Trump keeps roll­back on the ta­ble

Pres­i­dent push­ing for new vote on Oba­macare re­peal

Sun Sentinel Broward Edition - - NATION & WORLD - By Noam N. Levey Staff writer Lisa Mas­caro con­trib­uted. noam.levey@la­times.com

WASH­ING­TON — Ap­proach­ing the 100-day mark in of­fice with­out ac­tion on the Af­ford­able Care Act, Pres­i­dent Don­ald Trump is push­ing again for a vote on the sweep­ing House bill to roll back the 2010 law.

But even as House Repub­li­cans and ad­min­is­tra­tion of­fi­cials con­tinue to dis­cuss po­ten­tial changes to the leg­is­la­tion, there is lit­tle ev­i­dence GOP lead­ers are close to get­ting the votes needed to get the bill out of the House.

As of Thurs­day af­ter­noon, no new vote had been sched­uled by House Repub­li­can lead­ers .“The ques­tion is whether it can get 216 votes in the House, and the an­swer isn’t clear at this time,” said a se­nior GOP aide, who asked not to be iden­ti­fied dis­cussing in­ter­nal party dis­cus­sions.

Trump, speak­ing at a White House news con­fer­ence, also did not com­mit to seek­ing a vote next week, say­ing he hoped the bill could come back for a vote soon. “The plan gets bet­ter and bet­ter and bet­ter, and it has got­ten re­ally, re­ally good,” he said.

More im­me­di­ately, the White House faces a po­ten­tial gov­ern­ment shut­down un­less law­mak­ers can agree on a new spend­ing mea­sure by the end of next week. Fur­ther com­pli­cat­ing that are demands from in­sur­ers and pa­tient ad­vo­cates that the Trump ad­min­is­tra­tion com­mit to con­tin­u­ing to pro­vide ad­di­tional fi­nan­cial aid to low-in­come Amer­i­cans who buy health cov­er­age through Oba­macare mar­ket­places.

Many law­mak­ers would like the aid to be in­cluded in the new spend­ing bill, but Trump has sug­gested that he might op­pose that to force Democrats to ac­cept other changes to the health bill.

House Speaker Paul Ryan, R-Wis., was forced to can­cel a planned vote on the GOP re­peal bill last month af­ter it be­came clear that too many rank-and-file Repub­li­cans op­posed the leg­is­la­tion.

Since then, sev­eral law­mak­ers have been work­ing to amend the con­tro­ver­sial leg­is­la­tion to win sup­port from hold­outs in the con­ser­va­tive House Free­dom Cau­cus and from more cen­trist law­mak­ers, many of whom were loath to sup­port leg­is­la­tion that would leave mil­lions more Amer­i­cans with­out health in­sur­ance.

The orig­i­nal bill, called the Amer­i­can Health Care Act, would have re­sulted in 24 mil­lion fewer Amer­i­cans with health cov­er­age over the next decade, ac­cord­ing to an anal­y­sis by the Con­gres­sional Bud­get Of­fice.

And while health in­sur­ance pre­mi­ums would have been lower for some con­sumers, many older and lower-in­come Amer­i­cans would have been priced out of cov­er­age by the GOP plan.

The House leg­is­la­tion would dis­man­tle the Oba­macare ex­ten­sive sys­tem for ex­pand­ing health in­sur­ance cov­er­age to mil­lions of Amer­i­cans, cut­ting nearly a $1 tril­lion in fed­eral aid that has al­lowed states to ex­pand the Med­i­caid safety net pro­grams and scal­ing back tax sub­si­dies that help mil­lions of low-and mid­dle in­come Amer­i­cans buy com­mer­cial health plans.

At the same time, the House bill would re­peal ma­jor taxes that the cur­rent law im­posed to fund the ex­pan­sion of health cov­er­age. The House bill also scraps the un­pop­u­lar re­quire­ment in the cur­rent law that Amer­i­cans have in­sur­ance or pay a penalty.

De­spite rolling back key pil­lars of Oba­macare, the House bill still gen­er­ated fierce re­sis­tance from many con­ser­va­tive law­mak­ers, who said it did not go far enough.

But an in­creas­ing num­ber of GOP law­mak­ers have been voic­ing new con­cerns amid a wide­spread pub­lic back­lash against the House leg­is­la­tion. On Mon­day, Rep. Jeff Den­ham, R-Calif., an­nounced that he would not sup­port his party’s health care leg­is­la­tion un­less it left sig­nif­i­cant part­sof Oba­macare in­tact.

The changes to the House Repub­li­can bill now un­der dis­cus­sion — first re­ported by the Huff­in­g­ton Post— would fur­ther weaken sev­eral key con­sumer pro­tec­tions in the cur­rent law, in­clud­ing the guar­an­tee that Amer­i­cans could get cov­er­age even if they are sick.

Repub­li­can law­mak­ers have been ex­plor­ing ways to give states the flex­i­bil­ity to scrap th­ese pro­tec­tions. States could, for ex­am­ple, once again al­low in­sur­ers to charge sick con­sumers more than healthy ones and could lift re­quire­ments that all health plans cover a ba­sic set of ben­e­fits, such as men­tal health and ma­ter­nity care.

Rep. Tom MacArthur, RN. a cen­trist who has been work­ing on the new lan­guage, said in a Face­book post that sick pa­tients would still be able to get cov­er­age be­cause states would be re­quired to of­fer a spe­cial health plan, known as a high-risk pool, for peo­ple un­able to get other cov­er­age.

“This amend­ment will make cov­er­age of pre-ex­ist­ing con­di­tions sacro­sanct for all Amer­i­cans,” he said.

The new GOP pro­pos­als drew swift crit­i­cism from many pa­tient ad­vo­cates and others.

“This lat­est at­tempt to re­peal the ACA is full of bro­ken prom­ises and de­cep­tive rhetoric,” said De­bra Ness, pres­i­dent of the Na­tional Part­ner­ship for Women& Fam­i­lies.

“While Pres­i­dent Trump and lead­ers in Congress promised to pro­tect health cov­er­age for those with pre-ex­ist­ing con­di­tions, this new plan un­der­mines this crit­i­cally im­por­tant and wildly pop­u­lar ACA provi­sion.”

SHAWN THEW/EPA

Pres­i­dent Don­ald Trump ap­pears to be re­ceiv­ing scant Repub­li­can sup­port on get­ting the health bill out of the House.

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