GOP law­mak­ers may face voter fury as they re­turn home for Easter break

Modern Healthcare - - NEWS - By Har­ris Meyer

The White House is twist­ing the arms of House Repub­li­cans to back re­vi­sions of the failed Oba­macare re­peal and re­place bill.

But many GOP law­mak­ers worry about the reception they’ll face when they go home for the two-week re­cess. They’ll likely en­counter con­stituents an­gry and wor­ried about los­ing their health cov­er­age. Health­care provider groups also may come call­ing.

The law­mak­ers also may face fire from con­ser­va­tive vot­ers who want to see a 7-year-old prom­ise to wipe out the Af­ford­able Care Act fi­nally ful­filled.

Pro-ACA ac­tivists are or­ga­niz­ing peo­ple to turn out at town hall events held by rep­re­sen­ta­tives and se­na­tors around the coun­try, and at so-called “with you or with­out you” events in dis­tricts where law­mak­ers aren’t sched­ul­ing town halls. Some House Repub­li­cans be­ing tar­geted in­clude Cal­i­for­nia con­gress­men Jeff Den­ham and Tom McClin­tock, Ken­tucky’s Jim Comer, Randy Hult­gren in Illi­nois, and Vir­ginia’s Bob Good­latte.

“We’ll be show­ing up at Rep. Good­latte’s open-door meet­ing on April 13,” said John Schal­dach, of Har­rison­burg In­di­vis­i­ble, a lib­eral-lean­ing ac­tivist group. “He knows he’s out of line with his dis­trict on this one.”

“Peo­ple will be rais­ing their voices dur­ing the re­cess that they want mem­bers to move on from re­peal­ing the ACA and find bi­par­ti­san pro­pos­als to keep peo­ple cov­ered, lower costs, and pro­tect peo­ple with pre-ex­ist­ing con­di­tions,” said Claire McAn­drew, direc­tor of cam­paign strat­egy for Fam­i­lies USA, a pro-ACA ad­vo­cacy group.

In Fe­bru­ary, Repub­li­cans had many un­com­fort­able face­offs with peo­ple who told them Oba­macare had saved their lives. That’s partly why GOP lead­ers had hoped to pass ACA re­peal-and-re­place leg­is­la­tion be­fore the Easter re­cess, to re­duce the chances their mem­bers would lose their nerve af­ter get­ting a blast of face-to-face anger from vot­ers.

House Repub­li­cans now worry about more back­lash.

Rep. Mark Amodei of Ne­vada told Bloomberg News he doesn’t even know what to tell his con­stituents or health­care in­dus­try rep­re­sen­ta­tives back home be­cause “I don’t know what the lat­est it­er­a­tion of the bill is.” He wanted the House to hold hear­ings with in­dus­try feed­back on the leg­is­la­tion. No such hear­ings were held.

Repub­li­cans from con­ser­va­tive dis­tricts fear the fury of vot­ers who sent them to Wash­ing­ton to roll back the ACA, said Robert Blendon, an ex­pert on health­care pol­i­tics at Har­vard.

“The Repub­li­can bill isn’t very pop­u­lar,” he said. “But the big­gest prob­lem they’ll have is they promised to do some­thing and did noth­ing.”

That’s why the White House and some House Repub­li­cans were still talk­ing last week about re­turn­ing early from re­cess to vote on an amended Amer­i­can Health Care Act.

The re­vi­sions re­port­edly would let HHS grant waivers to states to re­lax the ACA’s in­sur­ance rules—such as min­i­mum es­sen­tial ben­e­fits and com­mu­nity rating. The idea is to let in­sur­ers sell cheaper, stripped-down health plans that would at­tract health­ier con- sumers. The amended bill also would pro­vide an ex­tra $15 bil­lion over 10 years to es­tab­lish high-risk pools or pay in­sur­ers for the costs of their sick­est and most ex­pen­sive en­rollees.

House ul­tra­con­ser­va­tives and rel­a­tive mod­er­ates re­main di­vided over the bill’s pro­vi­sions. An­a­lysts say the leg­is­la­tion would spike the num­ber of unin­sured Amer­i­cans and sharply in­crease costs for many con­sumers, par­tic­u­larly those who are older and have chronic con­di­tions.

The lat­est Kaiser Health Track­ing Poll, con­ducted last week, il­lus­trates the whip­saw of pub­lic opin­ion con­gres­sional Repub­li­cans face. It found that 64% of the pub­lic over­all said it was a good thing Congress did not pass the AHCA. But 54% of Repub­li­cans saw the fail­ure as a bad thing. And 58% of Repub­li­cans said the AHCA didn’t pass mainly be­cause it didn’t go far enough to end Oba­macare.

On the other hand, three-fourths of the pub­lic, in­clud­ing 51% of Repub­li­cans, said the Trump ad­min­is­tra­tion should try to make Oba­macare work.

Blendon said Repub­li­cans face dif­fer­ent prob­lems with dif­fer­ent groups of vot­ers over health­care. When the 2018 midterm elec­tions get closer, they could en­counter highly en­er­gized Democrats and in­de­pen­dents who vote against them based on their un­pop­u­lar health­care bill.

But as they pon­der their vis­its home, they’re most wor­ried about base vot­ers who dis­like Oba­macare, Blendon stressed. “They’re say­ing, ‘I can’t go home and say I passed noth­ing.’ ”

“The big­gest prob­lem they’ll have is they promised to do some­thing and did noth­ing. That’s very hard to ex­plain.” ROBERT BLENDON Health­care pol­icy ex­pert Har­vard Univer­sity


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