Senate Majority Leader Mitch McConnell says Republicans will release a discussion draft of their version of the health care bill on Thursday, with a vote likely next week.

Private health care talks have been underway in the Senate for weeks. McConnell tapped a 13-member working group last month to hash out senators’ differences over the House-passed American Health Care Act. McConnell’s office has since taken the lead drafting the Senate version of the party’s long-promised legislation to dismantle the Affordable Care Act.

Senate Republicans have been coy — or simply out of the loop — on the specifics in the Senate plan, but here is what we know about what might be in the bill and where it could be headed:

It Sounds A Lot Like The House Bill

After the House passed AHCA in early May, leading senators asserted that the Senate would go their own way. “We’re writing a Senate bill and not passing the House bill,” Sen. Lamar Alexander, R-Tenn., said then. “We’ll take whatever good ideas we find there that meet our goals.”

In the end, those goals appear to be aligned.

The structure of the Senate bill, as described by GOP senators and aides, appears fundamentally the same as the House-passed plan.

The Senate bill is also expected to repeal the individual mandate and all or most of the ACA’s taxes, phase out the Medicaid expansion as well as change how the Medicaid program is funded, establish a system of tax credits to help people buy insurance if they choose, and make it easier for states to opt-out of the ACA’s mandates for preexisting conditions and minimum insurance coverage mandates.

There will be changes. For instance, the Senate version is expected to include more generous tax credits to make sure older, poorer Americans don’t get hit with higher costs. Republicans are also battling over how best to remake the Medicaid program, with key vote senators like Shelley Moore Capito of West Virginia sounding skittish about Medicaid reductions.

Other Republicans are excited by the bill. Sen. John Barrasso, R-Wyo., has been one of the most vocal advocates for Obamacare repeal. “People didn’t want to have to buy this product. This is a sinking ship, people are ready to jump off,” he said Tuesday. Republicans like Barrasso see the bill as a win for the GOP and for the promises they made on the campaign trail.

“We eliminate the individual mandate. You’ll see more people as free citizens making a decision to not have Obamacare insurance, but certainly have more freedom,” Barrasso said.

The Process Stinks

“Can you say it was done openly? With transparency and accountability? Without backroom deals and struck behind closed doors? Hidden from the people? Hell no you can’t! Have you read the bill? Have you read the reconciliation bill? Have you read the manager’s amendment? Hell no you haven’t!”

That’s not Senate Minority Leader Chuck Schumer in 2017, that was former Minority Leader John Boehner in 2010 before House Democrats passed the Affordable Care Act.

Republicans vilified Democrats seven years ago for negotiating the final details of Obamacare behind closed doors. Today Senate Republicans’ response could be: We learned it from watching you.

The Senate has not held any public hearings on their health care bill (the House did), senators involved in the talks have been tight-lipped on the substance, and the public will only have a few days to see it before it gets a vote.

McConnell brushed off questions about transparency. “They’ll have plenty of time,” he told reporters Tuesday. “We’ve been discussing all the elements of this endlessly for seven years. Everybody pretty well understands it. Everybody will have adequate time to take a look at it.”

That argument rings hollow with some of his fellow Republicans. “We used to complain like hell when the Democrats ran the Affordable Care Act. Now, we’re doing the same thing,” Sen. John McCain, R-Ariz., told CNN.

“If you’re frustrated in the lack of transparency in this process, I share your frustration,” Sen. Mike Lee, R-Utah, said in a Facebook video for his constituents. Lee is a part of the 13-member working group, but he said he hasn’t seen the draft bill. “I just haven’t been able to see it yet and as far as I know the overwhelming majority of my colleagues haven’t been able to see it either.”

Failure Is An Option

McConnell has been quietly leading Republicans’ to a vote next week but that doesn’t mean it’s going to pass.

“We’re going to make every effort to pass a bill that dramatically changes the current health care law,” McConnell said when asked if he has the votes.

“I think the leader has made it pretty clear we’re going to vote, one way or another, and hopefully we’ll have 50 votes when that time comes,” Senate Republican Conference Chairman John Thune said when asked if he believed McConnell would bring a bill to the floor that didn’t have the votes to pass.

While no Republican senator has yet come out opposed the bill, McConnell has only a two-vote margin of error with many senators voicing problems with the legislation.

“If our bill comes in with greater subsidies than Obamacare, it makes it hard for conservatives to support a bill that actually has greater subsidies than Obamacare,” Sen. Rand Paul, R-Ky., told reporters in regards to the tax credits in the GOP plan. “That for me is a nonstarter.”

Conservatives like Ted Cruz of Texas and Mike Lee have Utah have been skeptical about the bill’s ability to ultimately lower premium costs for Americans. Both are seen as potential ‘no’ votes on the bill.

More moderate senators like Susan Collins of Maine and Lisa Murkowski of Alaska are also seen as potential ‘no’ votes on the other end of the spectrum.

Defeat of the House-passed bill wouldn’t necessarily end the health care debate in Congress, but it would redefine it.

Wisconsin GOP Sen. Ron Johnson hinted at what that would look like at a constituent event last Friday. “I’m not sure if we’re going to come up with 50 votes with a Republican solution. Let’s stabilize the markets and then, long-term, work with the Democrats colleagues to actually fix the healthcare system,” Johnson said.

The White House Doesn’t Love It — Yet

The White House has maintained a light tough when it comes to shaping the policies in the health care bill, but President Trump reportedly told a group of senators last week that the bill passed in the House was “mean” and he wanted the final bill to do more to help needier Americans.

