Senators' demands underscore McConnell's health care problem

Facing solid Democratic opposition to demolishing former President Barack Obama's 2010 overhaul, Republicans will lose if just three of their 52 senators defect.

In a report that complicated McConnell's task, the nonpartisan Congressional Budget Office delivered a damaging critique last week of the GOP-written bill the House approved May 4.

Booting that many people off health care coverage is a nonstarter for many Republican senators.

The number can be reduced by spending more on Medicaid, fattening tax credits for people buying insurance and boosting government payments to insurers to help them lower consumers' costs.

The House bill would halt extra federal funds in 2020 that 31 states get for Obama's expansion of the federal-state health care program for poorer and disabled Americans.

The legislation would also give states fixed federal sums annually, ending the open-ended payments Washington has always made to reflect growing medical expenses and caseloads.

The House bill does that and bars the use of federal health insurance tax credits for policies covering abortion.

With its remoteness, high living costs and small pool of residents, Alaska has had the highest premiums in the U.S. since Obama's law took effect, says Cynthia Cox, an associate director at the nonpartisan Kaiser Family Foundation.