The U.S. Senate returned from recess to tackle the issue of passing the American Health Care Act (AHCA), and it now appears that majority leader Mitch McConnell, R-Ky., intends to complete work and have the Senate vote on the bill by the end of June to avoid weighing down the rest of Republicans’ agenda. McConnell is leading a 13-member working group that is getting close to a framework considering provisions that would reduce premiums and provide more generous tax subsidies than those in the House version. The Senate is expected to have a draft of the bill this week.

The American Hospital Association (AHA) and SDAHO are urging members to reach out to their senators and ask them to ensure that the Senate version of the AHCA protects the most vulnerable – children, the poor, the disabled and those with pre-existing conditions.

McConnell is likely to push for some “modest” changes to the House bill that would involve maintaining the required $133 billion in savings and $666 billion in tax cuts. These cuts would have a larger negative impact on non-expansion states, including South Dakota. There is wrangling over which inflationary index would be utilized, along with discussions on a new cap for Medicaid payments. Conservatives prefer the urban consumer price index that would reduce Medicaid spending even further. While moderates would like to see an inflationary index more closely tied to the rate of medical inflation.