u.s. senate republicans make one last attempt overhaul obamacare special parliamentary procedure allow bill pass simple majority expire end month late proposal call graham-cassidy bill sponsor republican senators lindsey graham bill cassidy dean heller ron johnson would give state money form block grant allow design healthcare systems maintain regulations affordable care act former democratic president barack obama signature domestic policy achievement federal fund would run 2027 would need reauthorized bill gain momentum week republicans aim deliver seven-year campaign promise one president donald trump top campaign pledge bill sponsor say close 50 vote need passage vice president mike pence cast tie-breaking vote necessary main provision proposal like previous repeal bill graham-cassidy proposal retroactively repeal so-called individual mandate requirement everyone purchase health insurance else pay fine also retroactively repeal mandate certain employers provide health insurance workers health policy experts say individual mandate need induce young healthy people may otherwise forgo coverage buy insurance offset cost sick expensive patients bill author say state could maintain obamacare expansion medicaid government health insurance program poor disable choose legislation repeal enhance federal fund expansion begin 2020. limit medicaid spend begin 2020 implement per capita cap proposal aim distribute equal fund state medicaid provide block grant base number enrollees state block grant couple repeal medicaid expansion would slash fund 31 state expand government program state expand would see short-term boost federal fund state would also allow introduce medicaid work requirements many eligible adults receive benefit fundamental change government program bill maintain obamacare rule children allow stay parent health insurance age 26 one law popular provision one favor trump legislation allow state opt requirement insurers charge sick healthy people rat state would able set high-risk pool expensive patients purchase coverage healthy individuals would able purchase cheap bare-bones health plan would also enable state waive obamacare requirement insurers cover 10 essential health benefit maternity newborn care prescription drug mental health addiction treatment proposal repeal obamacare tax suppose help pay law future include so-called cadillac tax high-cost employer-sponsored insurance tax medical device manufacturers repeal few tax previous repeal efforts bill would also 2020 repeal income-based tax credit help low-income people purchase health insurance bill defunds plan parenthood women health organization conservatives oppose due abortion birth control service one year factbox late obamacare repeal bill would block grant money state gut medicaid