader and allow more exclusions.
The bill is expected to roll back Obamacares enhanced Medicaid spending which is likely to force governors to cut coverage over four years beginning in 2020. Earlier Senate conversations called for a three-year phase out. This is a coup for moderates who worry about cutting off coverage abruptly. States would still be allowed to expand Medicaid through 2019.
The bill is also expected to dramatically reshape Medicaid. Instead of an open-ended entitlement, states would get a set amount of money per person. In a win for conservatives, the Senate is expected to cut the program as aggressively as the House did until 2025 or 2026 and then make payments that grow in line with inflation. States are expected to have significant new flexibility for how they run their Medicaid programs. Republicans are likely to include a carve-out for certain children with complex medical needs, according to several sources.
The bill is expected to repeal Obamacares taxes, but how soon that is done is fluid because it would likely depend on how much tax revenue is needed to cover other costs associated with the GOP plan.
Cost-sharing subsidies to help pay insurers for low-income individuals' out-of-pocket expenses are expected to be continued through the annual appropriations process, requiring a 60-vote threshold.
Lawmakers are weighing moving a House-approved fund that provided $115 billion for states to stabilize their insurance markets to the Children's Health Insurance Program. Doing so would preserve restrictions on federal funding of abortion.
