Graham and Cassidy release new health bill draft with more money for Alaska, Maine, Arizona, Kentucky

Senate Republicans and President Trump have not given up on their last-ditch effort to significantly modify Medicaid and the Affordable Care Act, which needs to pass this week to avoid a filibuster from Democrats. On Sunday night, Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) released a new draft of their Graham-Cassidy bill, designed to win over holdouts in part by sending more money to Alaska, Maine, Arizona, and Kentucky, the home states of four key senators.

The new version of Graham-Cassidy also includes a special carveout for Alaska, a 25 percent increase in federal matching Medicaid funds. Sen. Lisa Murkowski (R-Alaska) has not said how she plans to vote, Sens. Rand Paul (R-Ky.) and John McCain (R-Ariz.) are pretty hard no votes, and on Sunday's CNN State of the Nation, Sen. Susan Collins (R-Maine) said it would be "very difficult for me to envision a scenario where I would end up voting for this bill," citing its changes to Medicaid, weakened protections for people with pre-existing conditions, and the lack of a Congressional Budget Office analysis of its effects.

In addition to the new funds for certain states, the new draft would make it easier for states to scrap federal insurance requirements, often without a waiver, including increasing the caps on out-of-pocket costs and allowing insurers to drop coverage for maternity care, mental health treatment, drug addiction, and other benefits now deemed essential. It would also allow states to create "multiple risk pools" for healthy and sick people. "This revised bill is tantamount to federal deregulation of the insurance market," said Larry Levitt of the nonpartisan Kaiser Family Foundation. "If there were any doubt that people with pre-existing [conditions] are at risk of being priced out of individual insurance, this bill removes them."

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The main hospital, doctor, and insurance groups released a rare joint letter Saturday opposing the bill, though GOP donors are reportedly upset that ObamaCare is still law. Sen. Ted Cruz (R-Texas) told the Texas Tribune Festival in Austin that "right now, they don't have my vote. And I don't think they have Mike Lee's either," referring to a GOP colleague from Utah. Republicans can only lose two votes.