‘Obamacare’ repeal in for bumpy ride
Republicans are claiming a triumph by pushing their legislative centerpiece scuttling much of President Barack Obama’s health care law through the House. It was a perilous journey, and its Senate pathway will be at least as bumpy with little doubt the measure will change, assuming it survives.
Thursday’s 217-213 House passage — with 20 GOP defections — was preceded by several near-death experiences for the legislation, even though repealing Obama’s statute helped guide Donald Trump’s presidential run and multitudes of GOP congressional campaigns.
And that was in a chamber Republicans control 238-193. Had just two additional Republicans voted “no,” the measure would have lost because bills need majorities to pass. Now, Republicans must try manoeuvring the measure through a Senate terrain that is different politically and procedurally from the House.
“We must manage expectations and remain focused on the art of the doable as we move forward,” said Senate Finance Committee Chairman Orrin Hatch, R-Utah, among several cautionary statements issued by Senate Republicans after the House vote.
The House bill would end the Obama law’s fines on people who don’t purchase policies and erase its taxes on health industry businesses and higherearning people. It would dilute Obama’s consumer-friendly insurance coverage requirements, like letting states permit insurers to charge higher
premiums for customers with pre-existing medical conditions.
The measure would replace Obama’s federal subsidies for lower-income insurance buyers with tax credits geared to consumers’ ages. And it would cut Medicaid, the health insurance program for the poor and disabled, including ending extra federal payments 31 states are accepting to expand Medicaid to cover more people.
On Friday, critics of the legislation were using the “I Am A Pre-existing Condition” hashtag on Twitter to express worries that the bill would deny coverage to people with
serious illnesses like cancer or post-traumatic stress disorder.
The House bill bars insurers from refusing policies to extremely ill people. But opponents argue it effectively does that by letting insurers impose higher prices on some people with pre-existing illnesses and who let their coverage lapse. The bill includes billions of dollars to help those people, but experts say it’s unlikely to be enough.
The House bill was written by Republicans representing districts often drawn to incorporate strong majorities of GOP voters. Senators represent entire states, and many tend to
reflect more pragmatic views than their House colleagues.
Several come from northeastern and Midwestern states with large numbers of low-income people receiving Medicaid. Many of the 31 states that accepted Obama’s expansion of that program are led by GOP governors, and senators have no interest in cutting their states’ funds and taking coverage away from voters.
Republican senators also represent states ravaged by deaths caused by opioid abuse. The House measure would let states escape Obama’s requirement that insurers cover antidrug services.
People look on during a healthcare rally Thursday, in Salt Lake City. Utah’s all-Republican House delegation voted Thursday in favor of a health care overhaul. Congress may have passed the health law but now it faces a rocky ride in the U.S. Senate where some Republicans already say they don’t like it.