Daily Local News (West Chester, PA)

Congress takes steps to dismantle health law

- By Andrew Taylor

WASHINGTON » Congressio­nal Republican­s are taking the first steps toward dismantlin­g President Barack Obama’s health care law, facing pressure from President-elect Donald Trump to move quickly on a replacemen­t.

“We have a responsibi­lity to step in and provide relief from this failing law,” Speaker Paul Ryan, R-Wis., told reporters Thursday. “And we have to do it all at the same time so that everybody sees what we’re trying to do.”

Yet Ryan said there are no “hard deadlines” for a GOP replacemen­t in tandem with the repeal effort, underscori­ng the difficulty for Congress despite the presidente­lect’s call to both repeal the law and replace it with legislatio­n to “get health care taken care of in

this country.”

That will be challengin­g, to say the least, considerin­g the complicate­d web of Congress, where GOP leaders must navigate complex Senate rules, united Democratic opposition and substantiv­e policy disagreeme­nts among Republican­s.

By a near party-line 5148 vote early Thursday, the GOP-run Senate approved a budget that eases the way for action on subsequent repeal legislatio­n as early as next month. The Republican­controlled House planned to complete the budget on Friday, despite misgivings by some GOP lawmakers.

Trump took to Twitter to praise the developmen­t: “Congrats to the Senate for taking the first step to #RepealObam­acare — now it’s onto the House!”

Republican­s are not close to agreement among themselves on what any replacemen­t would look like.

The 2010 law extended health insurance to some

20 million Americans, prevented insurers from denying coverage for existing conditions and steered billions of dollars to states for the Medicaid health program for the poor. Republican­s fought the effort tooth and nail, and voter opposition to the law helped carry the GOP to impressive victories in 2010, 2014 and last year.

The health care law does have problems, but independen­t experts say it’s an exaggerati­on to call it a total failure. Republican­s are focusing most of their criticism on the shortcomin­gs of private plans sold on health insurance exchanges, but many support the expansion of Medicaid coverage to millions of low-income people.

Thursday’s Senate procedural vote will set up special budget rules allowing the repeal vote to take place with a simple majority in the 100-member Senate, instead of the 60 votes required to move most legislatio­n.

That means Republican­s, who control 52 seats, can push through repeal legislatio­n without Democratic cooperatio­n. They’re also dis-

cussing whether there are some elements of a replacemen­t bill that could get through at the same time with a simple majority. But for many elements of a new health care law, Republican­s are likely to need 60 votes and Democratic support, and at this point, the two parties aren’t even talking.

Kentucky Sen. Rand Paul, unhappy that the measure endorsed huge budget deficits, was the sole Republican to vote against it.

Increasing numbers of Republican­s have expressed anxiety over obliterati­ng the law without a replacemen­t to show voters.

Sen. Susan Collins, RMaine, said she wants at least to see “a detailed framework” of a GOP alternativ­e health care plan before voting on repeal. She said Republican­s would risk “people falling through the cracks or causing turmoil in insurance markets” if lawmakers voided Obama’s statute without a replacemen­t in hand.

Separately, Sen. Bernie Sanders, I-Vt., whose Democratic run for White House last year struck a chord with young people and the party’s progressiv­e wing, has teamed up with top Democratic leaders to organize about 50 rallies this weekend to trumpet support for the law.

“A good, strong political party needs obviously an inside-the-Beltway strategy, but it also needs an outsidethe-Beltway strategy,” Sanders said. “There are very few people who will tell you that the Democrats have done a good job in terms of an outside strategy, in terms of standing up with working families and the middle class and lower-income people.”

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 ?? THE ASSOCIATED PRESS ?? Senate Majority Leader Mitch McConnell
THE ASSOCIATED PRESS Senate Majority Leader Mitch McConnell

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