In early GOP win on health care re­peal, Congress OKs bud­get

The Hazleton Standard-Speaker - - FROM THE FRONT - By ALAN FRAM and AN­DREW TAY­LOR

WASH­ING­TON — As­cen­dant Repub­li­cans drove a bud­get through Congress on Fri­day that gives them an early but crit­i­cal vic­tory in their cru­sade to scrap Pres­i­dent Barack Obama’s health care over­haul.

The vote trains the spot­light on whether they and Don­ald Trump can de­liver on re­peated pledges to not just erase that statute but re­place it.

Demon­strat­ing the GOP’s will­ing­ness to plunge into a defin­ing but risky bat­tle, the House used a near party-line 227-198 roll call to ap­prove a mea­sure that pre­vents Se­nate Democrats from de­rail­ing a fu­ture bill, thus far un­writ­ten, an­nulling and re­shap­ing Obama’s land­mark 2010 law. The bud­get, which won Se­nate ap­proval early Thurs­day, does not need the pres­i­dent’s sig­na­ture.

“The ‘Unaf­ford­able’ Care Act will soon be his­tory!” Trump tweeted Fri­day in a dig at the statute’s name, the Af­ford­able Care Act. Trump takes the pres­i­den­tial oath next Fri­day.

The real work looms in com­ing months as the new ad­min­is­tra­tion and con­gres­sional Repub­li­cans write leg­is­la­tion to erase much of the health care law and re­place it with a GOP ver­sion. Repub­li­cans have in­ter­nal divi­sions over what that would look like, though past GOP pro­pos­als have cut much of the ex­ist­ing law’s fed­eral spend­ing and eased cov­er­age re­quire­ments while re­ly­ing more on tax ben­e­fits and let­ting states make de­ci­sions.

Fri­day’s vote was pre­ceded by de­bate that saw hy­per­bole on both sides and un­der­scored how the two par­ties have al­ter­nate-uni­verse views of Obama’s over­haul. Democrats praised it for ex­tend­ing cov­er­age to tens of mil­lions of Amer­i­cans, help­ing fam­i­lies af­ford poli- cies and se­niors buy pre­scrip­tions, while Repub­li­cans fo­cused on the ris­ing pre­mi­ums and de­ductibles and limited ac­cess to doc­tors and in­sur­ers that have plagued many.

House Speaker Paul Ryan, R-Wis., said the health care law was “so ar­ro­gant and so con­trary to our found­ing prin­ci­ples” and had not de­liv­ered on Obama’s prom­ises to lower costs and pro­vide more choice.

“We have to step in be­fore things get worse. This is noth­ing short of a res­cue mis­sion,” Ryan said.

“Our ex­per­i­men­ta­tion in Soviet-style cen­tral plan­ning of our health care sys­tem has been an ab­ject fail­ure,” said fresh­man Rep. Jodey Ar­ring­ton, R-Texas.

House Mi­nor­ity Leader Nancy Pelosi, D-Calif., said Ryan was ped­dling “mythol­ogy” and said the GOP was mov­ing to­ward wors­en­ing health care for con­sumers.

“They want to cut ben­e­fits and run. They want to cut ac­cess and run,” she said of Repub­li­cans.

“This is a sad day in the his­tory of this coun­try as Repub­li­cans be­gin the process of de­stroy­ing health care in Amer­ica,” said Rep. Ha­keem Jef­fries, D-N.Y., ar­gu­ing that the GOP has no re­place­ment in hand. “All you have is smoke and mir­rors, and the Amer­i­can peo­ple are get­ting ready to get screwed.”

Nine Repub­li­cans joined all voting Democrats in op­pos­ing the bud­get.

The bud­get’s ap­proval means Se­nate Democrats won’t be al­lowed to fil­i­buster the fu­ture re­peal-and-re­place bill — a piv­otal ad­van­tage for Repub­li­cans. They con­trol the Se­nate 52-48, but it takes 60 votes to end fil­i­busters, or end­less pro­ce­dural de­lays that can scut­tle leg­is­la­tion.

Repub­li­cans have made an­nulling Obama’s law and re­plac­ing it a top goal for the past seven years. GOP rifts and an Obama veto pre­vented them from achiev­ing any- thing other than hold­ing scores of votes that served as po­lit­i­cal mes­sag­ing.

Trump, too, made tar­get­ing Obama’s over­haul a pri­mary tar­get dur­ing his cam­paign. At his news con­fer­ence Wed­nes­day, Trump — who’s sup­plied few de­tails of what he wants — said his emerg­ing plan will be “far less ex­pen­sive and far bet­ter” than the statute.

De­spite their con­cep­tual unity, plenty of Repub­li­cans have shown skit­tish­ness in re­cent days about the po­lit­i­cal reper­cus­sions of charg­ing into a bat­tle that, with Trump in the White House, puts en­act­ing new laws within reach.

Many ex­pressed op­po­si­tion to lead­ers’ ini­tial em­pha­sis on first pass­ing a re­peal bill and then fo­cus­ing on a re­place­ment — a process that could pro­duce a gap of months or longer. Trump has also pushed Congress to act fast.

Numer­ous Repub­li­cans have in­sisted on learn­ing how their party will re­craft the na­tion’s $3 tril­lion-a-year health care sys­tem be­fore voting to void ex­ist­ing pro­grams. Twenty mil­lion Amer­i­cans are cov­ered by Obama’s ex­pan­sion of Med­i­caid or by poli­cies sold on ex­changes, and mil­lions of oth­ers have ben­e­fited from the cov­er­age re­quire­ments it has im­posed on in­sur­ers.

There are in­ter­nal GOP chasms over lead­ers’ plans to use their bill to halt fed­eral pay­ments to Planned Par­ent­hood and pare Med­i­caid cov­er­age. There are also dis­agree­ments over how to pay for the GOP re­place­ment, with many Repub­li­cans leery of Ryan’s pro­posal to tax part of the value of some health in­sur­ance pro­vided by em­ploy­ers.

Even with their dis­putes, the GOP’s ral­ly­ing be­hind their bud­get spot­lighted the po­lit­i­cal im­per­a­tive fac­ing Repub­li­cans to de­liver on a bat­tle cry that has sus­tained them for years.

J. SCOT T APPLEWHITE/As­so­ci­ated Press

House Ma­jor­ity Leader Kevin McCarthy of Cal­i­for­nia walks through the Capi­tol in Wash­ing­ton on Fri­day as mem­bers at­tend a closed-door in­tel­li­gence brief­ing. Congress has ap­proved the first step to­ward dis­man­tling Pres­i­dent Barack Obama’s health care law as Repub­li­cans pushed a bud­get through Congress that pro­vides an early but cru­cial vic­tory in the ef­fort.

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