GOP leaders are confident of care bill passage
WASHINGTON — President Trump and House GOP leaders leaned hard Wednesday on undecided Republicans, including vulnerable Californians in swing districts, in a last-ditch effort to pass their proposed repeal of the Affordable Care Act this week.
By late in the day, Republican leaders expressed confidence they had the support they needed to repeal former President Barack Obama’s signature legislative victory, and said the House would vote Thursday.
“Do we have the votes? Yes. Will we pass it? Yes,” House Majority Leader Kevin McCarthy of Bakersfield told reporters.
Members said Trump was making calls to wavering center-right Republicans, holding
long chats that included thinly veiled threats that he would support potential primary challengers if they don’t vote for the bill and send it to the Senate.
The House’s failure to pass an earlier version of the repeal-and-replace measure was one of the biggest defeats for Trump in his first 100 days in office. The new version, crafted to win over far-right conservatives who see little or no role for government in the health care market, would allow states to apply for waivers from Affordable Care Act requirements that insurers offer coverage to everyone in an age group at the same price, regardless of whether they have preexisting health conditions. Such states would have to set up “highrisk pools” to help people with pre-existing conditions pay for coverage.
House Republican leaders said Wednesday that the legislation would be amended to add $8 billion for these pools over five years. That was enough to win over some Republicans, including Rep. Fred Upton of Michigan, a key swing vote who had earlier said he would vote “no.” But others in the GOP’s center-right faction were wavering.
Groups opposing the bill said the extra $8 billion would do little to enable everyone with pre-existing conditions pay what would probably be exorbitant premiums. Rep. Mike Thompson, a St. Helena Democrat on the Ways and Means Committee, said the additional money would provide sick people with an extra $200, which “does not buy health insurance for somebody with preexisting conditions. It’s laughable.”
Critics also pointed out that like an earlier Republican repeal-andreplace bill that stalled in March, the new bill would gut federal funding that has allowed millions of people to obtain insurance through Medicaid since the Affordable Care Act was passed.
The Congressional Budget Office estimated that 24 million people who now have coverage would lose or drop it under the original bill. The nonpartisan office has not yet analyzed the latest measure.
In addition to the Medicaid cuts, the GOP measure would let states waive Affordable Care Act requirements that all insurance policies cover certain “essential benefits,” such as emergency-room visits and maternity care.
With no Democrats expected to back the new bill, GOP leaders can afford to lose no more than 22 votes in their 238-member House majority. Various media counts put the Republican “no” votes at around 19, with two dozen undecided.
The measure presents an ugly choice for many California Republicans, especially those representing districts that voted for Hillary Clinton over Trump in November.
California enthusiastically embraced the Affordable Care Act and used it to provide coverage to nearly 5 million people, largely through Medicaid. Repeal of the law could cost the state an estimated $160 billion in federal funds.
There are 14 Republicans in the California House delegation, seven of whom represent districts that Clinton won. Five of the seven say they have not made up their minds on the new bill, despite the heavy lobbying by Trump and GOP leaders.
The undecided members largely made themselves scarce Wednesday. Rep. Darrell Issa, R-Vista (San Diego County), who narrowly won re-election in November, rushed past reporters and declined to comment. A day earlier, he told a reporter for the Hill online news site who asked how he intended to vote that it was “none of your business.”
Rep. Ed Royce, RFullerton (Orange County), also ducked reporters Wednesday.
Late Wednesday, Anthony Wright of Health Access California, said that two of the undecideds, Rep. David Valadao of Hanford (Kings County) and Steve Knight of Lancaster (Kings County) are now supporting the bill. And one who had said he was opposed, Jeff Denham of Turlock (Stanislaus County), now says he is in favor of it, Wright said.
Valadao has said people in his largely poor rural district are worried about potentially losing health coverage they gain under the Medicaid expansion.
Rep. Dana Rohrabacher, R-Costa Mesa (Orange County), said he was still waiting to see the final legislation. “I have to see what’s in it before I can say,” he said.
The White House and GOP leaders are eager to hold a vote this week. The House is scheduled to begin a weeklong recess Friday, and if members leave town without voting, whatever momentum the new version has generated is likely to evaporate.
California Democrats predicted that many of their GOP colleagues would be jeopardizing their seats by voting for the bill.
“It’s not hard to identify California Republicans who would be in deep, deep trouble — I believe career-ending trouble — if they support this bill,” said Rep. Jared Huffman, D-San Rafael. “It is so out of step with our state, and so harmful to the state and their constituents specifically.”
Rep. Jackie Speier, D-Hillsborough, called it a “suicide vote” for Republicans. She said repeal of the Affordable Care Act would have repercussions far beyond those gaining coverage under the law, to those who get health care coverage through their employers.
Repeal would “totally undermine health care for tens of millions of Americans, and it’s not just Americans who didn’t have health care before,” Speier said. She noted that in addition to letting states opt out of essential benefits coverage, the GOP measure would waive the Affordable Care Act’s ban on coverage caps for some types of care in states that dropped those essential benefits.
“This is all about the president being able to wave a win and show his signature on” a major piece of legislation, Speier said. “Which he’s not going to be able to do because it’s never going to be able to get out of the Senate. It’s the showman at his worst.”
“It’s not hard to identify California Republicans who would be in deep, deep trouble ... if they support this bill.” Rep. Jared Huffman, D-San Rafael