Trump’s week­end push

Repub­li­cans di­vided over re­peal­ing Af­ford­able Care Act be­fore re­plac­ing it

The Denver Post - - NEWS - By Hope Yen

WASH­ING­TON» Pres­i­dent Don­ald Trump made a week­end push to get a Repub­li­can Se­nate bill to re­peal and re­place for­mer Pres­i­dent Barack Obama’s health care law “across the fin­ish line,” Trump’s top leg­isla­tive aide said Sun­day, main­tain­ing that a re­peal-only op­tion also re­mained in play if Repub­li­cans can’t reach agree­ment.

Marc Short, the White House’s leg­isla­tive di­rec­tor, said Trump was mak­ing calls to wa­ver­ing sen­a­tors and in­sisted they were “get­ting close” on pass­ing a bill.

But Short said Trump con­tin­ues to be­lieve that re­peal-only leg­is­la­tion should be con­sid­ered af­ter rais­ing the pos­si­bil­ity Fri­day. Se­nate Ma­jor­ity Leader Mitch McCon­nell, R-Ky., has dis­missed that sug­ges­tion and said he in­tended to pro­ceed with leg­is­la­tion be­ing ne­go­ti­ated dur­ing the July 4 re­cess.

“We hope when we come back, the week af­ter re­cess, we’ll have a vote,” Short said. But he added: “If the re­place­ment part is too dif­fi­cult for Repub­li­cans to get to­gether, then let’s go back and take care of the first step of re­peal.”

Trump on Fri­day tweeted the sug­ges­tion of re­peal­ing the Obama-era law right away and re­plac­ing it later, an ap­proach that GOP lead­ers and the pres­i­dent him­self con­sid­ered but dis­missed months ago as im­prac­ti­cal and po­lit­i­cally un­wise. But the tweet came amid con­tin­u­ing signs of GOP dis­agree­ment among mod­er­ates and con­ser­va­tives over the bill. Repub­li­cans hold a 52-48 ma­jor­ity in the Se­nate. Just three GOP de­fec­tions would doom the leg­is­la­tion, be­cause Democrats are united in op­po­si­tion.

Repub­li­cans re­turned to their home districts late last week, brac­ing for a flood of phone calls, emails and tele­vi­sion ad­ver­tis­ing from con­ser­va­tive and lib­eral groups aimed at pres­sur­ing sen­a­tors. Sen. Bill Cas­sidy held a town hall meet­ing Fri­day to talk about flood re­cov­ery in Ba­ton Rouge, Louisiana’s cap­i­tal city, but au­di­ence mem­bers an­gry over the GOP health care bill at times chanted over Cas­sidy’s an­swers and crit­i­cized the se­cre­tive leg­isla­tive process.

“I wish we weren’t do­ing it one party,” Cas­sidy said Sun­day, adding he re­mains un­de­cided on how he will vote.

Trump’s sug­ges­tion had the po­ten­tial to har­den di­vi­sions within the GOP as con­ser­va­tives com­plain that McCon­nell’s bill does not go far enough in re­peal­ing Obama’s health care law while mod­er­ates crit­i­cize it as overly harsh in kick­ing peo­ple off in­sur­ance rolls, shrink­ing the Med­i­caid safety net and in­creas­ing pre­mi­ums for older Amer­i­cans.

“It’s not easy mak­ing Amer­ica great again, is it?” McCon­nell said late Fri­day. He has pre­vi­ously in­di­cated that if Repub­li­cans fail to reach agree­ment, he will have to ne­go­ti­ate with Democrats, who want to fix Obama’s health care law with­out re­peal­ing it.

Short said the White House re­mained hopeful af­ter Se­nate Repub­li­cans sub­mit­ted two ver­sions of the bill to the Con­gres­sional Bud­get Of­fice for scor­ing dur­ing the week­long re­cess. Texas’ Sen. Ted Cruz is push­ing a con­ser­va­tive ver­sion that aims to ag­gres­sively re­duce costs by giv­ing states greater flex­i­bil­ity to cre­ate sep­a­rate high­er­risk pools. The other seeks to bol­ster health care sub­si­dies for lower-in­come peo­ple, per­haps by pre­serv­ing a tax boost on high earn­ers.

Health and Hu­man Ser­vices Sec­re­tary Tom Price said ne­go­ti­a­tions over the Se­nate bill were fo­cus­ing on ways to ad­dress the is­sue of Med­i­caid cov­er­age so that “no­body falls through the cracks,” com­bat­ing the opi­oid cri­sis and giv­ing fam­i­lies more choice in se­lect­ing their in­sur­ance plan.

But con­ser­va­tive Sen. Rand Paul, R-Ky., said he didn’t think a re­peal-an­dreplace bill could win 50 votes. He and Sen. Ben Sasse, R-Neb., have been urg­ing McCon­nell to con­sider a re­peal-only bill first.

“I don’t think we’re get­ting any­where with the bill we have. We’re at an impasse,” Paul said. He crit­i­cized Se­nate lead­ers, say­ing they were seek­ing to win over mod­er­ates with multi­bil­lion-dol­lar pro­pos­als to com­bat the opi­oid epi­demic and boost tax sub­si­dies to help lower-in­come peo­ple get cov­er­age.

“The bill is just be­ing lit up like a Christ­mas tree full of bil­lion-dol­lar or­na­ments, and it’s not re­peal,” Paul said. “I think you can get 52 Repub­li­cans for clean re­peal.”

Even be­fore Trump was in­au­gu­rated in Jan­uary, Repub­li­cans had de­bated and ul­ti­mately dis­carded the idea of re­peal­ing the over­haul be­fore re­plac­ing it, con­clud­ing that both must hap­pen si­mul­ta­ne­ously. Do­ing oth­er­wise would in­vite ac­cu­sa­tions that Repub­li­cans were sim­ply toss­ing peo­ple off cov­er­age and would roil in­sur­ance mar­kets by rais­ing the ques­tion of whether, when and how Congress might re­place Obama’s law once it was gone.

But at least nine GOP sen­a­tors ex­pressed op­po­si­tion af­ter a CBO anal­y­sis last week found that McCon­nell’s draft bill would re­sult in 22 million peo­ple los­ing in­sur­ance over the next decade, only 1 million fewer than un­der the House-passed leg­is­la­tion that Trump pri­vately told sen­a­tors was “mean.”

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