GOP senators discovering hurdleswhile legislating

washington » Remember the Republican health care bill?

Washington is fixated on President Donald Trump’s firing of FBI chief James Comey and burgeoning investigations into possible connections between Trump’s presidential campaign and Russia.

But in closed-door meetings, Senate Republicans are trying to write legislation dismantling President Barack Obama’s health care law. They would substitute their own tax credits, ease coverage requirements and cut the federal-statemedicaid program for the poor and disabled that Obama enlarged.

Thehouse passed its version this month, but not without difficulty, and now Republicans who run the Senate are finding hurdles, too.

A look at some of those obstacles:

SHORT-TERMFIX?

GOP senators say they’re discussing a possible shortterm bill if their health care talks drag on. It might include money to help stabilize shaky insurance markets with subsidies to reduce out-of-pocket costs for low-earning people and letting states offer skimpier, and therefore less expensive, policies.

It’s unclear Democrats would offer their needed cooperation, but Republicans are talking about it.

“We’ve discussed quite a bit the possibility of a twostep process,” said Sen. Lamar Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee. “In 2018 and ’19, we’d basically be a rescue team to make sure people can buy insurance.”

That could mean Republicans might even temporarily extend Obama’s individual mandate — the requirement that people buy coverage or face tax penalties. It’s perhaps the part of Obama’s law that Republicans most detest. But it does prompt some people to purchase insurance, which helps curb premiums and make markets viable.

Alexander, R-tenn., said there’s a “strong bias” to address short- and long-term problems in a single bill.

“If we can’t do the real thing, we’d have to do the next best thing,” Senate Finance Committee Chairman Orrin Hatch, R-utah, said of short-term legislation.

TIME IS TICKING

Because Democrats oppose the repeal effort unanimously, Republicans will need 50 of their 52 senators to back their overhaul so Vice President Mike Pence’s tiebreaking vote would clinch passage. GOP senators show no signs of producing a bill soon.

Time is important, especially with Trump’s problems distracting lawmakers. Insurance companies could grow increasingly spooked by the uncertainty and make health care markets even worse by raising premiums or pulling out.

Also, the longer it takes Republicans to write the legislation, the less time they’ll have for tax cuts and other GOP priorities.

BUDGETUNCERTAINTY

The Congressional Budget Office plans to release its estimate Wednesday of the House health care bill’s cost and howitwould affect coverage. Those numbers will give senators a starting point and could be a big deal.

Congress’ nonpartisan budget analyst projected in March that an earlierhouse versionwould mean 24 million additional uninsured people. That scared off many Republicans and complicatedhouse leaders’ job of passing their legislation.

Senators will examine whether the House bill still cuts Medicaid by $840 billion over a decade and reduces taxes — largely on higher earners and health industry sectors — by around $1 trillion. Democrats targeted both reductions as unfair.

Also being watched is whether a number of late changes in the House bill will force thehouse to vote again on the legislation. That would be a major problem for thegop, which nudged the measure through the House by four votes.