Sens. Bill Cassidy, R-La., and Lindsey O. Graham, R-S.C., will release a revised version of their health care bill Monday aiming to send more health care dollars to the states of key holdout Republicans.

The Cassidy-Graham bill overhauls the Affordable Care Act by lumping together spending on subsidies and Medicaid expansion and redistributing it to states in the form of block grants.

Alaska would get 3 percent more funding between 2020 and 2026 and Maine would get 43 percent more funding during that time period, according to a summary of the revised legislation obtained Sunday by The Washington Post.

Republican senators from both states, Lisa Murkowski of Alaska and Susan Collins of Maine, have said they want to understand how Cassidy-Graham would affect their states before supporting the bill.

Both senators have expressed deep opposition to cuts to health care spending under previous versions. Independent analysts had estimated that both states would lose federal funding under the earlier Cassidy-Graham bill.

Collins, a moderate Republican who has opposed previous efforts that cut Medicaid and eased coverage requirements, said in a TV interview that it was “very difficult” to envision herself voting for the health care bill.

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Speaking on CNN’s “State of the Union,” Collins cited concerns about how the Cassidy-Graham legislation would affect Medicaid recipients and people with preexisting medical conditions, among other things.

“It is very difficult for me to envision a scenario where I would end up voting for this bill,” Collins said. “I have a number of serious reservations about it.”

Collins voted against a repeal bill in July, and she is a key vote in the current dynamic.

She said she chatted at length with Vice President Mike Pence on Saturday, but it wasn’t enough to sway her. She said she wants to see the limited analysis due out this week from the nonpartisan Congressional Budget Office before making a final decision.

Arizona, where Republican Sen. John McCain has also indicated he may not vote for the bill, would see a 14 percent increase in funding, according to the estimates. The estimates also take into account the amount of money states would save because they no longer have to match the expanded Medicaid program with any of their own dollars.

The floundering Republican attempt to undo the Affordable Care Act met hardening resistance from key Republican senators Sunday that left it on the verge of collapse even as advocates vowed to keep pushing for a vote this week.

With party leaders just one “no” vote away from defeat, Republican senators from across the political spectrum distanced themselves from the plan written by Cassidy and Graham. They voiced opinions ranging from measured skepticism to outright hostility toward a proposal that had already been trending toward failure over the past three days.

The fresh discord over a signature Republican promise added turbulence to the start of a critical week for President Trump and Senate Majority Leader Mitch McConnell (R-Ky.). In addition to health care, both are watching Tuesday’s special-election primary runoff in Alabama, a high-stakes intraparty fight between establishment Republicans and conservatives that could set the tone for the midterm elections next year. Republican leaders also are expected to unveil their most detailed blueprint yet of tax cuts they hope to pass by the end of the year.


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