2 House pan­els OK GOP health bill

If it wins House ap­proval, as ex­pected, the bill will go the Se­nate, where stiff op­po­si­tion is ex­pected.

Austin American-Statesman - - FRONT PAGE - Robert Pear and Thomas Ka­plan

The Repub­li­can drive to repeal for­mer Pres­i­dent Barack Obama’s health care law ad­vanced Thurs­day as two House com­mit­tees ap­proved broad leg­is­la­tion to undo the law and re­place it with a more mod­est sys­tem of tax cred­its and a roll­back of Med­i­caid ex­pan­sion.

The House En­ergy and Com­merce Com­mit­tee en­dorsed the leg­is­la­tion on a party-line vote of 31-23 af­ter a ses­sion that lasted more than 27 hours. The House Ways and Means Com­mit­tee had ap­proved the mea­sure in a predawn ses­sion on Thurs­day. The House Bud­get Com­mit­tee must give its ap­proval to the mea­sure next week be­fore a fi­nal House vote that House Speaker Paul Ryan plans for the week of March 20.

Repub­li­cans said they were ful­fill­ing a po­lit­i­cal prom­ise to up­root a law that had done un­told dam­age. Democrats said the bill would rip health in­sur­ance away from mil­lions of Amer­i­cans and in­crease costs for many oth­ers, and they have the back­ing of a grow­ing num­ber of sen­a­tors,

health care providers and some con­ser­va­tives.

But Repub­li­cans on both House pan­els held to­gether and re­jected a va­ri­ety of Demo­cratic amend­ments while do­ing lit­tle to change the health bill.

Many of the amend­ments were drafted to make Repub- li­cans look heart­less or rash, forc­ing them to cast votes that could be cited in cam­paign ad­ver­tise­ments in next year’s midterm elec­tions.

“T o day marks the be­gin­ning of the end of Obamacare,” Rep. Steve Scalise, R-La., the ma­jor­ity whip, said af­ter the votes Thurs­day. “This bill guts Obamacare and starts put- ting pa­tients back in charge of their health care, with­out gov­ern­ment bu­reau­crats tell- ing them what they can or can­not buy.”

Rep. Greg Walden, R-Ore., chair­man of the En­ergy and Com­merce Com­mit­tee, said the bill rep­re­sented the big- gest change in fed­eral enti- tle­ment pro­grams since the cre­ation of Med­i­caid in 1965.

The bill would re­place Med­i­caid’s open-ended enti- tle­ment with a per-benefi- ciary al­lot­ment of fed­eral money for low-in­come peo­ple. It would also cut fed­eral pay­ments to states for the ex­pan­sion of Med­i­caid — a change that has caused deep con­cern among gov­er­nors of both par­ties and Repub­li­can sen­a­tors from states that ex­panded Med­i­caid, like Ohio, Colorado and West Vir­ginia.

“This is the most rad­i­cal re­write to Med­i­caid that we have seen in decades,” said Rep. Kathy Cas­tor, D-Fla. “The bill will rip cov­er­age away from many of our neigh­bors.”

Mo­ments be­fore the bill emerged from the En­ergy

and Com­merce Com­mit­tee, Rep. Peter Welch, D-Vt., said: “The fix is in. Repub­li­cans will get the votes. That’s the bad news. The good news is that Democrats stayed here

all night and put up a spir- ited fight.”

If it wins House ap­proval, as ex­pected, the bill will go the Se­nate, where law­mak- ers from both par­ties con­tinue to lodge their oppo- sition. Sen. Tom Cot­ton, R-Ark., a con­ser­va­tive who

has largely stuck with lead- er­ship, took to Twit­ter on Thurs­day morn­ing to voice his con­cerns.

“House health care bill can’t pass Se­nate w/o ma­jor changes,” Cot­ton wrote, adding in a sub­se­quent post, “What mat­ters in long run is bet­ter, more af­ford­able health care for Amer­i­cans, NOT House lead­ers’ arbi- trary leg­isla­tive cal­en­dar.”

Even the chief med­i­cal offi- cer of Med­i­caid, Dr. An­drey Ostro­vsky, broke with the lead­er­ship of the Depart­ment of Health and Hu­man

Ser­vices and en­dorsed the po­si­tion of health care providers, op­pos­ing the Repub­li­can bill.

Among other pro­pos­als, Repub­li­cans on the Ways and Means Com­mit­tee turned back Demo­cratic amend

ments re­quir­ing that peo- ple not lose health cov­er­age un­der the Repub­li­can leg­is­la­tion and that the plan not in­crease out-of-pocket costs for older peo­ple, a crit­i­cal is­sue for the AARP.

The con­sid­er­a­tion by the Ways and Means Com­mit- tee amounted to a pro­ce­dural step on the way to a full House vote on the health plan. Hour af­ter hour passed with Democrats air­ing their griev­ances about the leg­is­la­tion and of­fer­ing sym­bolic amend­ments meant to get Repub­li­can mem­bers on the record about their views.

“This is a his­toric step, an im­por­tant step, in the repeal of Obamacare, and free- ing mil­lions of Amer­i­cans, pa­tients and lo­cal busi­nesses from that pain,” said Rep. Kevin Brady, R-The Wood­lands, chair­man of the Ways and Means Com­mit­tee. He called the panel’s dis­cus­sion “long but fruit­ful.”

The En­ergy and Com­merce Com­mit­tee worked through the night and was still at work at 6 a.m. on Thurs­day.

The com­mit­tee re­jected a Demo­cratic amend­ment to pre­serve a part of the health care law that pro­vides low-in­come peo­ple with fi­nan­cial as­sis­tance to help cover deductibles, co-pay­ments and other outof-pocket costs for health care. The Repub­li­cans’ bill would elim­i­nate those sub­si­dies, start­ing in 2020.

“They are pri­mar­ily in red states that you rep­re­sent,” Rep. Frank Pal­lone Jr. of New Jersey, the se­nior Demo­crat on the com­mit­tee, told the Repub­li­cans. “These are your

con­stituents. These are work- ing peo­ple. They are not eli- gible for Med­i­caid. They are not get­ting health in­sur­ance

The con­sid­er­a­tion by the Ways and Means Com­mit­tee amounted to a pro­ce­dural step on the way to a full House vote on the health plan.

on the job.”

Repub­li­cans coun­tered that the Obama ad­min­is­tra­tion had spent bil­lions of dol­lars on the sub­si­dies even though Congress never ap­pro­pri­ated money for the pur­pose. The Repub­li­can bill pro­vides money to states that they can use to make health care more af­ford­able,

they said, and states could, if they wished, use those funds to help peo­ple with out-of-pocket costs.

The com­mit­tee also re­jected an amend­ment to elim­i­nate a pro­vi­sion that would re­place Med­i­caid’s open-ended en­ti­tle­ment with a per-ben­e­fi­ciary al­lot­ment of fed­eral money.

GABRIELLA DEMCZUK / THE NEW YORK TIMES

House Speaker Paul Ryan, R-Wis., dis­cusses the pro­posed Amer­i­can Health Care Act at a news con­fer­ence on Capi­tol Hill in Wash­ing­ton on Thurs­day.

DOUG MILLS / THE NEW YORK TIMES

Pres­i­dent Don­ald Trump dis­cusses ef­forts to repeal and re­place the Af­ford­able Care Act dur­ing a meet­ing with Repub­li­can law­mak­ers at the White House on Tues­day. The Repub­li­can bill pro­vides money to states that they can use to make health care more af­ford­able, the bill’s sup­port­ers said.

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