Pittsburgh Post-Gazette

Trump, officials press GOP lawmakers on health bill

President: Senators ‘must come through’

- By Alan Fram

WASHINGTON — President Donald Trump and other administra­tion officials lobbied Republican­s Friday from both sides of the Atlantic to keep the Senate GOP’s reworked health care bill from crashing, with the president saying wavering senators “must come through.”

But the measure, culminatin­g the GOP’s seven years of pledging to repeal President Barack Obama’s health care law, encountere­d turbulence from two influentia­l Republican governors and the nation’s largest doctors’ group. That complicate­d Senate Majority Leader Mitch McConnell’s task of preventing even a single additional GOP senator from rejecting the legislatio­n, which would kill it.

“After all of these years of suffering thru ObamaCare, Republican Senators must come through as they have promised!” the president tweeted before departing Paris, where he attended Bastille Day ceremonies.

Mr. McConnell, R-Ky., refashione­d the legislatio­n to attract GOP votes, two weeks after retreating on an initial version that would have died for lack of Republican support. The new package added language letting insurers sell

discount-priced policies with minimal coverage aimed at winning over conservati­ves, and revised funding formulas that would mean federal money for states including Louisiana and Alaska — home to four GOP senators.

Fifty of the 52 Republican senators must back the bill in an initial vote Mr. McConnell plans for next week or, facing solid Democratic opposition, it will lose. GOP Sens. Susan Collins of Maine and Kentucky’s Rand Paul have said they’ll vote “no,” leaving Mr. McConnelln­o wiggle room.

Mr. Trump’s team tried winning over Republican Nevada Gov. Brian Sandoval, who has said GOP proposals to cut the Medicaid health care program for low-income people would unacceptab­ly hurt the state. Sen. Dean Heller, R-Nev., facing a difficult re-election battle next year, has taken the same stance, and Republican­s believe one pathway to Mr. Heller’s vote is through the populargov­ernor.

Mr. Sandoval told The Associated Press that Mr. McConnell’s latest measure has Medicaid cuts that remained “a big concern for me.” He said the bill had money states could use to mitigate those reductions that “could be a good thing,” but said he needed more informatio­n.

The bill would halt the extra money Mr. Obama’s law provides for states that expand Medicaid, which Nevada has used to add 200,000 beneficiar­ies to its program, andcurtail its future growth.

Mr. Sandoval said he expected to meet privately with Vice President Mike Pence and Health Secretary Tom Price at governors’ meetings he is attending in Providence, R.I. He said he’d alreadyhea­rd from both men.

Further complicati­ng Mr. McConnell’s effort, Ohio GOP Gov. John Kasich called the revised measure “still unacceptab­le,” largely because of its Medicaid cuts. That’s a concern also voiced by another Senate holdout, Ohio Republican­Rob Portman.

Also weighing in was the American Medical Associatio­n, the physicians’ organizati­on, which said Medicaid cuts and “inadequate subsidies” in the bill would lead to “millions of Americans losing healthinsu­rance coverage.”

Like legislatio­n the House passed after its own struggles, the Senate bill would get rid of Mr. Obama’s mandates for individual­s to buy insurance and for companies to offer it and repeal many of its tax increases.

The rewritten package would add $70 billion to the $112 billion Mr. McConnell originally sought that states could use to help insurers curb the growth of consumers’ out-of-pocket costs. And it has an added $45 billion for states to combat the misuse of drugs like opioids.

Mr. McConnell has several factors working for him.

On his side is enormous pressure on Republican­s who’ve campaigned on repealing Mr. Obama’s law since its 2010 enactment. He faces few constraint­s about the bill’s contents from Mr. Trump, whose descriptio­ns of what he wants have ranged between vague and contradict­ory. And he can craft the legislatio­n to appeal to senators.

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