Health-care vote could come soon
Congressional leaders and the Trump administration are mounting another push to repeal and replace Obamacare.
But revamping the 2010 Affordable Care Act might be an uphill fight because the political dynamics
that doomed an earlier attempt appear unchanged.
President Donald Trump, during a White House news conference, said he’d like the newly revised measure to pass the House next week, when he marks his 100th day in office.
“I’d like to say next week, but I believe we will get it … whether it’s next week or shortly thereafter,” he told reporters, adding there’s “no give-up” in his administration.
“The plan gets better and better and better, and it’s gotten really, really good,” Trump said.
But few have seen the updated proposal, and fewer still are certain the dynamics have changed since an attempted Obamacare replacement fell short last month.
“The challenge is if you try to write it more conservative, you don’t want to lose anybody in the center,” Rep. Pat Tiberi, R-Genoa Township, said Thursday after an appearance before the Columbus Metropolitan Club. “This is the biggest challenge right now.”
According to media reports, House leaders planned to circulate draft legislation as early as Thursday night and hold a vote next week. Speaker Paul Ryan said Wednesday the House was “very close” to striking a health-care deal that would garner the 216 votes needed to pass.
The Washington Post reported that Rep. Tom MacArthur, R-N.J., has authored an amendment that would continue requiring insurers in the individual market to provide “essential health benefits” such as maternity care, prescription drugs and substance-abuse treatment. The amendment is meant to attract GOP moderates, but some observers said it might alienate the most-conservative Republicans.
Tiberi said changes were in the works to appeal to the latter.
“Our more-conservative members want more flexibility given to the governors in the individual market and having things be waiverable,” he said.
Tiberi was referring to federal health-care waivers that he said would allow states to come up with their own insurance schemes as long as at least as many people are covered at no additional cost.
Comment could not be obtained from Rep. Jim Jordan, R-Urbana, whose Freedom Caucus provided the mostvisible conservative opposition to last month’s Obamacare alternative.
Rep. Joyce Beatty, D-Jefferson Township, who also was at the Columbus Metropolitan Club, is wary of the proposal.
“I’m hearing they want states to have a lot of options,” she said. “That’s very frightening to me because we have states that would be supporting plans that don’t make sure everyone is covered.”
The Associated Press reported that optimism
“Unless over the break (Ryan’s) been able to come up with something very unique, I would be surprised that we would be able to get to the 216 people we need to pass something.”
—Rep. Joyce Beatty
about an emerging plan is being driven largely by a deal brokered by leaders of the Freedom Caucus and the moderate Tuesday Group aimed at giving states more flexibility to pull out of Obamacare provisions. The Post reported that waivers in the MacArthur amendment — MacArthur is a member of the Tuesday Group — would enable states to determine their own essential health benefits and allow insurers to charge higher premiums for those with existing conditions, so long as they also make a highrisk pool available to them.
High-risk pools are government-backed insurance for the most seriously ill people, a mechanism that often has failed for lack of sufficient financing.
Despite Republican infighting, Trump last month blamed Democrats after his attempt to replace Obamacare failed.
Democrats said they never were consulted then, and Beatty said Thursday that to the best of her knowledge, neither the administration nor House leadership has made an attempt to court Democratic support for the latest effort.
She also was skeptical of Ryan’s claim to be close to having 216 votes for controversial legislation that lawmakers hadn’t even read.
“You have to be able to count in Congress,” she said, referring to Republican leaders’ earlier claims to have come close to passing an Obamacare repealand-replace bill.
“It’s a balancing act. When (Ryan) would move to appease those who were in the Freedom Caucus, he would lose those who were in the middle. Unless over the break he’s been able to come up with something very unique, I would be surprised that we would be able to get to the 216 people we need to pass something.”
In an interview Thursday, budget chief Mick Mulvaney said he was surprised at “the toxicity levels” that have divided the GOP over health care and hoped lawmakers’ two-week break would prove “healing.”
Tiberi said he doesn’t believe that Ryan is mounting the latest push for a health-care bill to give Trump a significant legislative achievement during his first 100 days — a symbolically important milestone.
“In my mind, that is not the reason,” Tiberi said. “The reason is that the individual market is collapsing and we have to get on with fixing it.”
If a vote occurs next week, it will take place as the House must pass a budget measure to keep the government from shutting down.
“We’re going to have a lot of work to do when we return,” Beatty said. “We also have a budget to get settled. I was there when we shut down (in 2013), and as much as I am against a short-term budget, I’m aware that we’ve got to get something.”
Trump told reporters he thinks both health-care legislation and keeping the government operating can be accomplished. There has been talk of temporarily funding the government for a week, which could put that problem on the shelf while the Obamacare replacement is considered.