Nevada's Heller is fifth GOP senator to oppose health-care bill

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He tweeted Thursday night that he was "very supportive" of the measure. "Look forward to making it really special!"

Senate Republicans have little margin for error as they prepare for a vote this coming week on a bill to repeal and replace the Affordable Care Act. Trump wrote on Twitter on Thursday. Subsidies under the bill would help middle-income consumers buy insurance that pays 58 percent of the average patient's medical costs, down from 70 percent under Obamacare; it would also remove a different type of subsidy created to lower deductibles further for Americans earning less than around $30,000 a year.

Trump has spoken favorably about both the House-passed bill and the Senate version unveiled this week, though he declared several times as he ramped up his campaign for the presidency that he would not cut Medicaid. Make America great again?

One possibility is that McConnell is anxious that the provision runs afoul of the procedural rules allowing Republicans to pass the bill with a simple majority vote.

So why isn't the continuous-coverage provision already in the bill?

"The Senate draft health care bill is literally heartless", American Heart Association CEO Nancy Brown said.

"I can not support a piece of legislation that takes away insurance from tens of millions of Americans and hundreds of thousands of Nevadans", Heller said in a news conference held in his home state.

"Changes to the ACA must be made in the context of rational health policy". They've just wanted Congress to pass something. The House approved its version of the bill last month.

"Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor", the quartet explained. Trump was for it then too - giving Republicans an ultimatum to vote for it. "It's frustrating that instead of actually reviewing the legislative text some have chose to immediately oppose the bill before it was even introduced". But a defeat would be a bitter and damaging blow to Trump and his party.

For most of the last decade, moderate Republicans have sounded just like their conservative colleagues on Obamacare: The law was a disaster and had to be replaced.

The Senate bill maintains much of the structure of the House's but differs in key ways. It would permit state governments to make changes to Obamacare insurance plans that could then be adopted by private plans.

He indicated the Senate plan met that request. More people would be staying insured because they value the benefits of insurance over its cost, and fewer because they would pay a fine if they refrained.

Trump is selling the plans anyway.

It's not that Trump has never outlined clear promises on health care. He knows the amendment process will give senators an opportunity to sculpt the legislation to their liking. That could make care for preexisting conditions unaffordable even if it's covered by the plan. "I will be voting no". "Everybody's going to be taken care of much better than they're taken care of now".

But that was political rhetoric. The Senate bill also calls for a tighter cap on federal spending in Medicaid overall than the House bill did. They say the GOP plan would mean fewer people with coverage and higher costs for many.

"We're going to pay for it one way or another; there are no free lunches", she said in an interview with The Associated Press. Now, it's bigger than that. The Medicaid limit would move the nation closer to putting public health care programs on a budget, fiscal discipline that conservatives say is long overdue. "Let's get something that's going to work".

Since health care reform became the Senate's responsibility, the White House has been remarkably quiet on that front.

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