Johnny Isakson and David Perdue's opening offers on health care

In fact, Georgia’s senior senator followed much of the initial debate in real time from his hospital bed as he recovered from a pair of surgeries on his lower spine.

“Involuntary,” Isakson deadpanned as he recounted the hours spent watching cable news coverage of the legislation. “Under the influence of narcotics, by the way.”

It took the House GOP two months to get its Obamacare replacement bill, known as the American Health Care Act, over to the Senate, where the legislation now faces an uncertain future.

With the Democrats unwilling to touch any legislation that could unwind former President Barack Obama’s signature policy achievement, Republicans are left to pass a health care alternative on their own.

Majority Leader Mitch McConnell has an incredibly delicate task ahead as he seeks to unite his divided caucus behind a new proposal. The Kentucky Republican must find a plan that assuages both conservatives who want minimal government intervention in the health care system and moderates concerned about constituents losing coverage, with only two votes to spare.

Georgia’s senators aren’t considered big holdouts in this particular debate -- Isakson is known among GOP leaders as a team player and U.S. Sen. David Perdue has positioned himself as a key ally of President Donald Trump and his agenda. Their support, however, is crucial to the survival of any GOP plan.

In interviews late last week, both Perdue and Isakson expressed their desires to quickly replace Obamacare and flexibility regarding how exactly to do that.

Among their top priorities is making sure that the 19 states that didn’t expand Medicaid under Obamacare, including Georgia, don’t get financially disadvantaged under such legislation.

“I want to get something that works for the people who need it and that we maintain the independence for the states in terms of taking care of their own people,” Perdue said.

Both want to work with Democrats but indicated they weren't sure whether any proposal could win their colleagues' support, much less that of the 50 other Republicans.

Isakson, who had earlier backed a separate GOP health care plan that would let states decide whether to keep Obamacare or pursue something different, repeatedly emphasized that he did not want to commit himself to specific policy proposals at the expense of a final deal.

"You’ve got to consider everything in the totality of the proposal," he said.

Here is where the two stand on some of the health care debate’s biggest fault lines:

Perdue said he’s worried that a state with a growing population such as Georgia could end up locked into an outdated formula that could limit the stream of federal dollars. “We’re a growth state,” he said. “I’d prefer to have a per capita relationship in terms of how they manage that money out every year.” Isakson expressed similar concerns.

Both Isakson and Perdue echoed Gov. Nathan Deal, who has argued that any Republican health care plan must not “punish” Georgia and other states that haven’t expanded Medicaid. Boiling it down, they don’t want the Peach State to end up with fewer federal resources than expansion states in the long run. “Most of this stuff is ‘show me the money,’” Isakson said. “It’s all about cost, it’s all about compensation.” Perdue said that if a Senate bill sets aside a pot of funding for non-expansion states such as Georgia, he wants the governors to have the flexibility to send money to priorities such as ailing rural hospitals.

Perdue said he does not think “anybody making $200,000 needs a tax credit to pay for their health insurance” and that both age and income should be determining factors. Isakson previously supported a GOP proposal that would means test the House GOP’s age-based tax credits. In other words, it aims to redistribute the benefits toward lower-income people by phasing out the credits for wealthier individuals.

Isakson said there is “an obligation to provide a way for those who are uninsured or uninsurable to be able to be insured and insurable.” He also said he is not opposed to including incentives or eligibility requirements for wellness and disease management because of their ability to lower health care costs down the road. Perdue said there are ways of taking care of people with preexisting conditions without making the cost of care “explode” but did not elaborate.

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About the Author

Tamar Hallerman
Tamar Hallerman
Tamar Hallerman is The Atlanta Journal-Constitution's Washington correspondent, covering Congress, federal agencies and other government activities that...
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