Rand Paul released a list of demands for the Senate health care bill, and it shows why it might be impossible to pass

Sen. Rand Paul on Wednesday sent a letter to Majority Leader Mitch McConnell outlining requests for changes to the GOP health care bill.

Taken together, they are a prime example of why the bill will be so hard to pass even as leaders try to placate divided factions of the party and amend the legislation by Friday.

Paul announced that he would not support the current Senate bill, the Better Care Reconciliation Act (BCRA), soon after it was released because it did not go far enough in its repeal of Obamacare.

RELATED: A look at the Senate's all-male health care working group

13 PHOTOS
A look at the Senate's all-male health care working group
See Gallery
A look at the Senate's all-male health care working group
U.S. Senator Tom Cotton (R-AR) (L) and Senator David Perdue (R-GA) (R) unveil legislation aimed at curbing legal immigration by halving the number of legal immigrants admitted into the United States, at the U.S. Capitol in Washington, U.S. February 7, 2017. REUTERS/Jonathan Ernst
U.S. Senator Cory Gardner (R-CO) smiles after he was ceremonially sworn-in by Vice President Joseph Biden in the Old Senate Chamber on Capitol Hill in Washington January 6, 2015. REUTERS/Larry Downing (UNITED STATES - Tags: POLITICS HEADSHOT)
U.S. Senate Majority Leader Mitch McConnell (R-KY) speaks during a media briefing on Capitol Hill in Washington, U.S. April 25, 2017. REUTERS/Joshua Roberts
U.S. Senator Rob Portman (R-OH) speaks during a session called "The New Congress" at the Wall Street Journal's CEO Council meeting in Washington December 2, 2014. REUTERS/Kevin Lamarque/File Photo
U.S. Senator Pat Toomey (R-PA) speaks to the 38th annual Conservative Political Action Conference meeting in Washington DC, U.S. February 10, 2011. REUTERS/Larry Downing/File Photo
U.S. Senator John Thune addresses the media during the 2017 "Congress of Tomorrow" Joint Republican Issues Conference in Philadelphia, Pennsylvania, U.S. January 25, 2017. REUTERS/Mark Makela
U.S. Senator John Cornyn (R-TX)questions Supreme Court nominee judge Neil Gorsuch during a Senate Judiciary Committee confirmation hearing on Capitol Hill in Washington March 21, 2017. REUTERS/Joshua Roberts
Senator Ted Cruz (R-TX) questions Supreme Court nominee judge Neil Gorsuch during his Senate Judiciary Committee confirmation hearing on Capitol Hill in Washington March 21, 2017. REUTERS/Joshua Roberts
Chairman of the Senate Health, Education, Labor and Pensions Committee Lamar Alexander speaks during Rep. Tom Price's (R-GA) nomination hearing to be Health and Human Services secretary in Washington, U.S., January 18, 2017. REUTERS/Joshua Roberts
Senator Orrin Hatch (R-UT) during the second day of confirmation hearings on Senator Jeff Sessions (R-AL) nomination to be U.S. attorney general in Washington, U.S. January 11, 2017. REUTERS/Joshua Roberts
Sen. Mike Lee (R-UT) speaks at a rally for nominee Neil Gorsuch outside the Supreme Court in Washington, D.C., U.S. March 29, 2017. REUTERS/Aaron P. Bernstein
UNITED STATES - APRIL 4: Sen. John Barrasso, R-Wyo., speaks as Senate Republican leaders hold their media availability focusing on the confirmation of Neil Gorsuch as associate justice of the Supreme Court following their policy lunch on Tuesday, April 4, 2017. (Photo By Bill Clark/CQ Roll Call)
HIDE CAPTION
SHOW CAPTION
of
SEE ALL
BACK TO SLIDE

Here's a quick rundown of the four key changes Paul is seeking in the bill:

1. Create association health plans: This would allow groups of people to band together and create their own risk pool to access health insurance coverage. The current bill allows self-employed people to sign onto small business plans — Paul wants this expanded.

2. Reduce spending on "insurance company bail outs": The Senate bill currently includes funding that would help insurers offset costs for low-income Americans in the individual insurance market and a state stability fund that can be used to reduce premiums and expand coverage. Paul said these merely help to grow insurance companies' profits.

