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Senate GOP aims to release new health bill by week’s end

Senate Republicans are hoping to unveil a revamped draft of their legislation to repeal and replace Obamacare by the end of this week, though there are major questions about how it will address roiling GOP disagreement over a proposal touted by conservative senators.

New bill text could be unveiled to senators as soon as Thursday, according to sources familiar with the proposal. A Congressional Budget Office score is likely to follow as soon as next Monday; a vote could come by the end of next week.

Though Republicans are aiming to have a new CBO report of their latest proposal by early next week, it may not include an analysis of an amendment penned by GOP Sens. Mike Lee of Utah and Ted Cruz of Texas that would allow the sale of cheap insurance plans outside Obamacare’s regulatory structure.

Several Republicans said the so-called Consumer Freedom Act was not fully transmitted to CBO before the July Fourth recess, which could result in the incomplete analysis.

A conservative aide familiar with the negotiations said GOP leaders had only sent a summary of the legislation "for reasons unknown to us," leaving supporters to answer other questions for CBO late last week. Allies of leadership, however, argued the conservatives had been unresponsive.

Senate Majority Leader Mitch McConnell is expected to brief the full 52-member caucus on Tuesday and Wednesday on CBO’s analysis of proposed alterations to the Senate’s draft bill, which is far from the requisite 50 votes needed.

Republicans are leaning toward keeping some of Obamacare’s taxes to help lower premiums for low-income people, plowing $45 billion into fighting opioid addiction and allowing people to pay premiums with pre-tax money. How to get the support of senators from Medicaid expansion states is also unsolved.

A McConnell spokesman had no announcements on timing for consideration of the bill.

Republicans need "divine intervention" to get the negotiations back on track, said a Republican aide. Another aide said the negotiations aren’t expected to move significantly until the new CBO scores are released. The score on the Cruz amendment, if CBO can finish it, could show premiums spiking high enough to kill the proposal. The amendment does not currently have the support to pass the Senate.

"They’ll give Cruz every opportunity to sell his solution this week. He’s going to be the one making the sell this week. The question is whether the Cruz-Lee amendment costs you votes. The votes are clearly not there right now," said a person familiar with the negotiations.

The finger-pointing over the amendment’s status could have dire implications for the health care bill, which has now soaked up more than two months of the Senate’s time. Cruz, Lee and conservative groups have been pressing for the amendment to be included in the next draft of the Senate’s legislation, arguing that it will lower premiums for most people while still protecting people with pre-existing conditions and supplying them subsidies.

GOP critics like Sens. Chuck Grassley of Iowa, Susan Collins of Maine and Shelley Moore Capito of West Virginia have worried that Cruz’s amendment would make it harder for people with pre-existing conditions to get covered — arguments being amplified by Democrats. Opposition from those senators alone would tank the amendment.

On the Sunday, Cruz argued that his amendment is a compromise, not a shot from the right that should drive other Republicans away.

“The Consumer Freedom Amendment was designed to be a compromise, to bring together both conservatives and moderates to unify the party. How does it do that? Because it maintains preexisting conditions protections,” Cruz said on ABC’s “This Week.”

Yet if there is no CBO score on the provision, it would be impossible to evaluate whether the proposal would lower premiums and how it would affect insurance coverage numbers and the stability of insurance markets. GOP leaders are tentatively targeting next week for a floor vote on a health care bill, but they must have CBO scores for their proposal to pass the muster of the Senate parliamentarian.

Republicans are now wondering whether the conservative duo would accept something else as a condition for their support. A spokesman to Lee said he needs significant regulatory cuts in the Senate bill to support it.

Eliana Johnson contributed to this report.