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Senate Republicans, who for seven years have promised a repeal of the Affordable Care Act, took a major step on Thursday toward that goal, unveiling a bill to make deep cuts in Medicaid and end the law’s mandate that most Americans have health insurance. The 142-page bill would create a new system of federal tax credits to help people buy health insurance, while offering states the ability to drop many of the benefits required by the Affordable Care Act, like maternity care, emergency services and mental health treatment. (Pear and Kaplan, 6/22)

The bill would reverse the ACA’s expansion of Medicaid, a move that could affect millions of people, and would for the first time limit states’ overall Medicaid funding from Washington. It also would eliminate the requirement in the 2010 law that most Americans sign up for health insurance, and provide instead less-robust tax credits than the ACA to help people afford insurance. It would repeal hundreds of billions of dollars in taxes on businesses and high-income households and retroactively cut taxes on capital gains. (Armour, Peterson and Radnofsky, 6/22)

The Republican measure phases out the federal funding for ObamaCare’s expansion of Medicaid, which has provided coverage for about 11 million people in 31 states. (Sullivan, 6/22)

Already, the version of the bill the House passed last month included drastic reductions in Medicaid outlays of about $834 billion over 10 years. GOP senators' own version of the bill, which they made public Thursday, could go even further over the long term. Both the House and Senate bills aim to set a per-person cap on Medicaid spending in each state. That cap would adjust annually to take into account inflation. Through 2025, both bills would adjust the cap based on a measure of how rapidly medical costs are expanding — a measure known as the CPI-M. Starting in 2025, however, the Senate bill would change the formula, instead funding Medicaid based on a measure of how rapidly all costs are rising (technically, the Consumer Price Index for urban consumers, or just CPI-U). (Ehrenfreund, 6/22)

Since its inception in 1965, the federal government has matched state spending for Medicaid. The new bill would shift much of that burden back to states. (Rovner, 6/22)

Governors in several states that opted to expand Medicaid are wary of the Senate Republican plan to end the added federal funding for it within seven years. The proposal released Thursday calls for a slower phase-out of the Medicaid expansion than a bill adopted by the House. Yet it still would force those states to figure out what to do about the millions of lower-income Americans who used it to gain health coverage. (6/23)

"That's a big deal. It's a big shift," said John Corlett, president of the Center for Community Solutions, who also served as a director of Ohio's Medicaid program. "It means billions of dollars less in federal aid to states for their Medicaid programs." (Kurtzleben, 6/22)

The Senate bill, called the Better Care Reconciliation Act of 2017, would exclude disabled children, breast and cervical cancer patients and children covered under the Children's Health Insurance Program from the Medicaid cap formula. Experts say, however, that it would be difficult or impossible to protect any beneficiaries from the effects of the per capita cap structure, because states would receive fixed federal payments and have to make tough choices about cutting eligibility, benefits and payments to providers. (Meyer, 6/22)

Congress is moving fast toward repealing the Affordable Care Act, with an eye on revamping Medicaid, the health insurance program for low-income people. But most Americans say the program — which Republicans call a “broken system” — is working well on the national level and within their states. That’s according to a monthly tracking poll released Friday by the Kaiser Family Foundation. (Luthra, 6/23)

On the day Senate Republicans unveiled their health care bill, some military veterans say what the GOP rolled out is "un-American." Veterans from across Tennessee said they're speaking out on behalf of 2 million veterans nationwide who they think will lose or see reduced health care coverage because of the move by Congress to repeal and replace the Affordable Care Act, known as Obamacare. Led by 36-year retired Marine Corps veteran Lt. Gen. John Castellaw, who lives in rural Crockett County in West Tennessee, he and others said the proposed health care bill would potentially boot millions of veterans off health care that many depend on to supplement coverage or just give them access to doctors. (Lowary, 6/22)

President Trump famously called the House plan to repeal and replace Obamacare “mean” — entreating Senate Republicans to make their version of the bill more generous. Just hours before the Senate unveiled its draft legislation, he repeated that plea. “I’ve been talking about a plan with more heart. I’ve said, ‘Add some money to it,'” Trump told a crowd in Iowa Wednesday night. (Mershon, 6/22)