The Latest: Hawaii senator calls GOP bill ‘mean, ugly’

WASHINGTON (AP) — The Latest on the Republican legislation overhauling the Obama health care law (all times local):

6:30 p.m.

Hawaii Democratic Sen. Mazie Hirono is decrying the Republican health care bill as "mean, ugly" a day ahead of her own surgery.

Speaking on the Senate floor Monday, Hirono says people typically figure health insurance is a concern for someone else until they get sick. Hirono announced in May that she was being treated for kidney cancer.

She says she will have surgery Tuesday to remove a lesion on her rib.

But first she joined several Democratic senators in criticizing the GOP health care bill, saying it was a "tax cut for the rich bill."

Hirono says health care is a right, not a privilege. And in light of the budget analysis that found 22 million more Americans would be uninsured, Hirono says, "it's as bad as we thought."

6 p.m.

Senate Majority Leader Mitch McConnell is focusing on the tax cuts, deficit reduction and lower premiums cited in a nonpartisan analysis of the Senate's health care bill, and making no mention of the 22 million more Americans who would be uninsured.

McConnell put out a brief statement Monday after the release of the Congressional Budget Office report.

He says Americans need relief from the "failed Obamacare law," and says the Senate will soon act on a bill to give Americans better care.

The Kentucky Republican says the bill would lower premiums by 30 percent in 2020, cut taxes by $700 billion and reduce the deficit by $331 billion.

His statement omits any mention of the CBO prediction that 22 million more Americans would be uninsured in 2026 than under President Barack Obama's health care law.

4:20 p.m.

The Senate health care bill would result in 22 million more uninsured Americans over the next decade compared to current law.

That's according to an analysis Monday from the nonpartisan Congressional Budget Office.

The figure may further complicate Senate GOP leaders' plans to pass their bill this week. It's barely an improvement upon the health care bill that passed the House — which would have resulted in 23 million more uninsured.

Several GOP senators have said they want to see their bill cover more people than the House version. And President Donald Trump himself called the House bill "mean" — though he's lent his support to the Senate version and is lobbying for passage.

2:15 p.m.

The nation's largest doctors' group is outlining its opposition to the Senate Republican health care bill.

The American Medical Association sent a letter Monday to Senate leaders saying the draft legislation violates the medical oath to "first, do no harm."

The letter says the Republican plan is likely to lead to higher costs and greater difficulty in affording care for low- and middle-income patients.

The doctors' group says the Senate bill's Medicaid payment formulas threaten to "limit states' ability to address the health care needs of their most vulnerable citizens" and won't keep up with new medical innovations and epidemics such as the opioid addiction crisis.

The letter is signed by Dr. James L. Madara, the group's CEO. The AMA has about a quarter-million members.

2 p.m.

One of the nation's biggest health insurers says the Senate health care bill will "markedly improve" the individual insurance market's stability and moderate premium hikes.

Blue Cross-Blue Shield insurer Anthem says the bill will help in part by appropriating money for cost-sharing reduction payments and eliminating a health insurance tax.

Cost-sharing reduction payments help cover expenses like deductibles for people with modest incomes. President Donald Trump has discussed ending these payments, and insurers planning to return to the exchanges next year want a guarantee that the payments also will return.

Anthem Inc. sells coverage in key markets like New York and California. It has said tough market conditions have forced it to pull out of exchanges in three states for 2018: Ohio, Wisconsin and Indiana.

1:10 p.m.

Senate Republicans have issued a revised version of their health care bill. The changes include a penalty for people who let their insurance lapse.

Under the new package, people who lacked coverage for at least 63 days in the past year and then buy a policy would face a six-month delay before it takes effect.

Senate Majority Leader Mitch McConnell released his initial measure last week. It had no penalty for people who let their coverage expire.

The waiting period is designed to prompt healthy people who might not otherwise buy insurance to do so. That helps insurance companies pay for sicker customers who are more expensive to cover.

McConnell is hoping to push the measure through the Senate by the end of this week, but some Republicans are rebelling.

12:55 p.m.

An outside group backing President Donald Trump will begin targeting more Republican holdouts on the Senate's health care bill.

America First Policies is expanding its campaign against Nevada Sen. Dean Heller to include Kentucky Sen. Rand Paul, Texas Sen. Ted Cruz, Utah Sen. Mike Lee and Wisconsin Sen. Ron Johnson. Those lawmakers came out against the bill as written when it was made public last week.

A senior official with America First Policies says online and social media ads will remind voters that Republicans have promised to repeal President Barack Obama's signature health care legislation. The official demanded anonymity to discuss the plan.

The group also is preparing radio and television ads to run ahead of the vote, which could come at the end of this week.

— Julie Bykowicz

11:19 a.m.

A conservative Republican senator who doesn't back the GOP health care bill is using unusually sharp tones to criticize party leaders.

Wisconsin Sen. Ron Johnson is accusing top Republicans of trying to jam the legislation through the Senate. He says the leadership effort is "a little offensive" and says conservatives haven't had input into the proposal.

Senate Majority Leader Mitch McConnell introduced legislation last week rolling back much of President Barack Obama's health care law.

Johnson is among four conservatives and a moderate who said they don't back the measure but haven't ruled out supporting it if it's changed.

McConnell is working this week to make revisions to win over votes. The bill will win approval if just two of the 52 Senate Republicans support it. All Democrats oppose it.

10:54 a.m.

A nonpartisan group representing Republican and Democratic state officials who administer Medicaid programs says the GOP health care legislation advancing toward a Senate vote will not work.

In a strongly worded statement that reflects the "unanimous" views of its board, the National Association of Medicaid Directors said the Republican health care bill would be "a transfer of risk, responsibility, and cost to the states of historic proportions."

While the group's members differ over the concept of federal spending limits on the health program for low-income people, the board agreed that the inflation adjustments in the Senate bill "are insufficient and unworkable."

Medicaid has become perhaps the key sticking point in the congressional debate.

The group said Congress should focus on stabilizing insurance markets for now, and tackle Medicaid overhaul later in a more thoughtful manner.

2:54 a.m.

Senate Republicans skeptical about a GOP health overhaul bill are expressing some doubt about holding a vote on the measure this week.

Lawmakers are awaiting a key analysis from the nonpartisan Congressional Budget Office.

President Donald Trump is making a final push to fulfill a key campaign promise, insisting that Republicans are not "that far off" and signaling that last-minute changes are coming to win votes.

So far, five Republican senators are expressing opposition to the Senate GOP plan that would scuttle much of former President Barack Obama's health law. That's more than enough to torpedo the measure developed in private by Senate Majority Leader Mitch McConnell.

The holdouts are expressing willingness to negotiate, but many of them are pushing revisions that could risk alienating moderate Republicans in the process.