Politics: The Senate's plan to repeal and replace Obamacare has hit a setback

The newest version of the repeal-and-replace bill included amendments from Sens. Ted Cruz and Rob Portman.

Senate Republicans late Tuesday introduced a new version of their plan to repeal and replace Obamacare that ultimately failed a key procedural test, paving the way for what appears to be a more modest attempt at an overhaul of the nation's healthcare system.

The measure failed 57-43 in a procedural vote, as nine Republican senators joined all Democrats in opposing it. It needed 60 votes to advance.

The newest version of the Better Care Reconciliation Act — which Democratic Sen. Ron Wyden of Oregon nicknamed "Trumpcare 3.0" — reinserted an amendment that experts argue could have a big impact on people with preexisting medical conditions.

Procedural votes are used to gauge whether the legislation complies with the budget act it's trying to pass under. But it gives a glimpse of what the vote would look like if the bill came up for final passage.

The revised version of the bill proposed that more funds would be set aside for the opioid crisis, and that people would be able to pay for premiums using a health savings account. It also proposes deep cuts to Medicaid.

Here's the quick summary of what was in the new bill:

• The Consumer Freedom Amendment, proposed by Sen. Ted Cruz.
• The Portman Amendment, which provides $100 billion in funding to stabilize states.
• It also makes some changes to a section that would have made out-of-pocket maximums technically higher than what's allowed by the law.

The Portman Amendment

The bill includes an amendment from Sen. Rob Portman of Ohio, which would set up $100 billion in new funding to stabilize states. It would accomplish this by increasing funding from $19.2 billion a year to $30.2 billion. Portman has expressed concerns about the BCRA before for not providing enough funding for Medicaid tackling the opioid crisis.

The Consumer Freedom Amendment

Unlike the one scored last week by the Congressional Budget Office, this bill included an amendment from Cruz that critics said could make plans with adequate coverage unaffordable to those who have certain medical conditions.

The amendment would have allowed plans to exist that don't comply with two regulations set up under the Affordable Care Act, the law better known as Obamacare: community rating and essential health benefits. The latter could have had a big impact on people with preexisting conditions.

Under the Cruz amendment, titled the "Consumer Freedom Amendment," some health plans wouldn't have to necessarily adhere to the community rating and essential health benefits. Those that do would receive $70 billion in funding to offset the higher premiums that would result relative to the plans that don't cover the regulations. Whether that funding would be enough to make the plans affordable remains to be seen. While the CBO analysis might have shed some light, the amendment was pulled from the draft bill.

On Wednesday, the Department of Health and Human Services released a report on the Consumer Freedom Amendment, taking a look at what it would do in the context of the ACA — not the BCRA bill. The report came to the conclusion that Cruz's amendment would lower premiums in both the traditional ACA plans and the less regulated ones.

That goes against what experts say about the amendment. They argue that it is likely premiums under both types of plans would likely rise if the amendment was put in place. The insurance industry's lobbying group said the amendment would lead to "widespread adverse selection and unstable health insurance markets."

The newest version of the repeal-and-replace bill included amendments from Sens. Ted Cruz and Rob Portman. Read Full Story