Sanders bill expands Medicare for all, lacks details on cost

WASHINGTON (AP) — Liberal Sen. Bernie Sanders is ready to unveil his bill for starkly reshaping the country's current hodge-podge health care system into one where the government provides medical insurance for everybody.

Republican senators are preparing to roll out details of a last-ditch effort to repeal and replace President Barack Obama's health care law.

The rival packages have little in common, other than the likelihood that neither is going anywhere.

Seven weeks after the GOP drive to uproot Obama's 2010 health care law crashed in the Senate, two Republican senators, Lindsey Graham of South Carolina and Louisiana's Bill Cassidy, on Wednesday were releasing their plan for trying again.

They've struggled for weeks to round up sufficient support for the package. It would cut and reshape Medicaid, disperse money spent under Obama's law directly to states and erase Obama's penalties on people who don't purchase coverage.

No. 3 Senate GOP leader John Thune of South Dakota said Graham and Cassidy would need "a double-double bank shot" to prevail, a joking reference to an impossible basketball shot.

Like the failed Senate GOP repeal effort in July, the Graham-Cassidy push will get zero Democratic support. That means Senate Majority Leader Mitch McConnell, R-Ky., will need 50 of the 52 Republican senators, a margin he couldn't reach in July and is struggling to reach now.

Despite badgering by President Donald Trump that he keep trying, McConnell has expressed no interest in staging yet another vote that produces an embarrassing rejection by the GOP-controlled Senate. Conservatives are wary because the bill falls short in erasing Obama's wide-ranging coverage requirements.

"I don't think this bill will go anywhere," said Sen. Rand Paul, R-Ky.

Meanwhile, Sanders is introducing his bill for essentially expanding the Medicare health insurance program for the elderly to all Americans.

The progressive wing of the Democratic Party backs his bill, which would make health care less expensive and less complicated for many people and businesses. It would cover the 28 million Americans remaining uninsured despite Obama's law.

People would simply flash a card and be entitled to coverage, without out-of-pocket expenses like deductibles, according to Sanders aides. They would pay income-adjusted premiums, with the poorest paying nothing but the rich and profitable corporations seeing higher taxes, and people and businesses would no longer owe premiums to insurers.

Some Democrats fear the Vermont independent is exposing them to a lose-lose choice.

Don't support Sanders' plan and risk alienating the party's liberal, activist voters, volunteers and contributors. Back it and be accused by Republicans of backing a huge tax increase and government-run health care, and taking away employer-provided coverage for half the country that many people like.

Sanders rejects that.

"Because the people in this country want to move toward a Medicare-for-all system, that is divisive?" he said in an interview Tuesday, citing polls showing growing support.

At least 12 other Senate Democrats signed onto Sanders' bill by late Tuesday, including four potential presidential contenders: Kamala Harris of California, Massachusetts' Elizabeth Warren, New York's Kirsten Gillibrand and Cory Booker of New Jersey.

"It may be a good strategy toward getting the nomination" to be the Democratic presidential nominee, said Ron Pollack, chair emeritus of the liberal Families USA, who backs universal coverage but thinks Sanders' plan is politically unrealistic. "I don't think it's a good strategy for the general election."

To cover themselves, several Democrats are introducing their own bills that expand coverage without going as far as Sanders, including possible presidential aspirants Sens. Chris Murphy of Connecticut and Ohio's Sherrod Brown. Several Democrats facing tough re-election battles next year in GOP-leaning states say they want to focus on strengthening Obama's existing law, including Montana's Jon Tester and Missouri's Claire McCaskill.

Republicans say they're ready.

"We welcome the Democrats' strategy of moving even further left," said Katie Martin, spokeswoman for the Senate GOP's campaign organization.

A third effort, a bipartisan attempt to shore up individual insurance markets around the country, is showing early signs that the sides are having problems reaching agreement.

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., hope to reach a deal on continuing for at least a year the federal payments to insurers that Trump has threatened to halt. Republicans are also insisting on easing the Obama law's coverage requirements, which Democrats don't want to do.

Alexander said Tuesday that Republicans want "real state flexibility" to let insurers offer "a larger variety of benefits and payment rules."

Murray said she worried the GOP wants to "wind up increasing out-of-pocket costs for patients and families." That's something Democrats oppose.

McConnell said the Alexander-Murray talks "are underway and we'll see where they go."