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Remember health care? The Senate is voting next week.

Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

This is the web version of VoxCare, a daily newsletter from Vox on the latest twists and turns in America’s health care debate. Like what you’re reading? Sign up to get VoxCare in your inbox here.

Senate Republicans are gearing up for another run at their health care bill. Here's the schedule:

  1. Two versions of the revised bill will be released Thursday, Sen. Bob Corker (R-TN) told reporters — one with Ted Cruz's amendment, which would allow health insurers to sell non-Obamacare plans as long as they sell Obamacare-compliant plans, and one without it. "Plan A and Plan B." We'll get back to that in a moment.
  2. Congressional Budget Office scores of the various options will be released Monday, Sen. John Barrasso (R-WY) said.
  3. Then the Senate will vote on something later next week, Senate Majority Leader Mitch McConnell told reporters.

So how is the current bill going to be changed?

The Cruz proposal seems like the big question mark. Senate leadership is giving it serious consideration, but there are huge issues to work out. First, the policy could send the insurance markets into a death spiral.

It also might not fly under the Senate's procedural rules. And most importantly, it might simply not have the support it needs from the rest of the Senate Republican conference.

McConnell could give Cruz and Sen. Mike Lee (R-UT), who has made the amendment a condition of his support, a chance to offer the proposal as an amendment on the Senate floor. But when I asked Cruz today whether his plan would be added to the main bill or offered as an amendment, it sounded like the latter was a nonstarter.

"In order for this to pass, I believe it needs to be included in the text of the bill," Cruz told me.

What else? Bloomberg's Sahil Kapur reported that the revised Senate bill would keep some of Obamacare's taxes on the wealthy, a change that had been widely expected. That would give McConnell upward of $200 billion to add to the bill.

Corker said he didn't think the plan's Medicaid cuts would be reduced — which seems like a big problem for Sens. Shelley Moore Capito and Rob Portman — so presumably much of that money will go to increasing the financial assistance for private coverage. But as we reported, there isn't enough money to prevent a cut to that aid compared with Obamacare.

One other random tidbit: Sen. Lindsey Graham (R-SC) said he's working on some kind of health care proposal that could win over Democrats. He told me it would be an amendment to the Senate bill. As for what it will be, he said we'd have to wait and see.

So what does it all mean? Senate Republicans don't really seem any closer to getting 50 votes. The fine folks at Politico reported that the overarching feeling is pessimism about passing a health care bill. But they're pushing forward anyway.

Hang on.

Chart of the Day

Urban Institute

The winners and losers of the Senate health care bill. This makes it plain as day: If you make less money, you lose under the plan. If you make more money, you win. Read more from the Urban Institute.

Kliff’s Notes

Your daily top health care reads, with research help from Caitlin Davis

Today's top news

  • “Mitch McConnell delays August recess by two weeks”: “'Once the Senate completes its work on health care reform, we will turn to other important issues including the National Defense Authorization Act and the backlog of critical nominations that have been mindlessly stalled by Democrats,' McConnell said. In the new schedule, the Senate will go into recess after Aug. 11. It's a rare decision to change the calendar, as lawmakers in the House and Senate often schedule meetings in their districts and home states as well as overseas official travel.” —Joel Gehrke, Washington Examiner
  • “Senate GOP outlines revised health bill”: “Republican leaders on Tuesday outlined a revised ObamaCare replacement bill that will be unveiled on Thursday ahead of a planned vote next week. The revisions are aimed at winning over additional support, but it remains deeply in doubt whether the bill can get 50 votes. Importantly, senators said the Medicaid sections of the bill would remain largely unchanged from the initial draft, a blow to moderates who had pushed for easing cuts to Medicaid.” —Peter Sullivan, the Hill
  • “What's next if the Senate health bill fails”: “The Republican health care effort has been declared dead many times, so this is not a prediction. There's still a lot of motion, and we could see a revised Senate bill on Thursday and a vote next week. But it's time to at least consider what happens if Senate Republicans can't pass a health care bill.” —David Nather, Axios

Analysis and longer reads

  • “BCRA would damage employment and state economies, Commonwealth Fund finds”: “The Better Care Reconciliation Act, the Senate's alternative to the House-passed American Health Care Act, would likely result in 22 million more uninsured by 2026, according to the Congressional Budget Office. A Commonwealth Fund study, however, finds that the effects could be far deeper, leading to larger job losses and deeper reductions in state economies over that time.” —Jeff Lagasse, Healthcare Finance
  • “Health Reform, Both Real and Conservative”: “Rhode Island’s efforts started almost a decade ago. The governor, a Republican named Don Carcieri, asked the Bush administration for more flexibility with Medicaid in exchange for holding down costs. It was classic conservatism: reduce federal rules, give states more autonomy and let them keep some of the savings. Yet, unlike the Senate bill, Rhode Island’s plan didn’t slash Medicaid carelessly.” —David Leonhardt, New York Times
  • “Your Credit Score Soon Will Get A Buffer From Medical-Debt Wrecks”: “Changes in the way credit agencies report and evaluate medical debt are in the works that should reduce some of the painful financial consequences of having a health care problem. Starting Sept. 15, the three major credit reporting agencies — Experian, Equifax and TransUnion — will set a 180-day waiting period before including medical debt on a consumer’s credit report. The six-month period is intended to ensure there’s enough time to resolve disputes with insurers and delays in payment.” —Michelle Andrews, Kaiser Health News

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