GOP plan for health overhaul challenged

Prominent medical industry groups say bill leaves too many uninsured.

A constellation of influential groups representing the nation’s hospitals and physicians came out Wednesday against a House Republican proposal to overhaul the Affordable Care Act, marking the latest round of setbacks to the controversial plan.

Seven groups representing the nation’s hospitals, health systems and medical colleges collectively added their “significant concerns” to the growing opposition, focusing on the prospect of sharply lower numbers of insured Americans if the Republicans’ plans were to become law. Separately, the American Medical Association, a powerful lobbying group for physicians, rejected the bill for the same reason.

The new round of opposition underscored the challenge that proponents of the bill, known as the American Health Care Act, are facing. It came as the White House and House Republican leaders moved to try to overcome the surge of hostility to the bill from conservatives, Democrats and industry groups.

In a letter to Congress, the hospital groups, which included the

American Hospital Association, wrote, “Our assessment of this legislation as currently drafted is that it is likely to result in a substantial reduction in the number of Americans able to buy affordable health insurance or maintain coverage under the Medicaid program.”

They said they anticipated “tremendous instability for those seeking affordable coverage.”

The groups also addressed the proposed changes to Medicaid, warning that they would mean lost coverage and funding cuts for a program charged with caring for vulnerable children, elderly and disabled Americans.

The cuts forecast to providers, in combination with reduced coverage, would “reduce our ability to provide essential care to those newly uninsured and those without adequate insurance,” their letter said.

AMA chief executive James Madara, a doctor, wrote in a letter released Wednesday: “We cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations.”

The list of organizations opposing the measure has grown quickly since the bill was unveiled on Monday. The AARP came out against it Tuesday.

On the other side, a significant number of GOP conservatives have expressed opposition to the bill, saying it doesn’t do enough to cut what they call an unsustainable entitlement.

White House press secretary Sean Spicer said Wednesday that administration officials, including President Donald Trump, are engaged in a “full-court press” to sell the health-care bill through local radio and television interviews and meetings with stakeholders.

Republicans are counting on Trump to begin strong-arming lawmakers. The president is expected to personally call resistant Republicans; he has already invited some lawmakers to the White House and on Wednesday, he had dinner with one the bill’s staunch critics, Sen. Ted Cruz, R-Texas, and his wife.

“President Trump is very confident about the passage,” said Trump adviser Kellyanne Conway on Fox. “At some level, there is going to be a binary choice. You are either making good on the promise to repeal and replace Obamacare or you’re not.”

Spicer in his press briefing sought to pre-emptively discredit the nonpartisan budget analysis agency that is preparing to report on how much the bill will add to the federal deficit. Next week, the Congressional Budget Office will also forecast how many people could lose coverage if the measure is enacted, an area where the Republican plan is vulnerable.

“If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” Spicer said, accusing the office of mistakes in its forecasts about the Affordable Care Act.

On Capitol Hill, where a pair of House committees started trying to advance the legislation, House Speaker Paul Ryan expressed confidence the bill would eventually pass despite the rift in the party.

Ryan described the proposal as a “conservative wish list” that would deliver on years of GOP campaign promises to reform the nation’s health-care system.

“This is the covenant we made with the American people when we ran on a repeal-and-replace plan in 2016,” he said at a news conference. “I have no doubt we’ll pass this, because we’re going to keep our promises.”

The developments highlighted the high stakes confronting Ryan as that committee work got underway. The most imminent and serious threat is criticism from conservative lawmakers and advocacy groups, such as Heritage Action for America, Freedom-Works and the Club for Growth, which hold significant power to produce “no” votes within the right flank of Ryan’s conference. The speaker can lose only 21 Republican votes if the American Health Care Act is to pass in the House, and opponents are promising to use that leverage to force changes to the bill.

To reporters, Ryan played down the conservative rebellion, describing it as a temporary reaction from Republicans who have never held office under unified GOP control.

“We’re going through the inevitable growing pains of being an opposition party to being a governing party,” he said. “It’s a new feel, a new system for people.”

Meanwhile, the two House committees working on the bill were experiencing the kinds of partisan skirmishes expected to dominate the process over the next several weeks.

In a meeting of the House Ways and Means Committee, Democrats moved immediately to lambaste the bill and the process that produced it.

Rep. Lloyd Doggett, D-Texas, offered a motion to delay the hearing for one week to allow for further hearings on the bill and to examine the CBO report. The motion was voted down on a straight party-line vote.

“Health care is too important, it impacts too many lives, to have a health-care bill jammed though in the same manner as President Trump’s immigration order,” Doggett said. “What this bill needs is some extreme vetting.”

In the House Energy and Commerce Committee, Democrats engaged in another procedural protest as they questioned why the majority had constrained most members to one-minute speeches, rather than three-minute speeches.

In a sign of how strained relations between the two parties have become, New Jersey Rep. Frank Pallone Jr., the panel’s top Democrat, repeatedly sparred with Chairman Greg Walden, R-Ore., over parliamentary procedure once the House bill was called up for consideration.

As Pallone peppered Walden with questions and said Democrats were prepared to offer roughly 100 amendments, the Oregon Republican replied in an exasperated tone. “We’ll get through this,” he said. “Let’s all just settle down.”

But Democrats continued to press their objections, demanding that the committee clerk read the revised legislative proposal word-forword rather than skip that step for the sake of time, as is customary. Walden estimated that process alone would take two hours.