Repub­li­cans out­line health care over­haul

Northwest Arkansas Democrat-Gazette - - NATIONAL - ALAN FRAM In­for­ma­tion for this ar­ti­cle was contributed by Erica Werner, Matthew Daly and Stephen Oh­lemacher of The As­so­ci­ated Press

WASH­ING­TON — Top House Repub­li­cans un­veiled a rough sketch of a health care over­haul to law­mak­ers Thurs­day, but a lack of de­tail, cost es­ti­mates and GOP unity left un­re­solved the party’s plan to pass it through Congress.

At a pri­vate meet­ing in the Capi­tol base­ment, House Speaker Paul Ryan, R-Wis., and other party lead­ers de­scribed a broad vi­sion for void­ing much of Pres­i­dent Barack Obama’s 2010 statute and re­plac­ing it with con­ser­va­tive poli­cies. It fea­tures a re­vamped Med­i­caid pro­gram for the poor, tax breaks to help peo­ple pay doc­tors’ bills and fed­er­ally sub­si­dized state pools to as­sist those with costly med­i­cal con­di­tions in buy­ing in­sur­ance.

Law­mak­ers called the ideas op­tions, and many were con­tro­ver­sial. One be­ing pushed by Ryan and other lead­ers would re­place the tax in­creases in Obama’s law with new levies on the value of some em­ployer-pro­vided health plans — a po­lit­i­cal no-fly zone for Repub­li­cans averse to tax boosts.

“You have to leg­is­late with a sense of po­lit­i­cal re­al­ity,” said Rep. Tom Cole, R-Okla., who said back­ing that pro­posal “would set up an ad against you from mul­ti­ple di­rec­tions” dur­ing up­com­ing elec­tions.

The scant health care progress mir­rors a lack of move­ment on other is­sues in a gov­ern­ment run by the GOP. No pro­pos­als have sur­faced to pur­sue Pres­i­dent Don­ald Trump’s cam­paign prom­ises to build a bor­der wall with Mex­ico or but­tress the na­tion’s in­fra­struc­ture, and Repub­li­cans have yet to co­a­lesce around an­other pri­or­ity, re­vamp­ing the na­tion’s tax code.

Se­nate Repub­li­cans have crit­i­cized a House GOP plan to change how cor­po­ra­tions are taxed. Trump has said he will re­lease his own pro­posal in the com­ing weeks, but noth­ing had been pro­duced.

“At some point we need to move from imag­i­nary madeup plans to things that you can read on pa­per,” said Sen. Mark Warner, D-Va.

The health care out­line was aimed at giv­ing Repub­li­cans some­thing to ex­hibit dur­ing next week’s con­gres­sional re­cess, at a time of bois­ter­ous town- hall- style meet­ings packed with sup­port­ers of the Pa­tient Pro­tec­tion and Af­ford­able Care Act. Ryan told re­porters that Repub­li­cans would in­tro­duce leg­is­la­tion void­ing and re­plac­ing the statute after Congress re­turns in late February but of­fered no specifics.

Many Repub­li­cans took an up­beat tone after Thurs­day’s meet­ing, with Rep. Peter King, R-N.Y., say­ing, “We’re only 27 days into the new ad­min­is­tra­tion, so we have time.”

But they have re­peat­edly failed for seven years to rally be­hind a sub­sti­tute plan, and there are no guar­an­tees of suc­cess in re­plac­ing a law that has ex­tended cov­er­age to 20 mil­lion Amer­i­cans.

“We’re not go­ing to get out of this overnight,” Rep. Bill Huizenga, R-Mich., said of the over­all ef­fort.

Ac­cord­ing to doc­u­ments dis­trib­uted to mem­bers, the ex­pan­sion of Med­i­caid to mil­lions of ad­di­tional low-in­come peo­ple — al­most en­tirely fi­nanced by fed­eral tax­pay­ers — would be phased out. Ex­tra Med­i­caid money would flow to the 31 states that ac­cepted that ex­pan­sion and the 19 that didn’t, though it would end “after a cer­tain date” left un­spec­i­fied.

After that, states would get far more dis­cre­tion to de­cide who would be cov­ered by Med­i­caid. They also would de­cide whether to re­ceive fed­eral Med­i­caid funds on the ba­sis of the fluc­tu­at­ing num­bers of the pro­gram’s ben­e­fi­cia­ries or a set an­nual amount.

Sep­a­rately Thurs­day, Trump’s pick to run the gov­ern­ment’s ma­jor health in­sur­ance pro­grams said Med­i­caid needs a full over­haul but she doesn’t sup­port turn­ing Medi­care into a “voucher” plan.

In­di­ana health care con­sul­tant Seema Verma tes­ti­fied be­fore the Se­nate Fi­nance Com­mit­tee on her nom­i­na­tion to lead the Cen­ters for Medi­care and Med­i­caid Ser­vices. The $1 tril­lion agency over­sees pro­grams that cover about 1 out of 3 Amer­i­cans.

Verma of­fered some clues as to her think­ing but also de­flected many ques­tions. Sen. Ron Wy­den of Ore­gon, the rank­ing Demo­crat on the panel, later called the ex­er­cise “a missed op­por­tu­nity for the nom­i­nee.”

Repub­li­cans praised her per­for­mance, but two GOP se­na­tors said they were very con­cerned that re­vamp­ing Med­i­caid could leave tens of thou­sands unin­sured in their states.

AP/J. SCOTT APPLEWHITE

Sen. Bill Cas­sidy, R-La., speaks Thurs­day dur­ing a news con­fer­ence on Capi­tol Hill to an­nounce the Pa­tient Free­dom Act of 2017, a pos­si­ble GOP re­place­ment bill for the Af­ford­able Care Act. Pres­i­dent Don­ald Trump’s con­gres­sional agenda has made a pri­or­ity of re­peal­ing and re­plac­ing Pres­i­dent Barack Obama’s health care law.

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