US health­care re­form col­lapses

Kuwait Times - - FRONT PAGE -

WASH­ING­TON: US Pres­i­dent Donald Trump blasted con­gres­sional Democrats and “a few Repub­li­cans” yes­ter­day over the fail­ure of the GOP ef­fort to re­write the Obama health­care law, and warned, “we will re­turn”. Trump’s early morn­ing tweet un­leashed a bar­rage of crit­i­cism at Congress over the col­lapse of the GOP’s flag­ship leg­isla­tive pri­or­ity. For seven years, the party has pledged to re­peal Pres­i­dent Barack Obama’s law. “Most Repub­li­cans were loyal, ter­rific & worked re­ally hard,” Trump tweeted yes­ter­day morn­ing, but said, “We were let down by all of the Democrats and a few Repub­li­cans.” He added, “As I have al­ways said, let Oba­maCare fail and then come to­gether and do a great health­care plan. Stay tuned!”

Two GOP sen­a­tors - Utah’s Mike Lee and Jerry Mo­ran of Kansas - sealed the mea­sure’s doom late Mon­day when they an­nounced they would vote “no” in an ini­tial, crit­i­cal vote that had been ex­pected as soon as next week. That meant that at least four of the 52 GOP sen­a­tors were ready to block the mea­sure - two more than Ma­jor­ity Leader Mitch McCon­nell, R-Ky., had to spare in the face of unan­i­mous Demo­cratic op­po­si­tion.

“Re­gret­fully, it is now ap­par­ent that the ef­fort to re­peal and im­me­di­ately re­place the fail­ure of Oba­macare will not be suc­cess­ful,” McCon­nell said in a late evening state­ment

that es­sen­tially waved a white flag. It was the sec­ond sting­ing set­back on the is­sue in three weeks for McCon­nell, whose rep­u­ta­tion as a leg­isla­tive mas­ter­mind has been marred as he’s failed to unite his cham­ber’s Repub­li­cans be­hind a health over­haul pack­age that’s high­lighted jagged di­vides be­tween con­ser­va­tives and mod­er­ates. In late June, he aban­doned an ini­tial pack­age af­ter he lacked enough GOP sup­port to pass.

The episode has also been jar­ring for Trump, whose in­ter­mit­tent lob­by­ing and neb­u­lous, of­ten con­tra­dic­tory de­scrip­tions of what he’s wanted have shown he has limited clout with sen­a­tors. That de­spite a de­ter­mi­na­tion by Trump, McCon­nell and House Speaker Paul Ryan to demon­strate that a GOP run­ning the White House and Congress can gov­ern ef­fec­tively. Now, McCon­nell said, the Se­nate would vote on a mea­sure the GOP-run Congress ap­proved in 2015, only to be ve­toed by Obama - a bill re­peal­ing much of Obama’s statute, with a twoyear de­lay de­signed to give law­mak­ers time to en­act a re­place­ment. Trump em­braced that idea last month af­ter an ini­tial ver­sion of McCon­nell’s bill col­lapsed due un­der Repub­li­can di­vi­sions, and did so again late Mon­day.

“Repub­li­cans should just RE­PEAL fail­ing Oba­maCare now & work on a new Health­care Plan that will start from a clean slate. Dems will join in!” Trump tweeted. But the prospects for ap­prov­ing a clean re­peal bill fol­lowed by work on re­place­ment leg­is­la­tion, even with Trump ready to sign it, seemed shaky. Trump and party lead­ers had started this year em­brac­ing that strat­egy, only to aban­don it when it seemed in­ca­pable of pass­ing Congress, with many Repub­li­cans wor­ried it would cause in­surance mar­ket and po­lit­i­cal chaos be­cause of un­cer­tainty that they would ap­prove sub­sti­tute leg­is­la­tion.

McCon­nell’s failed bill would have left 22 mil­lion unin­sured by 2026, ac­cord­ing to the non­par­ti­san Con­gres­sional Bud­get Of­fice, a num­ber that many Repub­li­cans found un­palat­able. But the ve­toed 2015 mea­sure would be even worse, the bud­get of­fice said last Jan­uary, pro­duc­ing 32 mil­lion ad­di­tional unin­sured peo­ple by 2026 - fig­ures that seemed likely to drive a stake into that bill’s prospects for pass­ing Congress.

That would seem to leave McCon­nell with an op­tion he de­scribed last month - ne­go­ti­at­ing with Se­nate Mi­nor­ity Leader Chuck Schumer. That would likely be on a nar­rower pack­age aimed more at keep­ing in­sur­ers in dif­fi­cult mar­ket­places they’re ei­ther aban­don­ing or im­pos­ing rapidly grow­ing pre­mi­ums. “The core of this bill is un­work­able,” Schumer said in a state­ment. He said Repub­li­cans “should start from scratch and work with Democrats on a bill that low­ers pre­mi­ums, pro­vides longterm sta­bil­ity to the mar­kets and im­proves our health care sys­tem.”

Sim­i­lar to leg­is­la­tion the House ap­proved in May af­ter its own set­backs, McCon­nell’s bill would re­peal Obama’s tax penal­ties on peo­ple who don’t buy cov­er­age and cut the Med­i­caid pro­gram for the poor, el­derly and nurs­ing home res­i­dents. It rolled back many of the statute’s re­quire­ments for the poli­cies in­sur­ers can sell and elim­i­nated many tax in­creases that raised money for Obama’s ex­pan­sion to 20 mil­lion more peo­ple, though it re­tained the law’s tax boosts on high earn­ers.

Be­sides Lee and Mo­ran, two other GOP sen­a­tors had pre­vi­ously de­clared their op­po­si­tion to McCon­nell’s bill: mod­er­ate Maine Sen Su­san Collins and conservative Rand Paul of Ken­tucky. And other mod­er­ates were wa­ver­ing and could have been dif­fi­cult for McCon­nell and Trump to win over be­cause of the bill’s Med­i­caid cuts: Alaska’s Lisa Murkowski, Cory Gard­ner of Colorado, Rob Port­man of Ohio, Shel­ley Moore Capito of West Vir­ginia and Dean Heller of Ne­vada, prob­a­bly the most en­dan­gered Se­nate Repub­li­can in next year’s elec­tions.

The range of ob­jec­tions lodged by the dis­si­dent sen­a­tors un­der­scored the war­ring view­points within his own party that McCon­nell had to try patch­ing over. Lee com­plained that the GOP bill didn’t go far enough in rolling back Obama’s ro­bust cov­er­age re­quire­ments, while mod­er­ates like Collins be­rated its Med­i­caid cuts and the mil­lions it would leave without in­surance. McCon­nell’s re­vised ver­sion aimed to sat­isfy both camps, by in­cor­po­rat­ing lan­guage by Sen Ted Cruz of Texas al­low­ing in­sur­ers to sell skimpy plans along­side more ro­bust ones, and by adding tens of bil­lions of dol­lars to treat opi­oid ad­dic­tion and to de­fray con­sumer costs. His ef­forts did not achieve the in­tended re­sult. — AP

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