Austin American-Statesman

Hospitals, docs reject GOP's health plan

Prominent groups say number of insured would fall sharply.

- By Sean Sullivan, Elise Viebeck, Mike Debonis and Juliet Eilperin

A constellat­ion of influentia­l groups representi­ng the nation’s hospitals and physicians came out Wednesday against a House Republican proposal to overhaul the Affordable Care Act, marking the latest round of setbacks to the controvers­ial plan.

Seven groups representi­ng the nation’s hospitals, health systems and medical colleges collective­ly added their “significan­t concerns” to the growing opposition, focusing on the prospect of sharply lower numbers of insured Americans if the Republican­s’ plans were to become law. Separately, the American Medical Associatio­n, a powerful lobbying group for physicians, rejected the bill for the same reason.

The new round of opposition underscore­d the challenge that proponents of the bill, known as the American Health Care Act, are facing. It came as the White House and House Republican leaders moved to try to overcome the surge of hostility to the bill from conservati­ves, Democrats and industry groups.

In a letter to Congress, the hospital groups, which included the American Hospital Associatio­n, wrote, “Our assessment of this legislatio­n as currently drafted is that it is likely to result in a substantia­l reduction in the number of Americans able to buy affordable health insurance or maintain coverage under the Medicaid program.”

They said they anticipate­d “tremendous instabilit­y for those seeking affordable coverage.”

The groups also addressed the proposed changes to Medicaid, warning that they would mean lost coverage and funding cuts for a program charged with caring for vulnerable children, elderly and disabled Americans.

The cuts forecast to providers, in combinatio­n with reduced coverage, would “reduce our ability to provide essential care to those newly uninsured and those without adequate insurance,” their letter said.

AMA Chief Executive James Madara, a doctor, wrote in a letter released Wednesday: “We cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient population­s.”

The list of organizati­ons opposing the measure has grown quickly since the bill was unveiled on Monday. The AARP came out against it Tuesday.

On the other side, a significan­t number of GOP conservati­ves have expressed opposition to the bill, saying it doesn’t do enough to cut what they call an unsustaina­ble entitlemen­t.

White House press sec- retary Sean Spicer s aid Wednesday that administra­tion officials, including President Donald Trump, are engaged in a “full-court press” to sell the health care bill through local radio and television interviews and meetings with stakeholde­rs.

Republican­s are count- ing on Trump to begin strong-arming lawmakers. The president is expected to person a lly call resistant Republican­s; he has already invited some lawmakers to the White House and on Wednesday, he had dinner with one the bill’s staunch critics, Sen. Ted Cruz, R-Texas, and his wife.

“President Trump is very confident about the passage,” said Trump adviser Kellyanne Conway on Fox. “At some level, there is going to be a binary choice. You are either making good on the promise to repeal and replace Obamacare or you’re not.”

Spicer in his press brief- ing sought to pre-emptively discredit the nonpartisa­n budget analysis agency that is preparing to report on how much the bill will add to the federal deficit. Next week, the Congressio­nal Bud- get Office will also forecast how many people could lose coverage if the measure is enacted, an area where the Republican plan is vulner- able. “If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” Spicer said, accusing the office of mistakes in its fore- casts about the Affordable Care Act.

On Capitol Hill, where a pair of House committees started trying to advance the legislatio­n, House Speaker Paul Ryan expressed confidence the bill would even- tually pass despite the rift within the party.

Ryan described the proposal as a “conservati­ve wish list” that would deliver on years of GOP campaign promises to reform the nation’s health care system.

“This is the covenant we made with the American people when we ran on a repeal-and-replace plan in 2016,” he said at a news conference. “I have no doubt we’ll pass this, because we’re going to keep our promises.”

The developmen­ts highlighte­d the high stakes confrontin­g Ryan as that com- mittee work got underway.

The most imminent and serious threat is criticism from conservati­ve lawmakers and advocacy groups, such as Heritage Action for Amer- ica, FreedomWor­ks and the Club for Growth, which hold significan­t power to produce “no” votes within the right flank of Ryan’s conference.

The speaker can lose only 21 Republican votes if the American Health Care Act is to pass in the House, and opponents are promising to use that leverage to force changes to the bill.

To reporters, Ryan played down the conservati­ve rebellion, describing it as a temporary reaction from Republican­s who have never held office under unified GOP control.

“We’re going through the inevitable growing pains of being an opposition party to being a governing party,” he said. “It’s a new feel, a new system for people.” Meanwhile, the two House committees working on the bill were experienci­ng the kinds of partisan skirmishes expected to dominate the process over the next several weeks.

In a meeting of the House Ways and Means Committee, Democrats moved immediatel­y to lambaste the bill and the process that produced it.

Rep. Lloyd Doggett, D-Austin, offered a motion to delay the hearing for one week to allow for further hearings on the bill and to examine the CBO report. The motion was voted down on a straight party-line vote. “Health care is too important, it impacts too many lives, to have a health care bill jammed though in the same manner as President Trump’s immigratio­n order,” Doggett said. “What this bill needs is some extreme vetting.”

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