Senate Majority Leader Mitch McConnell is still short the 50 votes he needs to pass the bill, with several senators saying they’re withholding their support until they see final legislation. | J. Scott Applewhite/AP Senate GOP reveals Obamacare repeal bill but still lacks the votes After weeks of work behind closed doors, the GOP released its plan and is now trying to find the votes to pass it. 
 
 Senate Republican leaders unveiled their long-secret plan to repeal Obamacare Thursday, formally kicking off the search for the 50 votes needed for passage amid stark party divisions. 
 
 Just hours after Republicans were briefed on the bill, four conservatives put out a statement saying they were withholding their support for the plan. A number of moderate GOP senators, meanwhile, said they were still poring through the the 142-page bill, which was crafted after weeks of work behind closed doors. 
 
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 The broad contours of the plan — which would tear down large parts of the 2010 health law, cap one of the nation’s biggest entitlement programs and overhaul one-sixth of the U.S. economy — have come into focus in recent days. 
 
 Senate Majority Leader Mitch McConnell is pushing for a vote as early as next Thursday, ahead of Congress’ July 4 recess and before more opposition can mount. 
 
 But the Kentucky Republican is still short the 50 votes he needs to pass the bill. 
 
 GOP Sens. Ted Cruz, Ron Johnson, Mike Lee and Rand Paul said in a statement Thursday that they are "not ready" to support the measure, though they remained open to voting for it after further negotiations. 
 
 "It does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs," they said. 
 
 Cruz is pushing for an amendment to allow catastrophic, low premium plans, but it's not clear if the parliamentarian will allow them, according to Republicans. 
 
 Since Senate Democrats are unified in their resistance, Republicans are using a fast-track process that can evade filibusters. But they can only afford two defections and still maintain the thin majority needed to pass the repeal bill. 
 
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 Senate Minority Leader Chuck Schumer and other Democrats immediately took to the floor to blast the plan. 
 
 “The president said the Senate bill needed heart,” he said. “The way this bill cuts health care is heartless. The president said the House bill was mean. The Senate bill may be meaner.” 
 
 When asked if the Senate plan has enough heart at a White House event Thursday, President Donald Trump replied, “A little negotiation, but it's going to be very good.” Later, he tweeted that he was "very supportive" of the plan. 
 
 Former President Barack Obama blasted the Senate bill as a "massive transfer of wealth" that would skyrocket the cost of health care for poor and middle-class Americans. 
 
 "It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else," Obama wrote in a Facebook post. "Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm." 
 
 The Congressional Budget Office hasn't yet weighed in on how many fewer Americans are likely to be insured under the Republican plan, or answered the crucial political question of whether premiums would be reduced. That report is expected by early next week, setting up a sprint to gather votes ahead of a potential late-week vote. 
 
 The House bill, whose fundamental framework can be seen in the Senate plan, would leave 23 million fewer Americans insured over the next decade, according to CBO. 
 
 The Senate bill — blandly dubbed the Better Care Reconciliation Act of 2017 — eliminates Obamacare’s mandates and hundreds of millions of dollars in taxes on the wealthy and the health industry. Notably, it doesn’t impose any new requirement that people purchase or maintain coverage — a major element that Republican leaders said they’re still working on. 
 
 The bill would also phase out Obamacare's Medicaid expansion over three years beginning in 2021 and make deep cuts to the long-term Medicaid program, while allowing states to impose work requirements on certain beneficiaries. It keeps the structure of Obamacare's insurance subsidies to help low-income people buy insurance, but tweaks them to cover only those making up to 350 percent of the federal poverty line — down from the 400 percent covered under Obamacare. 
 
 The bill bars the use of subsidies for plans that include abortion coverage, though some Republicans have said that the provision may not survive due to the Senate's strict procedural rules under reconciliation. Planned Parenthood would be defunded for one year. 
 
