Pressure, rifts grow amid GOP’s health law revamp
President Donald Trump declared Monday that “Nobody knew that health care could be so complicated.” Yet the opposite has long been painfully obvious for top congressional Republicans, who face mounting pressure to scrap the law even as problems grow longer and knottier.
With the GOP-controlled Congress starting its third month of work on one of its marquee priorities, unresolved difficulties include how their substitute would handle Medicaid, whether millions of voters might lose coverage, if their proposed tax credits would be adequate and how to pay for the costly exercise.
The nonpartisan Congres- sional Budget Office made their job even dicier recently, giving House Republicans an informal analysis that their emerging plan would be more expensive than they hoped and cover fewer people than former President Barack Obama’s statute. The
analysis was described by lobbyists speaking on con- dition of anonymity to discuss private conversations with congressional aides.
For many in the party, those problems, while major, are outweighed by pledges they’ve made for years to repeal Obama’s 2010 law and substitute a GOP alterna- tive. Conservatives favoring full repeal are pitted against more cautious moderates,
and governors looking to curb Medicaid’s costs also worry about constituents losing coverage. But Repub- licans see inaction as the worst alternative and lead- ers may plunge ahead as soon as next week with ini- tial House committee votes on legislation.
“I believe they have left themselves no choice. Polit- ically they must do some- thing,” Douglas Holtz-Eakin, a Republican economist and health analyst, said Monday.
Trump spoke about health care’s complexities on a day he held White House talks with dozens of governors worried Republicans could shift a huge financial burden to the states by curbing Medicaid, the federal-state program that helps low-income people and those in nursing homes pay bills. Republi- can governors said later that Trump would describe some specifics of his own plan in an address Tuesday to a joint session of Congress.
Trump also met with insur- ance company executives concerned that uncertainty about possible GOP changes could roil the marketplace. Insurers said they remain committed to working with the administration and the GOP-led Congress.
Trump said the cur- rent health insurance mar- ket is “going to absolutely implode”— a contention he and other Republicans have made repeatedly. With premiums, deductibles and other out-of-pockets costs increasing in many indi- vidual markets, Democrats concede that changes are needed. But they contest that dire description and have no interest in helping Republicans kill Obama’s statute.
Senate Minority Leader Chuck Schumer, D-N.Y., said Republicans have yet to win any Democratic support for their effort and said “the odds are very high” Obama’s law won’t be repealed.
Congress returned Monday from a recess that spotlighted hurdles the GOP faces.
Many Republicans endured rough receptions at town hall meetings from activist backers of Obama’s overhaul.
Governors meeting in Washington received a consultants’ report warning that planned Republican cuts in Medicaid and federal subsidies for consumers buying private insurance would risk coverage for many people
and serious funding gaps for states.
The plan House Republicans are considering includes helping people pay doctors’ bills with tax credits based on age, not income, and expanding tax-advantaged health savings accounts.
They would also end Obama’s expansion of Medicaid to more low-earners and the open-ended federal payments states currently receive to help pay for the program.