Hospi­tals, docs re­ject GOP's health plan

Prom­i­nent groups say num­ber of in­sured would fall sharply.

Austin American-Statesman - - FRONT PAGE - 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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