3. Eliminate premium tax credits: The current BCRA would give people making between 100% and 350% of the federal poverty line money to buy insurance. In the letter, Paul asked McConnell "to reconsider the advanced, refundable nature of this entitlement."

4. Eliminate the continuous coverage requirement: The BCRA includes a provision that says anyone who goes without insurance for more than 63 consecutive days in a year must wait six months in the following year before they can get access to coverage again. Paul said this constituted another version of Obamacare's individual mandate and asked McConnell to "simply allow insurance companies to impose a waiting period."

Paul's policy goals are consistent with the conservative message he has touted since the release of the House's version of health care reform.

Politically, however, none of the requests are likely tenable if McConnell wants to get the needed 50 votes to pass the BCRA.

RELATED: GOP senators who oppose the Republican Obamacare replacement bill

7 PHOTOS
GOP senators who oppose the Republican Obamacare replacement bill
See Gallery
GOP senators who oppose the Republican Obamacare replacement bill
Senator Rand Paul (R-KY) speaks to reporters after Senate Republicans unveiled their version of legislation that would replace Obamacare on Capitol Hill in Washington, U.S., June 22, 2017. REUTERS/Joshua Roberts
U.S. Senator Mike Lee (R-UT) questions Supreme Court nominee judge Neil Gorsuch during a Senate Judiciary Committee confirmation hearing on Capitol Hill in Washington March 21, 2017. REUTERS/Joshua Roberts
Senator Susan Collins (R-ME) questions witnesses about Russian interference in U.S. elections to the Senate Intelligence Committee in Washington, U.S., June 21, 2017. REUTERS/Joshua Roberts
WASHINGTON, D.C. - APRIL 05: Senate Homeland Security Committee Chairman Sen. Ron Johnson (R-WI) speaks during a Senate Homeland Security Committee hearing on April 5, 2017 on Capitol Hill in Washington, D.C. (Photo by Zach Gibson/Getty Images)
WASHINGTON, DC - APRIL 03: Senate Judiciary Committee member Sen. Ted Cruz (R-TX) delivers prepared remarks during an executive business meeting to debate and vote on Supreme Court nominee Judge Neil Gorsuch's nomination out of committee and on to a vote by the full Senate in the Hart Senate Office Building on Capitol Hill April 3, 2017 in Washington, DC. If Senate Republicans fail to get the 60 votes necessary to confirm Gorsuch then Democrats have threatened to filibuster the nominee. Senate Majority Leader Mitch McConnell (R-KY) has said he intends to have a vote on Gorsuch this week. (Photo by Chip Somodevilla/Getty Images)
Senator Dean Heller (R-NV) arrives at the Senate Judiciary Committee Privacy, Technology and the Law Subcommittee hearing on The Surveillance Transparency Act of 2013 on Capitol Hill in Washington, November 13, 2013. REUTERS/Yuri Gripas (UNITED STATES - Tags: POLITICS MILITARY SCIENCE TECHNOLOGY HEADSHOT)
HIDE CAPTION
SHOW CAPTION
of
SEE ALL
BACK TO SLIDE

More moderate senators, like Dean Heller of Nevada, Susan Collins of Maine, Shelley Moore Capito of West Virginia, and Rob Portman of Ohio have publicly said they would not support the current iteration of the bill because it goes too far in some of its changes to the current health care system. The Medicaid cuts are too deep, and the spending to help people get access to care is not enough, these senators have said.

If McConnell meets Paul's demands, that would likely solidify those four members opposition, killing the bill.

But attempting to pick up the moderate wing also poses a problem. Losing Paul could mean that conservative senators like Mike Lee of Utah, Ted Cruz of Texas, and Ron Johnson of Wisconsin would follow. McConnell can only afford two defections for the bill to pass.

McConnell is reportedly aiming to get a deal done by Friday in order to get a vote on the revised bill as soon as the Senate returns from its week-long July 4 recess.

More from Business Insider:
'Trump doesn't bring us any votes': Trump appears to be losing influence on healthcare
'What you feel isn't relevant': Sen. Angus King grills intel leaders on whether Trump tried to influence them
New York's subway system is falling apart — and furious passengers are blaming Cuomo

Read Full Story

Sign up for Breaking News by AOL to get the latest breaking news alerts and updates delivered straight to your inbox.

Subscribe to our other newsletters

Emails may offer personalized content or ads. Learn more. You may unsubscribe any time.