First steps taken for re­peal of Oba­macare

GOP-led Se­nate de­ci­sion sets up rules that will al­low a sim­ple ma­jor­ity vote to ap­prove ac­tion

The Reporter (Lansdale, PA) - - FRONT PAGE - By An­drew Tay­lor

Congress is poised to com­plete its ini­tial step to­ward dis­man­tling Pres­i­dent Barack Obama’s health care law, as Repub­li­cans di­vided over how to re­place it face pres­sure from Don­ald Trump for quick ac­tion.

By a near party-line 51-48 vote early Thurs­day, the GOP-run Se­nate ap­proved a bud­get that eases the way for ac­tion on sub­se­quent re­peal leg­is­la­tion as soon as next month.

The Repub­li­can-con­trolled House planned to com­plete the bud­get on Fri­day, even amid mis­giv­ings by some GOP law­mak­ers. Aim­ing to build mo­men­tum, the of­fice of House Speaker Paul Ryan, R-Wis., dis­trib­uted an email un­der­scor­ing sup­port for the mea­sure by the con­ser­va­tive group Her­itage Ac­tion.

“We must act quickly to bring re­lief to the Amer­i­can peo­ple,” said Se­nate Ma­jor­ity Leader Mitch McCon­nell, R-Ky.

The pres­i­dent-elect oozed con­fi­dence at a news con­fer­ence on Wed­nes­day, promis­ing his in­com­ing ad­min­is­tra­tion would soon re­veal a plan to both re­peal so­called Oba­macare and re­place

it with leg­is­la­tion to “get health care taken care of in this coun­try.”

“We’re go­ing to do re­peal and re­place, very com­pli­cated stuff,” Trump told re­porters, adding that both elements would pass vir­tu­ally at the same time. That promise, how­ever, will be al­most im­pos­si­ble to ful­fill in the com­pli­cated web of Congress, where GOP lead­ers must nav­i­gate com­plex Se­nate rules, united Demo­cratic op­po­si­tion and sub­stan­tive pol­icy dis­agree­ments among Repub­li­cans.

Pas­sage of Thurs­day’s mea­sure would per­mit fol­low-up leg­is­la­tion to es­cape the threat of a fil­i­buster by Se­nate Democrats. Repub­li­cans are not close to agree­ment among them­selves on what any Oba­macare re­place­ment would look like, how­ever.

Repub­li­cans plan to get leg­is­la­tion void­ing Obama’s law and re­plac­ing parts of it to Trump by the end of Fe­bru­ary, House Ma­jor­ity Leader Kevin McCarthy, RCalif., said Wed­nes­day on “The Hugh He­witt Show,” a con­ser­va­tive ra­dio pro­gram. Other Repub­li­cans have said they ex­pect the process to take longer.

The 2010 law ex­tended health in­sur­ance to some 20 mil­lion Amer­i­cans, pre­vented in­sur­ers from deny­ing cov­er­age for pre-ex­ist­ing con­di­tions and steered bil­lions of dol­lars to states for the Med­i­caid health pro­gram for the poor. Repub­li­cans fought the ef­fort tooth and nail and voter op­po­si­tion to Oba­macare helped carry the party to im­pres­sive wins in 2010, 2014 and last year.

Thurs­day’s Se­nate pro­ce­dural vote will set up spe­cial bud­get rules that will al­low the re­peal vote to take place with a sim­ple ma­jor­ity in the 100-mem­ber Se­nate,

in­stead of the 60 votes re­quired to move most leg­is­la­tion.

That means Repub­li­cans, who con­trol 52 seats, can push through re­peal leg­is­la­tion with­out Demo­cratic co­op­er­a­tion. They’re also dis­cussing whether there are some elements of a re­place­ment bill that could get through at the same time with a sim­ple ma­jor­ity. But for many elements of a new health care law, Repub­li­cans are likely to need 60 votes and Demo­cratic sup­port, and at this point the two par­ties aren’t even talk­ing.

Sen. Rand Paul of Ken­tucky, un­happy that the mea­sure en­dorsed huge bud­get deficits, was the sole Repub­li­can to vote against it.

In­creas­ing num­bers of Repub­li­cans have ex­pressed anx­i­ety over oblit­er­at­ing the law with­out a re­place­ment to show vot­ers.

Sen. Su­san Collins, RMaine, said she wants at least to see “a de­tailed

frame­work” of a GOP al­ter­na­tive health care plan be­fore vot­ing on re­peal. She said Repub­li­cans would risk “peo­ple fall­ing through the cracks or caus­ing tur­moil in in­sur­ance mar­kets” if law­mak­ers voided Obama’s statute with­out a re­place­ment in hand.

Collins was among a hand­ful of Repub­li­cans to oc­ca­sion­ally break ranks to sup­port some Demo­cratic amend­ments aimed at sup­port­ing such things as ru­ral hos­pi­tals and a man­date to cover pa­tients with pre­ex­ist­ing med­i­cal con­di­tions.

They were all shot down by ma­jor­ity Repub­li­cans any­way.

In the House, many mem­bers of the con­ser­va­tive Free­dom Cau­cus were in­sist­ing on first learn­ing de­tails about what a GOP sub­sti­tute would look like — or putting some elements of the re­place­ment mea­sure in the re­peal bill.

“We need to be vot­ing for a re­place­ment plan at the same time that we vote for re­peal,” said Rep. Mark Mead­ows, R-N.C., an in­flu­en­tial con­ser­va­tive.

Some more mod­er­ate

House Repub­li­cans were un­happy, too, in­clud­ing Rep. Tom MacArthur, RN.J., a leader of GOP cen­trists in the House Tues­day Group. He said he would op­pose the bud­get be­cause there was too lit­tle in­for­ma­tion about the re­place­ment, in­clud­ing whether peo­ple re­ceiv­ing ex­panded Med­i­caid cov­er­age or health care sub­si­dies un­der the ex­ist­ing law would be pro­tected.

“We’re load­ing a gun here,” MacArthur said. “I want to know where it’s pointed be­fore we start the process.”

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