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GOP Releases Its Skinny Repeal Bill

Mere hours before an expected vote, the GOP finally released Thursday night the text of its "skinny repeal" bill. As expected, the bill would repeal the Affordable Care Act's individual and employer mandate penalties and its medical device tax. The bill, which the GOP is calling the Health Care Freedom Act, also defunds Planned Parenthood (and allocates some additional money to community health centers), increases existing limits on contributions to Health Savings Accounts, and makes some changes to the 1332 "innovation waivers" that states can seek under the ACA.

Both the Planned Parenthood and state waiver language appear to have been modified from previous legislation to comply with the Senate parliamentarian's concerns. The new waiver language, according to Adrianna McIntyre, a health-policy expert who has followed the GOP's efforts to modify the waivers closely, appears to preserve many of the ACA's protections (community rating, the essential health benefits, etc.), although oversight by the Department of Health and Human Services may be weaker if a bill like this is passed.

The outcome of the vote, which is now expected to occur in the middle of the night, remains unclear. Earlier on Thursday evening, Republican Senators John McCain (R-Arizona), Lindsey Graham (R-South Carolina), Ron Johnson (R-Wisconsin), and Bill Cassidy (R-Louisiana) held a press conference saying they would only vote in favor of the skinny repeal bill if Speaker of the House Paul Ryan (R-Wisconsin) provided assurances that the House of Representatives would not actually take up and pass such legislation. "I'm not going to vote for a bill that is terrible policy and horrible politics just because we have to get something done," Graham said.

Graham, Johnson, and Cassidy have since said they've received the assurances they'd sought from Ryan and will vote for skinny repeal, although McCain has not indicated which way he'll vote.