Dayton Daily News

Ryan: Health care bill likely to be changed

House speaker says seniors should get more assistance.

- By Mike Debonis

The Republican health care plan moving rapidly toward a crucial House vote this week is likely to be changed to give older Americans more assistance to buy insurance, Speaker Paul Ryan said Sunday.

“We think that we should be offering even more assistance than what the bill currently does,” Ryan, R-Wis., said in a “Fox News Sunday” interview, in which he confirmed that House leaders are eyeing a Thursday vote on its passage.

Meanwhile, a key conservati­ve senator said White House officials were continuing to negotiate through the weekend on even more dramatic revisions to the bill in hopes of winning over hard-liners who have threatened to tank the legislatio­n.

Sen. Ted Cruz, R-Texas, said he and two other conservati­ve leaders — Sen. Mike Lee, R-Utah, and Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus — met at President Donald Trump’s Mar-a-Lago resort in Florida in an attempt “to fix this bill.”

“I cannot vote for any bill that keeps premiums rising,” Cruz said, echoing the concerns of other hard-line lawmakers who want the legislatio­n to undo more of the Affordable Care Act’s insurance mandates. “President Trump said this is one big, fat negotiatio­n. Here is the central prize: If we lower premiums, and hopefully lower them a lot, that is a victory for the American people.”

“It’s a fine needle that needs to be threaded, no doubt about it,” said Health and Human Services Secretary Tom Price, speaking about the negotiatio­ns Sunday on ABC’s “This Week.”

Ryan’s declaratio­n that more would be done to help older Americans came after a third House moderate said Saturday that he could not support the bill “in its current form.”

Rep. Brian Fitzpatric­k, R-Pa., who represents a suburban Philadelph­ia district that has been heavily targeted by Democrats, said in a Facebook post that he was most concerned that the legislatio­n would roll back efforts to prevent and treat opioid abuse.

But he said that was one concern of many, and lawmakers from across the GOP’s ideologica­l spectrum have expressed fears that the American Health Care Act will not drive down prices. Reps. Ileana Ros-Lehtinen, R-Fla., and Leonard Lance, R-N.J., have cited that concern in announcing their opposition to the bill, and several other moderates remain undecided.

Those fears were stoked last week by a Congressio­nal Budget Office analysis that forecasted a short-term increase in premiums under the GOP law, and while premiums are expected to drop by roughly 10 percent over a 10-year horizon, some older and low-income people would face massive premium hikes.

Those over 50 but not yet 65 — and thus eligible for Medicare, the federal health program for seniors — represent a major issue in forging an alternativ­e to the ACA. That age group tends to have more medical issues than younger adults and, thus, higher insurance costs, and the ACA forbids insurers to charge their oldest customers more than three times their rates for young adults — essentiall­y having young adults cross-subsidize the cost of coverage for older ones.

But House Republican­s want to eliminate that feature of the law, and the GOP bill would allow a five-to-one ratio as part of an attempt to attract more of the younger, healthier customers whom insurers want.

In an extreme case laid out in the CBO report, a 64-yearold earning $26,500 a year would see yearly premiums rise from $1,700 under the ACA to $14,600 under the Republican plan.

 ?? J. SCOTT APPLEWHITE / AP ?? House Speaker Paul Ryan expressed confidence that the bill would pass the House this week — and then move to the Senate.
J. SCOTT APPLEWHITE / AP House Speaker Paul Ryan expressed confidence that the bill would pass the House this week — and then move to the Senate.

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