 Obamacare's $1 billion Prevention and Public Health Fund, which was designed to tackle threats like Zika and pay for preventive health services, would be eliminated by 2018. 
 
 Senate Republicans would allow states to opt out of some of Obamacare’s 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. Those waivers are aimed at loosening oversight of insurers and paving the way toward even lower premiums, though they could also prompt insurers to dramatically cut benefits and increase deductibles. 
 
 The bill won't 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. 
 
 Still, the Senate bill was met with near-universal backlash from patient advocates, hospitals and public health organizations. 
 
 Republicans are holding out hope that health insurance groups will ultimately come to the legislation's defense, some senators said. But the bill's fate will rest on how factions on either end of the conference's ideological spectrum react to the bill's sweeping proposals. 
 
 Indeed, conservatives, moderates and senators from Medicaid expansion states all remained on the fence even after coming out of the meeting. 
 
 "By the time I get back to my office I'm told I'll have a copy," said Sen. Lisa Murkowski (R-Alaska), a key moderate swing vote. "There was no paper. ... I want to get back to my office and actually take a look at it." 
 
 Along with other Medicaid expansion-state senators, like Ohio's Rob Portman and West Virginia's Shelley Moore Capito, Murkowski is worried about the consequences of cutting off Obamacare's enhanced funding so quickly, and pushed instead for rolling back expansion over as many as seven years. 
 
 Murkowski and Sen. Susan Collins have also warned against defunding Planned Parenthood as part of the bill, and expressed reservations about the impact certain provisions may have on elderly Americans' ability to afford coverage. 
 
 McConnell full remarks on Senate health care bill poster="https://v.politico.com/images/1155968404/201706/3914/1155968404_5480170897001_5480145898001-vs.jpg?pubId=1155968404" true 
 
 And among conservatives, there remain serious concerns over whether the repeal bill amounts to a "true" repeal of Obamacare and the regulations it imposes on the health care system. 
 
 
 
 Freedomworks, a conservative advocacy group, panned the proposal as "an amendment to ObamaCare" rather than a repeal, and urged Paul, Lee and Cruz to hold out until their demands are met. 
 
 Senate Republican leaders have spent the last few weeks trying to manage that delicate ideological balance, in hopes of charting a narrow path to 50 votes 
 
 Still, Republicans said Thursday's all-conference meeting demonstrated there are still a number of issues yet to be solved. 
 
 "It's obviously a discussion draft," said Sen. John Thune (R-S.D.). "So we've got members who are going to be interested in looking at the text and see what they can do to refine, improve and dial things accordingly to try to figure out how we get 50 votes." 
 
 Brianna Ehley, Rachana Pradhan and Rachael Bade contributed to this report. ||||| With only a slim majority in the Senate, Mitch McConnell always faced an uphill battle uniting the fractious Republican Party behind his plan to repeal and replace the Affordable Care Act. But in the four days since the majority leader revealed the draft text of his clumsily named Better Care Reconciliation Act, the revolt within his own caucus has proved more serious than it first seemed. With 10 senators saying they have reservations or outright oppose the bill, as of Sunday afternoon, it was already looking as if McConnell would need a legislative miracle to fulfill the G.O.P.’s seven-year quest to repeal Obamacare—and that was before the Congressional Budget Office released its report on the impact of the bill, which the federal scorekeeper estimated would increase the ranks of the uninsured by 22 million. One person on McConnell’s staff has reportedly been telling people they have only a 60 percent shot at closing the deal, though the odds may actually be lower. Josh Holmes, who previously served as McConnell’s chief of staff, said passing the bill would be like “a 747 landing on a suburban driveway.” 
 
