GOP lead­ers fight for sup­port of health bill

They’re open to changes to sway party skep­tics; op­po­si­tion em­bold­ened.

Austin American-Statesman - - FRONT PAGE - By Erica Werner

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.

PHO­TOS BY J. SCOTT APPLEWHITE / AS­SO­CI­ATED PRESS

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.”

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