In this week’s Reality Check, John Tracy explains why the vote on health care could have a big impact on Alaskans, and the politicians who approve it.

In the 2014 election, Mark Begich was one of the several Democratic Senators portrayed as the final vote that inflicted Obamacare on America.

It was a factor in losing his seat after one term.

Three years later, Alaska’s Senators may actually hold the key to the attempted repeal and replacement of the Affordable Care Act.

Senate Majority Leader Mitch McConnell is in a tough spot.

He can only afford to lose two members, and when five Republicans said they couldn’t support the bill as written, the Senate leader had no choice but to retreat.

Four of his members say the bill keeps too many of Obamacare’s protections.

The fifth, Senator Dean Heller of Nevada says the bill takes away too many and the massive cuts to Medicaid to offset tax cuts for the wealthy would harm the most vulnerable in his state.

McConnell’s dilemma is that making the bill more compassionate could cost him votes on the right while making the bill meaner could cost him the votes of moderates.

All eyes are on Senators Lisa Murkowski and Susan Collins of Maine. Both of whom have said they don’t support the bill at this time — largely because of the cuts to Medicaid, but also because of the bill’s one-year moratorium on Planned Parenthood funding.

Cutting funding to Planned Parenthood has become an almost pathological obsession of the far right.

Murkowski and Collins say they plan to offer an amendment to strike the Planned Parenthood provision from the bill.

Murkowski has said she can’t support a bill that defunds Planned Parenthood, but McConnell knows if Murkowski and Collins get their way, the bill could lose the support of his most conservative members.

He’ll be putting the pressure on our senior Senator and Alaskans will be looking to see if Lisa Murkowski holds firm on her commitment

Senator Dan Sullivan doesn’t have a problem with de-funding Planned Parenthood, but, has said he won’t support a bill that makes things worse for Alaskans.

The bill’s cuts and caps to Medicaid alone will lead to reduced coverage and higher costs for the state for the more than 130,000 Alaskans on the program.

Alaskans currently paying among the highest premiums in the country under Obamacare would not only pay more but, much more under the Republican bill.

They would likely be among the 15 million Americans expected to drop or lose their health coverage by the end of next year.

But, Republicans appear desperate to pass a bill — any bill that overturns Obamacare without making any of the improvements it so clearly needs.

As one Alaskan put it to me, if you’re old or sick, or plan to be either in the future, this bill is bad medicine.

Mark Begich stood behind his vote on Obamacare and paid a price for it. If Lisa Murkowski and Dan Sullivan vote yes on the current bill without substantive changes, it will be Alaskans who stand to pay the biggest price.

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