 While McConnell can afford to lose two votes, the holdouts are split ideologically between conservatives and moderates. In the former camp are Senators Rand Paul, Ted Cruz, Mike Lee, and Ron Johnson, who say the legislation doesn’t go far enough in dismantling Barack Obama’s signature legislation. In the latter group are Susan Collins, Dean Heller, Lisa Murkowski, and Cory Gardner—among others—who have voiced concerns about the impact the legislation will have on the uninsured rate and its steep cuts to Medicaid, which begin slower but ultimately go deeper than what was prescribed in the House bill. “This bill would mean a loss of coverage for millions of Americans, and many Nevadans. I’m telling you right now, I cannot support a piece of legislation that takes insurance away from tens of millions of Americans, and hundreds of thousands of Nevadans,” Heller said on Friday during a press conference. 
 
 On Monday, the C.B.O. confirmed the concerns of Heller and his fellow moderates. While the Senate bill is expected to reduce the federal deficit by $321 billion by 2026, over that same period, tens of millions of Americans are also expected to lose coverage. The budget office estimates that over the next year alone, 15 million more Americans would join the uninsured ranks under the B.C.R.A. than under the current law, and an additional 4 million people would lose employer-sponsored coverage. Over the next decade, that figure would balloon to 22 million—representing a marginal improvement over the House health-care bill. Premiums are also expected to spike by 20 percent in the first year, though the C.B.O. estimates that they will be roughly 30 percent lower in 2026 than under the A.C.A—primarily because plans would be stingier, and deductions much higher. While the highest-income households would benefit from a cumulative tax cut of some $541 billion over the next decade, that’s likely cold comfort to moderates like Collins, Heller, Murkowski and Gardner, who could face an electoral revolt in their home states. 
 
 Prior to the release of the C.B.O. score, Collins was already seen as less persuadable than some of her Republican peers. Along with Murkowski, the Maine senator has raised issue with language that would effectively defund Planned Parenthood—the removal of which could be a nonstarter for staunch conservatives like Lee and Cruz. And while Murkowski could be won over by changes to the bill that would help her home state of Alaska, Collins would be a much tougher sell. “She wants to remain engaged in negotiations, so it makes sense not to foreclose the option to vote ‘yes,’ ” the source told Allen. “But there is no way she'll vote for this bill, just on pro-life protections alone.” 
 
 Some of the protests are likely less than genuine, designed to extract concessions from McConnell that those senators can then bring back to their states. But other dissenters seem more ideologically opposed to the bill. Paul, Mike Allen notes, seems hung up on conservative principles and is expected to use his opposition to make a stand. He's talking about getting a 60-vote threshold revamp of [Obamacare],” one Senate source told him. “He wants this bill to fail.” 
 
 Nor are Collins and Paul the only Republicans who may end up voting “no.” Heller, who is widely seen as the most vulnerable G.O.P. senator in 2018, is the only moderate to have outright opposed the bill as currently written. McConnell, who is famously protective of his caucus, is expected to give Heller a pass, if they can’t negotiate a compromise. A pro-Donald Trump political group, meanwhile, has announced plans to launch a series of attack ads against Heller over health care, leaving the Nevada senator in an even tougher spot, and potentially undermining McConnell. Under attack from Trump’s allies, any concession by Heller now would look as if he folded under pressure—particularly in light of the C.B.O.’s devastating report. 
 
 The strict rules governing the budget reconciliation process, which McConnell plans to use to avoid a Democratic filibuster, create a separate set of problems. While Lee is considered amenable to negotiating, the changes he is seeking to the bill might violate the parameters for reconciliation. “I do think [Lee] wants to get to ‘yes.’ I think he realizes that if this fails, it kills the reconciliation vehicle and possibly the chance to repeal major elements of Obamacare,” Allen’s source noted. “But his vote will come [with] major improvements that may or cannot be accommodated by the budget rules constraining [reconciliation].” Lee and the rest of the conservative coalition will, however, likely applaud the $772 billion cut in Medicaid over and the cumulative $541 billion tax cut the Senate bill will provide over the next ten years—whether it will be enough to sway their votes remains to be seen. 
 
