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Where does the Senate go from here? Probably somewhere else. Reactions from several Republican senators to Wednesday’s estimate from the Congressional Budget Office on the American Health Care Act didn’t bode well for passage in the Senate. “With today’s news, the ‘collapse and replace’ of Obamacare may prove to be the most effective path forward,” tweeted Sen. Lindsey Graham of South Carolina. Sen. Dean Heller of Nevada, who is probably the most vulnerable GOP senator up for re-election next year, said the bill doesn’t do enough to protect the state’s Medicaid population or people with pre-existing conditions. Sen. Bill Cassidy of Louisiana doesn’t believe the AHCA passes the “Kimmel test,” a reference to late-night host Jimmy Kimmel, whose monologue about his newborn son, who was born with a heart defect, and healthcare coverage went viral a few weeks ago. “Congress’s focus must be to lower premiums with coverage which passes the Jimmy Kimmel Test. The AHCA does not,” said Cassidy, who has been pushing his own bill with Sen. Susan Collins, R-Maine, that would let states choose whether to keep Obamacare or use federal funding for their own version. The CBO score said that 23 million people would go without insurance over the next decade and it would cut $119 billion from the deficit. But one of the most damning parts of the score said that an amendment that lets states opt out of key Obamacare insurance mandates could force sicker people to pay more for healthcare and quickly make coverage unaffordable. Senate leadership always hinted they would start from scratch and go their own way, but some senators have said they will keep parts of the bill in their version. The Senate healthcare working group is scheduled to meet today, as they do every Tuesday and Thursday to discuss their version of healthcare reform. Wonder just how much of the agenda the CBO score will take up?

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Vote before August recess? Maybe? Sen. John Cornyn, R-Texas, the No. 2 in the Senate, hinted that there could be a vote on healthcare in the next few months. “My own guess is we will have it done some time before August,” he told reporters Wednesday. But Cornyn didn’t commit to any deadline, saying that if “we miss it by a day or two that isn’t a big story.” Full disclosure, it probably would be. Cornyn downplayed Majority Leader Mitch McConnell’s comments in a Reuters interview Wednesday that the Senate doesn’t have the 50 votes needed to pass any healthcare bill. “There’s no bill. That’s the reason why we don’t have 50 votes,” Cornyn said. A group of more than a dozen GOP senators from all sides of the political spectrum have been meeting for weeks. Focusing on topics such as Medicaid spending, tax credits and Obamacare’s insurance mandates. But those meetings have yet to bridge major divisions between centrist and conservative senators. Cornyn said the Senate doesn’t “have the luxury of time,” since insurers have to submit their proposed rates for the 38 states that use next month. He also hinted that the Senate is likely to vote on some type of healthcare legislation. “I don’t think we have any choice,” Cornyn said. “Even if we were to do nothing on repeal and replace, we would still have to salvage the failing Obamacare individual markets.”

Highlights from the CBO report: Here are the quick takeaways from the score:

  • 23 million people would go without insurance over the next decade, which is down from the previous estimate of 24 million people not having insurance.
  • One-sixth of the population will be affected by Rep. Tom MacArthur’s waiver that lets states opt out of insurer mandates such as community rating, which prevents insurers from charging sick people more money. People who are healthier would choose to buy less expensive, skimpier plans, the report projects, while people who are have more medical needs would have only expensive plans to choose from, and may not be able to buy coverage at all.
  • Premiums would decline, sort of. The score shows that premiums would rise by 20 percent in 2018, an election year, and then by 5 percent the following year. After that, results would vary by state depending on which applies…