GOP lead­ers un­veil new health law out­line, di­vi­sions re­main

The Mercury (Pottstown, PA) - - NEWS - By Alan Fram

WASH­ING­TON >> Top House Repub­li­cans un­veiled a rough sketch of a mas­sive health care over­haul to rank-and-file law­mak­ers Thurs­day, but a lack of de­tail, cost es­ti­mates and GOP unity left un­re­solved the prob­lem that’s plagued them for years: What’s the party’s plan and can Congress pass it?

At a closed-door meet­ing in the Capi­tol base­ment, House Speaker Paul Ryan, RWis., and other party lead­ers de­scribed a broad vi­sion for void­ing much of Pres­i­dent Barack Obama’s 2010 statute and re­plac­ing it with con­ser­va­tive poli­cies. It fea­tures a re­vamped Med­i­caid pro­gram for the poor, tax breaks to help peo­ple pay doc­tors’ bills and fed­er­ally sub­si­dized state pools to as­sist those with costly med­i­cal con­di­tions in buy­ing in­sur­ance.

Law­mak­ers called the ideas op­tions, and many were con­tro­ver­sial. One be­ing pushed by Ryan and other lead­ers would re­place the tax in­creases in Obama’s law with new levies on the value of some em­ployer-pro­vided health plans — a po­lit­i­cal no-fly zone for Repub­li­cans averse to tax boosts.

“You have to leg­is­late with a sense of po­lit­i­cal re­al­ity,” said Rep. Tom Cole, R-Okla., who said back­ing that pro­posal “would set up an ad against you from mul­ti­ple di­rec­tions” dur­ing up­com­ing elec­tions.

The scant health care progress mir­rors a lack of move­ment on other is­sues in a cap­i­tal run by the GOP. No pro­pos­als have sur­faced to pur­sue Pres­i­dent Don­ald Trump’s cam­paign prom­ises to build a bor­der wall with Mex­ico or but­tress the na­tion’s in­fra­struc­ture, and Repub­li­cans have yet to co­a­lesce around an­other pri­or­ity, re­vamp­ing the na­tion’s tax code.

Se­nate Repub­li­cans have crit­i­cized a House GOP plan to change how cor­po­ra­tions are taxed. Trump has said he will re­lease his own pro­posal in the com­ing weeks, but noth­ing had been pro­duced, draw­ing mock­ery from Democrats.

“At some point we need to move from imag­i­nary madeup plans to things that you can read on pa­per,” said Sen. Mark Warner, D-Va.

The health care out­line was aimed at giv­ing Repub­li­cans some­thing to ex­hibit dur­ing next week’s con­gres­sional re­cess, at a time of bois­ter­ous town hall meet­ings packed with sup­port­ers of Obama’s law. Ryan told re­porters that Repub­li­cans would in­tro­duce leg­is­la­tion void­ing and re­plac­ing Obama’s statute af­ter Congress re­turns in late Fe­bru­ary, but of­fered no specifics.

Many Repub­li­cans took an up­beat tone af­ter Thurs­day’s meet­ing, with Rep. Peter King, R-N.Y., say­ing, “We’re only 27 days into the new ad­min­is­tra­tion, so we have time.”

But they have re­peat­edly failed for seven years to rally be­hind a sub­sti­tute plan, and there are no guar­an­tees of suc­cess in re­plac­ing a law that has ex­tended cov­er­age to 20 mil­lion Amer­i­cans.

“We’re not go­ing to get out of this overnight,” Rep. Bill Huizenga, R-Mich., said of the over­all ef­fort.

There are sure clashes ahead this time over cru­cial specifics that could jeop­ar­dize the en­tire ef­fort. And law­mak­ers said they were await­ing of­fi­cial cost es­ti­mates from the non­par­ti­san Con­gres­sional Bud­get Of­fice, which could ig­nite other bat­tles if the price tag is dis­con­cert­ingly high.

Obama’s law levied $1.1 tril­lion in taxes over a decade to fi­nance its ex­panded cov­er­age to mil­lions. GOP lead­ers said some or all of those taxes could be re­pealed, with the rev­enue re­placed by a new tax on health care that em­ploy­ees re­ceive at work.

Two peo­ple fa­mil­iar with the pro­posal said in­di­vid­u­als would pay taxes on the value of such cov­er­age above $12,000, and above $30,000 for fam­i­lies. Repub­li­cans would not con­firm those amounts, though House Ways and Means Com­mit­tee Chair­man Kevin Brady, R-Texas, told re­porters “the vast, vast ma­jor­ity of Amer­i­cans” would be un­af­fected.

Ac­cord­ing to doc­u­ments dis­trib­uted to mem­bers and ob­tained by The As­so­ci­ated Press, the ex­pan­sion of Med­i­caid to mil­lions of ad­di­tional poorer peo­ple — al­most en­tirely fi­nanced by fed­eral tax­pay­ers — would be phased out. In a com­pro­mise aimed at re­solv­ing a bit­ter dis­pute, ex­tra Med­i­caid money would flow to the 31 states that ac­cepted that ex­pan­sion and the 19 that didn’t, though it would end “af­ter a cer­tain date” left un­spec­i­fied.

Af­ter that, states would get far more dis­cre­tion to de­cide who would be cov­ered by Med­i­caid. They’d also de­cide whether to re­ceive fed­eral Med­i­caid funds based on the fluc­tu­at­ing num­bers of the pro­gram’s ben­e­fi­cia­ries or a set an­nual amount.

The tax penal­ties Obama’s law levies on peo­ple who don’t buy in­sur­ance would be abol­ished, as would fed­eral sub­si­dies for most peo­ple buy­ing cov­er­age on the on­line ex­changes the statute es­tab­lished. They would be re­placed by tax cred­its for peo­ple who don’t have jo­bor gov­ern­ment-pro­vided health cov­er­age and tax-ad­van­taged health sav­ings ac­counts. Repub­li­cans said de­ci­sions on amounts have not been made.

THE AS­SO­CI­ATED PRESS

House Speaker Paul Ryan of Wis., joined by House Ma­jor­ity Whip Steve Scalise of La., right, and Rep. Greg Walden, R-Ore., de­parts a news con­fer­ence on Capi­tol Hill in Wash­ing­ton, Tues­day, Feb. 14, 2017.

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