GOP aims for do-over to replace Obamacare

Chances of agreement between key House factions appear slim.

WASHINGTON — Frustrated with their failure to repeal Obamacare, and wary of facing voters over spring recess, House Republicans are embarking on another push to salvage President Trump’s promise to replace the Affordable Care Act.

With the White House leading the effort, Vice President Mike Pence presented lawmakers options in meetings that were set to stretch late into Tuesday evening. Some Republicans say they want to stay in town this week to finish the job.

But chances remain slim that Republican leaders can build consensus between the GOP factions — the conservative House Freedom Caucus and more centrist Tuesday Group — that doomed the last effort. House Speaker Paul D. Ryan (R-Wis.) lowered expectations that a deal could be struck soon.

“Look, the president would like to see this done,” White House Press Secretary Sean Spicer told reporters Tuesday.

“I’m not going to raise expectations,” Spicer said. “But I think that there are more and more people coming to the table with more and more ideas about [how] to grow that vote.”

The effort shows the risks ahead for Trump’s party after Republicans promised for years they would undo the healthcare law once they had control of Congress and the White House, only to botch it with last month’s abandoned vote.

Trump lashed out in anger at the Freedom Caucus after the failed effort, tweeting criticism of the group. When he called out leaders by name in high-profile attacks, the move backfired, with others coming to their defense. The result was more political infighting in the GOP.

But now, as Trump approaches the end of his presidency’s first 100 days without the key legislative win and GOP lawmakers head home for two weeks, they have common cause in urgently searching for a better message, or to at least show voters they haven’t given up.

“A lot of us have said we should stay and do it,” said Rep. Scott Perry (R-Pa.), a Freedom Caucus member.

The proposals being floated are mostly tweaks to the bill Ryan engineered with other party leaders, which failed to generate enough support for passage.

That legislation, the American Health Care Act, would have resulted in as many as 24 million more Americans being without insurance, largely by clipping subsidies that help some buy insurance and scaling back some states’ expansion of Medicaid for low-income patients.

The measure House GOP leaders championed was deeply unpopular, and even now, nearly two-thirds of Americans polled said it was a “good thing ” that it did not pass. At the same time, 75% — and a majority of Republicans — said Trump and his administration should do what they can to make the current law work, according to new polling from the nonpartisan Kaiser Family Foundation.

Pence is presenting options that the administration hopes can win over more Freedom Caucus members without chasing away those from the Tuesday Group.

Under the White House proposal, states would have the option of doing away with requirements that insurers provide a minimum level of 10 “essential benefits,” including those for pregnancy care and mental health treatment.

Conservatives want to end those Obamacare regulations because they believe fewer rules will lead to cheaper plans.

States would also be allowed to do away with the “community rating,” which would let prices rise for some patients, effectively gutting Obamacare’s guarantee that people can get coverage even if they are sick. The guarantee would be meaningless if, for example, a cancer patient could not afford a plan that covers chemotherapy.

The White House is also discussing more funding for high-risk pools that would offer coverage to sick people who could not get policies on the existing market.

Many states, including California, operated such pools before the Affordable Care Act, but they proved inadequate for covering sick patients.

Republicans may also revive an idea to continue a 0.9% payroll tax on high-income earners to produce $15 billion to ensure coverage for various patients.

Democrats, who have opposed GOP attempts to gut Obamacare, will almost certainly reject these changes, which they argue will lead to bare-bones policies and leave more Americans without necessary healthcare.

Spicer said Pence and White House Chief of Staff Reince Priebus both “feel very optimistic with the tone of the conversation and the ideas that are coming out and the willingness of folks to find common ground.”

But House Republicans remained hesitant to suggest a deal could be struck in the days ahead.

“We’re not there yet,” said one GOP aide, granted anonymity to discuss the situation. “It’s not clear any of this will result in any movement from where they are.”