 McConnell is facing a narrow window to wrangle enough support for the Better Care Reconciliation Act ahead of the vote, which is expected as early as Thursday. And there is still one unknown factor at play: Trump. On Sunday, the president confirmed earlier media reports that he had told Republican senators that he thought the House’s American Health Care Act was “mean.” So far, surrogates for his administration have been insisting that the Senate bill’s massive Medicaid cut would not actually break his campaign promise to protect the program—an obvious deception that other allies have struggled to spin. Who knows what will happen if anyone manages to explain to Trump what the legislation would actually do. ||||| Senate Republican leaders unveiled what they called a "discussion draft" of their long-awaited health care bill, a part of the party's ongoing efforts to repeal and replace the Affordable Care Act. 
 
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 Five Republican senators have already come out in opposition to the Senate bill, the Better Care Reconciliation Act, jeopardizing its passage. 
 
 Critics on both sides of the aisle said the bill, which was drafted behind closed doors by a small group of Senate leaders and committee staffers, has been shrouded in secrecy. 
 
 Trump told reporters Thursday that there will be "a little negotiation, but it's going to be very good." 
 
 Republicans 'not ready' to support the bill 
 
 GOP Sens. Ted Cruz of Texas, Ron Johnson of Wisconsin, Mike Lee of Utah and Rand Paul of Kentucky released a joint statement saying, "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." 
 
 They added, "There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs." 
 
 In a separate statement, Paul said he'll oppose the bill "in its current form, but I remain open to negotiations." 
 
 "The current bill does not repeal Obamacare. It does not keep our promises to the American people," he said. 
 
 On Friday, Sen. Dean Heller, R-Nev., joined the group, saying at a press conference that "this bill is not the answer, it's simply not the answer." 
 
 "In this form, I will not support it," said Heller. 
 
 Sen. Susan Collins, R-Maine, told reporters Thursday she has "not yet had the opportunity to read the text of the bill, and the details really matter." 
 
 "I see some positive features of this bill that are improvements over the House, and I see some negative features based on my first analysis," she said. "I don't like the provision that eliminates federal funding for Planned Parenthood. It makes no sense to single out Planned Parenthood from all the Medicaid providers. There's already a ban against using federal funds for abortions, so there's absolutely no need for that." 
 
 A vote from Collins, who has been willing to break from her party, would be key to ensuring the bill's passage. 
 
 Senate Republicans can afford to lose only two of their members to pass the bill, assuming Democrats remain united in their opposition. 
 
 Republicans acknowledge tough road ahead for bill 
 
 As members left a meeting about the bill, many said they were encouraged by their first impressions of the text but were hesitant to say if it would clear the 50 vote threshold for passage. 
 
 "There's a lot to digest. It's very complicated," Sen. Pat Toomey, R-Pa., said as he left the gathering. 
 
 Some Republicans said they liked how the Senate bill calculates the value of tax credits to help individuals pay for insurance. 
 
 While the House bill linked the tax credits to age only, the Senate bill considers age, income and geographical area. 
 
 "A person making about $12,000 a year will have more access and a lower cost of health insurance. And that's a really good thing," said Sen. Tim Scott, R-S.C. 
 
 But Sen. John Thune, R-S.D., a member of Senate leadership, acknowledged that the draft would not pass in its current form. 
 
 "Right now the challenge is, how do we get to 50?" he said. 
 
 Senate Majority Leader Mitch McConnell indicated that he wants to get a vote before the July 4 legislative recess. 
 
 Democrats and ACA supporters unhappy 
 
 The bill's release was met with significant opposition from Democrats and other supporters of the Affordable Care Act. 
 
 Under current law, all insurance plans have to include, at a minimum, specified essential health benefits, including ambulance service, hospitalization, maternity care and prescription drug coverage. Under the Senate bill, states would be allowed to apply for waivers from those regulations and essentially scrap them to write their own rules. 
 
