GOP leaders fight for support of health bill
They’re open to changes to sway party skeptics; opposition emboldened.
Undaunted by fel— low Republicans’ defiance, GOP leaders and the White House redoubled their efforts Tuesday to muscle legislation overhauling America’s health care system through Congress following a sobering estimate that it would result in millions of people dropping or losing health insurance coverage.
President Donald Trump, whose strong Election Day showing in GOP regions makes him the party’s ultimate Capitol Hill vote wrangler, discussed the legislation by phone with Congress’ two top Republicans. He also dispatched Vice President Mike Pence and health secretary Tom Price to hear GOP senators’ concerns.
With a crucial House committee vote slated for Thursday, Trump’s spokesman acknowledged the pres- ident and GOP leaders were open to making changes to win support.
“This has never been a take it or leave it,” said Press Secretary Sean Spicer.
The GOP bill is the part y ’s response to seven years of promising to repeal President Barack Obama’s 2010 health care overhaul. It would undo that law’s individual mandate, which requires most people to have coverage, by ending the tax penalty on those who don’t.
It would also provide agebased tax credits instead of the subsidies geared to income in Obama’s statute, end that law’s expansion of Medicaid and curb its future spending, and let insurers boost rates for seniors.
On Monday, the nonpartisan Congressional Budget Office said that within 10 years of its passage, the Republican legislation would reduce the ranks of the insured by 24 million, largely by cutting Medicaid recipients and people buying individual policies. That would be more than the 20 million who have gained coverage under Obama’s overhaul — and attach a big number to the dilemma faced by GOP governors and members of Congress whose states have benefited from so-called “Obamacare.”
“I plan to vote NO” on the GOP bill, Rep. Ileana Ros-Lehtinen, R-Fla., tweeted Tuesday. “As written the plan leaves too many from my #SoFla district uninsured.”
The budget office report also said the measure would reduce federal deficits by $337 billion over the next decade, largely by cutting Medicaid, the health insurance program for the poor, and eliminating Obama’s subsidies for low- and middle-income people. The report said that the bill’s changes would cut federal subsidies by half in a decade and that older, lower-earning people would be hit especially hard.
Those findings further energized Democrats, who already were unanimous in opposing the GOP repeal effort.
“Of course you can have savings if you cut off millions of people from access to health care,” said House Minority Leader Nancy Pelosi of California.
She said the measure’s shift of billions of dollars from lower- to higher-earning families actually would effectively transfer money from GOP to Democratic regions. Seemingly taunting Republicans, she added, “Explain that to your constituents.”
While Republican congressional leaders questioned the accuracy of the CBO estimate — pointing out that the CBO had previous overestimated the number of people who would sign up for coverage under Obama’s law — they moved Tuesday to begin considering changes to the replacement legislation.
Pence and Price discussed the legislation over lunch with GOP senators at the Capitol. Participants said senators suggested targeting the bill’s new tax credits more at lower-earning people, improving benefits for seniors and protecting the expansion of Medicaid, the federal-state program that helps lower-income people afford care.
Senate Majority Leader Mitch McConnell all but acknowledged the widespread assumption that the measure will be reshaped, saying, “It will be open to amendment in the Senate.” Emerging from the senators’ lunch — which included two House committee chairmen as well as Pence and Price — Sen. Pat Roberts, R-Kan., said, “All four of them are open to suggestions and change.”
Even so, criticism cascaded from both ends of the GOP political continuum, suggesting the leaders face a festering problem.
Freshman Rep. John Faso, R-N.Y., from a closely divided district in the Catskill Mountains, said he was concerned the bill would hurt hospitals and was undecided about supporting it. He’s a member of the House Budget Committee, where Thursday’s vote could be close.
Citing the bill’s projected increase in uninsured people, Rep. Leonard Lance, R-N.J., from another closely divided district, said he opposed the bill. Rep. Mark Amodei, R-Nev., said he was leaning toward voting no because of people losing coverage, saying of CBO’s projections, “If the numbers are in the ballpark, it sounds like we’ve gone back to where we started after seven years.”
Conservatives, on the other hand, continued complaining that the Republican measure doesn’t fully repeal Obama’s law, as they and Trump promised to do in last fall’s election campaigns. Their demands include voiding the law’s requirement that insurance policies cover 10 specified benefits like mental health services, which they say drives up consumers’ costs.
“Ultimately it will be President Trump that saves this deal,” said Rep. Mark Meadows, R-N.C., head of the hard-line conservative House Freedom Caucus.
No. 3 Senate leader John Thune, R-S.D., said he was working on a proposal to devote more of the GOP tax cut to lower-earning people. It would currently begin phasing out for people earning $75,000 annually.
“It’d be nice to add it to the House bill, but if necessary it’d be in the Senate,” Thune said of his plan.
Senate Majority Leader Mitch McConnell all but acknowledged the widespread assumption that the proposed GOP health overhaul measure will be reshaped. “It will be open to amendment in the Senate,” he said.
House Minority Leader Nancy Pelosi said the House Republican health care plan would effectively transfer money from GOP to Democratic regions and seemingly taunted her rivals: “Explain that to your constituents.”