On Tuesday, White House Spokesman Sean Spicer told reporters the president “wants a bill that has heart in it” but did not offer any specific policies Trump wants in the bill. Spicer also said he didn’t know if the president had seen a draft of the Senate bill.

If the Senate approves a bill next week, it still has more hurdles to go. The House either needs to pass the Senate bill as-is and send it to Trump’s desk, or the House and Senate have to go into a third round of negotiations in which both chambers would have to vote again on a final, compromise bill.

Either way, the health care debate is likely to continue into July if the Senate can pass a bill next week.

Democrats Debate How Far To Take Their Fight

Senate Democrats can’t filibuster the bill because it’s protected under special budget rules and only requires a majority vote. They’re all going to oppose it, but they can’t ultimately stop it from eventually getting an up-or-down vote.

Democrats have started a series of protests this week that could intensify as the Senate approaches that vote. They held the floor Monday evening for a series of speeches in opposition to the bill. On Tuesday, they invoked a rule to block any committee hearings from taking place that afternoon to draw attention to their opposition to the health care bill.

Outside Democratic activists associated with Indivisible are calling for Democrats to use every procedural tactic available to slow down debate. Since amendments are unlimited on a bill like this, one activist has even called on Democrats to introduce 40,000 amendments to keep the Senate on the bill through the 2018 midterms.

It’s unclear how Democrats will respond next week, but Schumer said Republicans should expect a fight. “If Republicans won’t relent and debate their health care bill in the open for the American people to see, then they shouldn’t expect business as usual in the Senate,” Schumer said in a statement.

NPR congressional reporters Scott Detrow and Geoff Bennett contributed to this report.

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The Republican effort to overhaul the Affordable Care Act, or Obamacare, has led to a standoff in the Senate.

Senate Democrats on Monday night began using parliamentary maneuvers to slow Senate business as part of a coordinated protest against the GOP push to pass an Obamacare replacement bill. A small group of Republican senators has been working in private for weeks, shielding from public view the bill and the negotiations surrounding it.

In a show of frustration with what they deem the GOP’s “shameful” and “secret” legislative process, Democrats on Monday also held the Senate floor with a series of back-to-back speeches.

“If Republicans are not going to allow debate on their bill on the floor or in committee, Democrats will make opportunities to debate,” said Senate Minority Leader Chuck Schumer, speaking Monday on the Senate floor. “And these are merely the first steps we’re prepared to take in order to shine a light on the shameful Trumpcare bill and reveal to the public the GOP’s backroom deal-making.”

Liberal activists cheered on social media as Schumer forced McConnell to object to a motion to hold public hearings on the health care bill, and then pressed the Republican leader to commit to 10 hours of open debate.

Senate Democrats, in taking action Monday, are inserting themselves into a process that has excluded them by design. Democratic lawmakers are also responding to growing pressure from progressive activists who have been calling for more aggressive opposition. Members of the Democratic base have expressed concern that Republicans are moving forward with their health care bill while attention has been focused elsewhere — namely on the Russia investigations.

Some Republicans are also out of the loop

It’s not just Democrats who have been left out of the health care deliberations. Many Republican senators have seen little more than an outline and a Power Point summary of the Senate health care legislation that is being drafted.

“It’s not unusual, especially for a big bill like this. It’s okay that the drafting is happening behind closed doors,” Tommy Binion, a congressional liaison at the conservative Heritage Foundation, told NPR’s Morning Edition.

While GOP senators aren’t objecting to the process as vehemently as Democrats, a number of Republicans, including Sen. Marco Rubio, R-Fla., say the health care legislation should eventually be subject to open debate.

“If it’s an effort to rush it from a small group of people straight to the floor on an up or down vote, it’ll be a problem,” Rubio said Sunday on CNN’s State of the Union.

McConnell: “Nobody is hiding the ball here”

The Republican health care bill could be voted on as early as next week – ahead of the July 4th recess — without any committee hearings or public input. For his part, Senate Majority Leader Mitch McConnell is defending the closed health care talks.

“Nobody is hiding the ball here,” McConnell, R-Ky., told reporters last week. “There have been gazillions of hearings on this subject when [Democrats] were in the majority, when we were in the majority. We understand the issue very well and we are now coming up with a solution.”

Republicans contend the secret Senate negotiations give them time and space free from scrutiny to hash out the significant and serious differences among themselves over contentious issues, such as phasing out Medicaid expansion and determining the plan’s coverage requirements.

Democrats say the closed talks are a tacit acknowledgment by Republicans that their efforts are unpopular.

“There’s only one reason why Republicans are doing this: They’re ashamed of their bill,” said Schumer on Monday. “The Republicans are writing their health care bill under the cover of darkness because they’re ashamed of it, plain and simple.”

While the Senate is crafting its own legislation, the House-passed American Health Care Act is viewed unfavorably by a majority of Americans – 55 percent – compared with 31 percent who viewed it favorably, according to a Kaiser Family Foundation poll released in May.

What’s more, the Congressional Budget Office estimated that the House health care bill would result in 23 million fewer people with insurance in a decade, and it would leave many sicker and older Americans with much higher costs.

Republicans eager to move on from health care

Still, Senate Republicans badly want to take up other priorities such as overhauling the country’s tax code.

“We’ve been debating Obamacare’s failures and what to do about them for so many years now,” McConnell said Monday on the Senate floor. “Members are very, very familiar with this issue. Thankfully, at the end of this process, the Senate will finally have a chance to turn the page on this failed law.”

Any legislation the Senate passes would head back to the House for consideration before President Trump can sign it into law.

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