 As the bill was being unveiled, a large demonstration formed outside McConnell's office, with people in wheelchairs staging a die-in and protesters chanting that no changes be made to Medicaid. Demonstrators were physically removed by Capitol Police officers. 
 
 Congressional Democrats were also forceful in their condemnation. 
 
 Senate Minority Leader Chuck Schumer slammed the Senate bill as "every bit as bad" as the American Health Care Act passed in the House. 
 
 "The president said the Senate bill needed heart. The way this bill cuts health care is heartless," Schumer said Thursday. "The president said the house bill was mean. The Senate bill may be meaner." 
 
 He continued, "The Senate Republican health care bill is a wolf in sheep's clothing, only this wolf has even sharper teeth than the House bill." 
 
 During her weekly press conference, House Minority Leader Nancy Pelosi said it's important to stop the legislation, which she called "a tax bill disguised as a health care bill." 
 
 Top medical organizations call on the Senate to reject the bill 
 
 So far, the Senate health care bill has not gotten any backing from top health or medical organizations. The American Public Health Association, the American Psychiatric Association and the American College of Obstetrics and Gynecology released statements urging the Senate to reject the Better Care Reconciliation Act and expressed concerns over the closed-door negotiation process. 
 
 "The Senate proposal represents a significant move in the wrong direction, resulting in fewer people having access to insurance, fewer patient protections and less coverage for essential behavioral health care," American Psychiatric Association's CEO and medical director, Saul Levin, said in a statement. 
 
 The American Public Health Association attacked the bill's closed-door shaping as "legislative malpractice." 
 
 The American College of Obstetrics and Gynecology said, "Despite numerous efforts to collaborate and provide input throughout this process, women's health expertise was rejected. It is reckless for legislation that will have such an immense impact on Americans' lives and the economy to proceed without opportunity for public hearings or any external commentary." 
 
 ABC News' John Parkinson, Mariam Khan and MaryAlice Parks contributed to this story.
– Senate Republicans on Thursday finally unveiled their answer to the House bill to repeal and replace the Affordable Care Act, and Vox has an explainer of what's in it. Some major sticking points: The Better Care Reconciliation Act will ask poor and middle-class Americans to pay more for less coverage, and Medicaid would be cut after expansions are rolled back. Medicaid patients would be unable to get treatment at Planned Parenthood, which would be defunded for a year. The bill also includes a tax break for the wealthy. Here's what else you need to know: First, Politico has the full text of the 142-page document Republicans are calling a "discussion draft." Three Republican senators can defeat the bill by joining Democrats to vote against it. FiveThirtyEight reports the most likely candidates are Rand Paul and Mike Lee (who don't believe it goes far enough; Paul recently said he doesn't want "ObamaCare lite") and Susan Collins and Lisa Murkowski (who want more protections for Medicaid and pre-existing conditions). ABC News reports four Republican senators have already said they won't vote for the bill without more information and negotiation: Paul, Lee, Ron Johnson, and Ted Cruz. They released a joint statement saying the bill doesn't do enough to repeal ObamaCare. The bill's writing was cloaked in such secrecy that the Week reports as of Thursday morning quite a few Republican senators still had not seen it; Murkowski, for example, told a reporter, "I am not a reporter, and I am not a lobbyist, so I've seen nothing." President Trump had called the House bill "mean" and in need of "more heart." So Scientific American takes a look to see if the Senate version fulfills that requirement. When asked by a reporter if the Senate bill had enough heart, Trump called it "very good" but in need of "a little negotiation," CNN reports. According to People, police dragged protesters—some of them in wheelchairs or wearing medical devices—away from Mitch McConnell's office and arrested them. The protesters, members of a national disability rights group, say people with disabilities are threatened by the bill. Finally, USA Today reports Senate Democrats plan to fight the bill through procedural requests to slow down the process. They called for any changes to the House's bill to be made public for at least 72 hours and be subject to CBO analysis.