Trump backs re­peal-only US health bill as ‘op­tion’

Kuwait Times - - HEALTH & SCIENCE -

Pres­i­dent Don­ald Trump is pres­sur­ing wa­ver­ing sen­a­tors to back a Repub­li­can bill to re­peal and re­place for­mer Pres­i­dent Barack Obama’s health care law but is hold­ing open a re­peal-only op­tion if Repub­li­cans can’t reach agree­ment over the July 4 re­cess, Trump’s top leg­isla­tive aide says. Marc Short, the White House’s leg­isla­tive direc­tor, said Trump was mak­ing week­end calls and be­lieved sen­a­tors were “get­ting close” on pass­ing a bill.

But Short main­tained that Trump con­tin­ues to be­lieve that re­peal-only leg­is­la­tion should also be con­sid­ered. Se­nate Ma­jor­ity Leader Mitch McCon­nell, R-Ky, has dis­missed the sug­ges­tion. McCon­nell says he in­tends to pro­ceed with GOP leg­is­la­tion be­ing ne­go­ti­ated dur­ing the week-long re­cess. He has pre­vi­ously said if Repub­li­cans don’t reach agree­ment, he will have to turn to Democrats, who want to fix Obama’s health care law with­out re­peal­ing it.

“Our pref­er­ence is to pass the bill the Se­nate has right now,” Short said. But he added: “If the re­place­ment part is too dif­fi­cult for Repub­li­cans to get to­gether, then let’s go back and take care of the first step of re­peal.”“That’s an op­tion,” Short em­pha­sized. Trump on Fri­day tweeted the sug­ges­tion to re­peal the Obama-era law right away and then re­place it later, an ap­proach that GOP lead­ers and the pres­i­dent him­self con­sid­ered but dis­missed months ago as im­prac­ti­cal and po­lit­i­cally un­wise.

The tweet came amid con­tin­u­ing signs of GOP dis­agree­ment among mod­er­ates and con­ser­va­tives over the bill. Repub­li­cans hold a 52-48 ma­jor­ity in the Se­nate. Just three GOP de­fec­tions would doom the leg­is­la­tion, be­cause Democrats are united in op­po­si­tion. Trump’s sug­ges­tion had the po­ten­tial to har­den di­vi­sions within the GOP as con­ser­va­tives com­plain that McCon­nell’s bill does not go far enough in re­peal­ing Obama’s health care law while mod­er­ates crit­i­cize it as overly harsh in kick­ing peo­ple off in­sur­ance rolls, shrink­ing the Med­i­caid safety net and in­creas­ing pre­mi­ums for older Amer­i­cans.

“It’s not easy mak­ing Amer­ica great again, is it?” McCon­nell said late Fri­day. Short said the White House re­mained hope­ful af­ter Se­nate Repub­li­cans submitted two ver­sions of the bill to the Con­gres­sional Bud­get Of­fice for scor­ing over the re­cess. Texas’ Sen. Ted Cruz is push­ing a con­ser­va­tive ver­sion that aims to ag­gres­sively re­duce costs by giv­ing states greater flex­i­bil­ity to cre­ate sep­a­rate higher-risk pools. The other seeks to bol­ster health care sub­si­dies for lower-in­come peo­ple, per­haps by pre­serv­ing a tax boost on high earn­ers. Health and Hu­man Ser­vices Sec­re­tary Tom Price said ne­go­ti­a­tions over the Se­nate bill were fo­cus­ing on ways to ad­dress the is­sue of Med­i­caid cov­er­age so that “no­body falls through the cracks,” com­bat­ing the opi­oid cri­sis, as well as giv­ing fam­i­lies more choice in se­lect­ing their in­sur­ance plan. “We think that Leader McCon­nell and his sen­a­tors within the Se­nate are work­ing to try to get this piece of leg­is­la­tion on track,” Price said.

But con­ser­va­tive Sen Rand Paul, R-Ky, said he didn’t think a re­peal-and-re­place bill could win 50 votes. Both he and Sen Ben Sasse, R-Neb, have been urg­ing McCon­nell to consider a re­peal only bill first. “I don’t think we’re get­ting any­where with the bill we have. We’re at an im­passe,” Paul said. He said Se­nate lead­ers were un­wisely seek­ing to win over mod­er­ates with multi­bil­lion dol­lar pro­pos­als to com­bat the opi­oid epi­demic and boost tax sub­si­dies to help low­er­in­come peo­ple get cov­er­age. “The bill is just be­ing lit up like a Christ­mas tree full of bil­lion-dol­lar or­na­ments, and it’s not re­peal,” Paul said. “I think you can get 52 Repub­li­cans for clean re­peal.”

Even be­fore Trump was in­au­gu­rated in Jan­uary, Repub­li­cans had de­bated and ul­ti­mately dis­carded the idea of re­peal­ing the over­haul be­fore re­plac­ing it, con­clud­ing that both must hap­pen si­mul­ta­ne­ously. Do­ing oth­er­wise would in­vite ac­cu­sa­tions that Repub­li­cans were sim­ply toss­ing peo­ple off cov­er­age and roil in­sur­ance mar­kets by rais­ing the ques­tion of whether, when and how Congress might re­place Obama’s law once it was gone. But at least nine GOP sen­a­tors ex­pressed op­po­si­tion af­ter a CBO anal­y­sis last week found that McCon­nell’s draft bill would re­sult in 22 mil­lion peo­ple los­ing in­sur­ance over the next decade, only 1 mil­lion fewer than un­der the Housep­a­ssed leg­is­la­tion that Trump pri­vately told sen­a­tors was “mean.”

Paul said Se­nate Repub­li­cans can do a re­peal-only bill con­cur­rently with a bill “they can call ‘re­place.’” Sasse, mean­while, said he would like to see a bill that would re­peal Oba­macare “with a de­lay.” “If we can do a com­bined re­peal and re­place over the next week, that’s great,” Sasse said. “If we can’t, though, then there’s no rea­son to walk away.” “I would want a de­lay, so that we could get straight to work. And then I think the pres­i­dent should call on the Se­nate to can­cel our Au­gust” re­cess, Sasse said. Short and Paul ap­peared on “Fox News Sun­day,” Price was on NBC’s “Meet the Press,” and Sasse spoke on CNN’s “State of the Union.” — AP

WASH­ING­TON: US Pres­i­dent Don­ald Trump talks to House Speaker Paul Ryan of Wis in the Rose Gar­den of the White House in Wash­ing­ton, af­ter the House pushed through a health care bill. — AP

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