Speaker seems to give boost to Senate health care push
WASHINGTON –
The Senate Republican plan for a scaled-back overhaul of the Affordable Care Act was headed for a cliffhanger vote when House Republican leaders said late Thursday that they were willing to use the proposal as a basis for negotiating a broader rollback of the law.
After a two-hour standoff, House Speaker Paul Ryan, R-Wis., issued a measured statement expressing openness to a House-Senate conference that many rank-and-file Republican senators have demanded as a condition for backing “skinny repeal” legislation that has little substantive appeal to them.
Ryan’s statement came as the Senate prepared for a marathon session of votes on health care legislation that was expected to begin late Thursday and extend into Friday morning. The speaker also scheduled a pivotal meeting with his House caucus Friday to hash out the Senate’s demands.
“If moving forward requires a conference committee, that is something the House is willing to do,” Ryan said. “The House remains committed to finding a solution and working with our Senate colleagues, but the burden remains on the Senate to demonstrate that it is capable of passing something that keeps our promise.”
Although the statement could ease tensions, it remained to be seen whether it will be enough to win over a bloc of Senate Republicans who earlier had declared the proposal “terrible.”
“I would like to have the kind of assurances he didn’t provide,” Sen. John McCain, R-Ariz., told reporters.
Sen. Lindsey Graham, R-S.C., left open the possibility that he could be swayed by further talks, telling reporters he did “not yet” support the measure.
Earlier, McCain, Graham and Sen. Ron Johnson, R-Wis., convened a news conference that highlighted the extent to which Republicans are struggling to reconcile their desire to tear down President Barack Obama’s landmark 2010 law with their inability to unite behind a replacement.
Republicans have been promising for seven years to repeal the Affordable Care Act (ACA) but never had a Republican in the White House to carry out their demands — until President Trump began urging lawmakers via speeches and tweets to send him something to sign.
McCain, Graham and Johnson — who could collectively defeat the Senate plan — said their support for a skinny repeal must not be used to trigger a hasty House vote before members head home for their August recess.
The commitment from Ryan alone wasn’t enough for McCain or Graham. McCain said Ryan’s statement did not go far enough to ensure that the legislation under consideration by Senate leaders would never pass the House.
“If I don’t get those assurances, I’m a ‘no,’ because I’m not going to vote for a pig in a poke,” Graham said. “I’m not going to vote for a bill that is terrible policy and horrible politics, just because we have to get something done.”
Many conservatives in both chambers object to the measure, which would remove key insurance mandates and make a handful of other changes, because they say it wouldn’t go far enough in repealing the ACA.
What’s in the bill
But, with lawmakers unable to agree on anything broader, it has become a last resort for Senate Majority Leader Mitch McConnell, R-Ky., to keep alive a longtime GOP promise. McConnell sent an email to Republican senators Thursday outlining the details of a skinny repeal.
The legislation would eliminate the law’s requirement that Americans obtain insurance or pay a tax penalty, and would suspend the mandate that companies employing 50 or more workers provide coverage for at least five years.
The measure also would eliminate funding for preventive health care provided under the 2010 law and block Medicaid recipients from being reimbursed for Planned Parenthood services. Finally, it would provide states more flexibility in how they administer their Medicaid programs under the law’s waiver program.
While the revamped health care bill is more modest than earlier versions, it still would have a major effect on the individual insurance market. Eliminating the ACA’s individual mandate could transform the makeup of those buying coverage, causing the premiums for those remaining in the system to rise significantly.
Sara Rosenbaum, a health law and policy professor at George Washington University, said the bill would make “enormous” changes to both private and public insurance.
A preliminary Congressional Budget Office estimate has found that 16 million people would lose coverage and that premiums would rise 20 percent if Republicans enacted a handful of the policies included in the pareddown repeal bill.
Major insurers are warning that the proposal could destabilize the individual insurance market. Blue Cross Blue Shield Association criticized it on Wednesday, and on Thursday the industry’s largest trade group suggested it was unacceptable.
“We would oppose an approach that eliminates the individual coverage requirement, does not offer continuous coverage solutions, and does not include measures to immediately stabilize the individual market,” America’s Health Insurance Plans wrote in a letter to Senate leaders.