Daily Freeman (Kingston, NY)

Not all GOP senators on board with health bill

Dems, Obama highly critical

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WASHINGTON » Senate Republican­s on Thursday launched their plan to shrivel Barack Obama’s health care law, edging a step closer to their dream of repeal with a bill that would slice and reshape Medicaid for the poor, relax rules on insurers and end tax increases on higher earners that have helped finance expanded coverage for millions.

Four conservati­ve GOP senators quickly announced initial opposition to the measure and others were evasive, raising the specter of a jarring rejection by the Republican-controlled body. But Senate Majority Leader Mitch McConnell, R-Ky., indicated he was open to discussion and seemed determined to muscle the measure through his chamber next week.

Release of the 142-page proposal ended the long wait for one of the most closely guarded bills in years. McConnell stitched it to-

gether behind closed doors, potentiall­y moving President Donald Trump and the GOP toward achieving perhaps their fondest goal — repealing former President Obama’s 2010 statute, his proudest domestic legacy.

At the White House, Trump spoke of a bill “with heart.” On Facebook, Obama said at the heart of the bill was “fundamenta­l meanness.”

The bill would end Obama’s tax penalties on people who don’t buy insurance — effectivel­y doing away with the so-called individual mandate — and on larger companies that don’t offer coverage to their

workers. It would offer less generous subsidies for people than Obama’s law but provide billions to states and insurance companies to buttress markets that in some areas have been abandoned by insurers.

McConnell must navigate a narrow route in which defections by just three of the 52 Republican senators would doom the legislatio­n. He and others said the measure would make health insurance more affordable and eliminate Obama coverage requiremen­ts that some people find onerous.

“We have to act,” McConnell said, “because Obamacare is a direct attack on the middle class, and American families deserve better than its failing status quo.”

Democrats said the measure would result in skimpier

policies and higher outof-pocket costs for many and erode gains made under Obama that saw roughly 20 million additional Americans gain coverage.

“We live in the wealthiest country on Earth. Surely we can do better than what the Republican health care bill promises,” said Senate Minority Leader Charles Schumer, D-N.Y.

Four conservati­ve senators expressed opposition but openness to talks: Ted Cruz of Texas, Kentucky’s Rand Paul, Mike Lee of Utah and Ron Johnson from Wisconsin. They said the measure falls short, missing “the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”

On the other hand, Republican Sens. Dean Heller

of Nevada, facing a competitiv­e 2018 re-election battle, Ohio’s Rob Portman and Shelley Moore Capito of West Virginia expressed concerns about the bill’s cuts to Medicaid and drug addiction efforts. And Susan Collins of Maine reiterated her opposition to language blocking federal money for Planned Parenthood, which many Republican­s oppose because it provides abortions.

At the White House, Trump called Democrats “obstructio­nists” for opposing the measure and added, “We’ll hopefully get something done and it will be something with heart and very meaningful.”

Obama was more than skeptical.

“If there’s a chance you might get sick, get old or start a family, this bill will

do you harm,” he wrote. He said “small tweaks” during the upcoming debate “cannot change the fundamenta­l meanness at the core of this legislatio­n.”

The House approved its version of the bill last month. Though Trump lauded its passage in a Rose Garden ceremony, he later called the measure “mean.”

The nonpartisa­n Congressio­nal Budget Office said under the House bill, 23 million fewer people would have coverage by 2026. The budget office analysis of the Senate measure is expected early next week.

The Senate bill would phase out extra money Obama’s law provides to 31 states that agreed to expand coverage under the federal-state Medicaid program. Those additional funds would continue

through 2020, then gradually fall and disappear entirely in 2024.

Beginning in 2020, the Senate measure also would limit the federal funds states get each year for Medicaid. The program currently gives states all the money needed to cover eligible recipients and procedures.

The Senate bill largely uses people’s incomes as the yardstick for helping those without workplace coverage to buy private insurance. That would focus the aid more on people with lower incomes than the House legislatio­n, which bases its subsidies on age.

The bill would let states get waivers to ignore some coverage requiremen­ts under Obama’s law, such as specific health services insurers must now cover.

 ?? J. SCOTT APPLEWHITE — ASSOCIATED PRESS ?? At the Capitol on Thursday, Senate Majority leader Mitch McConnell smiles after unveiling his caucus's health care legislatio­n.
J. SCOTT APPLEWHITE — ASSOCIATED PRESS At the Capitol on Thursday, Senate Majority leader Mitch McConnell smiles after unveiling his caucus's health care legislatio­n.

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