SALT LAKE CITY — Utah Sen. Mike Lee is one of four Republicans who say they are "not ready" to vote in favor of the party's health care reform legislation after it was unveiled in the U.S. Senate on Thursday.
“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor," Lee said in a joint statement with Sens. Ted Cruz, R-Texas, Ron Johnson, R-Wis., and Rand Paul, R-Ky.
The group's opposition potentially presents a major obstacle for Republicans' long-held goal of rolling back former President Barack Obama's Affordable Care Act.
The Senate plan cuts and reshapes Medicaid for the poor, ends Obama's tax penalties on people who don't buy insurance — effectively ending the so-called individual mandate — and on larger companies that don't offer coverage to their workers. It would offer less generous subsidies for people than Obama's law but provide billions to states and insurance companies to buttress markets that in some areas have been abandoned by insurers.
No Democrats are expected to vote in favor of the GOP's proposed health reform — passed in the House in May as the American Health Care Act and re-introduced Thursday as the Better Care Reconciliation Act — leaving Republicans with room for just two dissenting votes from within their own ranks, assuming Vice President Mike Pence will vote in favor of the bill.
Lee said he was still studying the text of the bill, but continues to prefer a full repeal of the Affordable Care Act in order to ignite bipartisan cooperation from Democrats.
"That is the only way that I think we would end up with bipartisan support for whatever comes next, whatever comes after Obamacare," Lee told KSL NewsRadio's Doug Wright. "Because Democrats certainly aren't going to vote for anything that's repealing Obamacare in the process."
Lee told Wright he would not vote for any health reform bill unless he concludes it "moves the American people in the direction to where health care is going to be made more affordable."
"There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs,” Lee said in his joint statement with Cruz, Johnson and Paul.
The bill received immediate support from Sen. Orrin Hatch, R-Utah, whose staff had been helping to draft the bill for several weeks. Hatch spokesman Matt Whitlock said in a statement that Hatch "was closely involved in the drafting process and secured a number of critical health care victories for Utah."
The Senate bill, Hatch believes, will stabilize insurance markets and reduce premiums.
"The status quo under Obamacare is simply unacceptable," he wrote in an opinion published in the Deseret News on Friday. "Once replaced, premiums will be lower, allowing Utahns more freedom to spend hard-earned income, while quality will improve, providing Utahns the care they deserve."
Whitlock said Hatch believes Senate Majority Leader Mitch McConnell's goal of voting on the bill by the end of next week is possible.
"But (Hatch) would like members to have as much time as they need to review the legislation," Whitlock told the Deseret News.
But when CNN asked whether the vote on the bill should be extended beyond next week, Hatch replied "I don't think so."
"Let's face it, this is going to be a tough process, no matter when it occurs," Hatch told CNN. "And, I think it's better to face these problems and face them straight up, of course that's why we have the amendment process, that's why we have different points of view."
Asked whether it would be wise to vote on the bill next week, Lee answered, "probably not, in my opinion."
"This is not the way I would have done it. I don't think it's the way we should do it," he told Wright.
Lee, who said in a Facebook Live video earlier this week he was upset that only staff members of a handful of senior Senate leaders had access to the bill, continued to showcase his displeasure about the process.
"It certainly is frustrating when anything works like this in Washington," he said.
In a speech on the Senate floor Wednesday, Hatch called criticisms of the bill being considered behind closed doors the result of "poll-tested ... strategy" from Democrats and "so off-base that it would almost be humorous if the issue was something less important."
Gov. Gary Herbert said during his monthly news conference on KUED that he agrees "having openness and transparency is important," but added he recalls the Affordable Care Act being conducted in a similarly behind-the-scenes manner.
Herbert said he is supportive of the portion of the bill that gives the state the option of receiving Medicaid funding in block grants.
"For me, a block grant would be the best of all worlds. Just give me the money — we'll figure it out and do what we need to do in Utah," the governor said. "We already have the lowest cost health care in Utah, it's not like we're not doing things pretty well."
The Utah Health Policy Project slammed the Senate process "that shut out industry experts, doctors, insurers, and everyday people."
The organization also criticized the bill for retaining proposals by the House for expansive Medicaid cuts.
Utah Health Policy Project spokesman Jason Stevenson said the bill also contains inadequate requirements of insurers, allows for easy work-around maneuvers to deny meaningful coverage to people with pre-existing conditions and limits the effectiveness of federal subsidies for insurance premiums.
The bill also puts states at financial risk because of unrealistic inflation mechanisms calculated into the block grant funding, Stevenson said. The bill switches from using the Medical Consumer Price Index to the mainstream Consumer Price Index beginning in 2026.
"Funding (for states) is going to go down dramatically," Stevenson said. "(The Consumer Price Index) is an inflation index that doesn't represent the true cost of medical inflation. It vastly underestimates the cost of medical care."
State Sen. Gene Davis, D-Salt Lake City and a member of the Utah Legislature's Health Reform Task Force, disagreed with Herbert's assessment, saying the only flexibility given to the state is the option to make deep Medicaid cuts and tell recipients, "sorry, there's no more money, good-bye."
"Flexibility is a two edge sword," Davis said. "Flexibility isn't great if it is driven by budget, especially in health care."
The Utah Health Policy Project joined with Voices for Utah's Children, Disability Law Center of Utah, Alliance for a Better Utah, Comunidades Unidas (Communities United), Utah Statewide Independent Living Council, Legislative Coalition for People with Disabilities and Utah Family Voices to issue a demand for an open debate process.
"We demand a full and vigorous Senate hearing process — including the Senate Finance Committee which Sen. Hatch chairs — to seek input and ideas from Utah health care experts and consumers in order to create a better policy proposal," the statement said.