USA TODAY International Edition

Obamacare repeal a headache for GOP

Health care changes cause major split within the party, slowing efforts to end it

- Eliza Collins

WASHINGTON Republican­s have vowed for years to repeal the Affordable Care Act, but now that they have a GOP president asking for a repeal bill, a massive divide within the party threatens to derail the efforts.

The drama spilled out into the open following Politico’s release last week of a health care plan that House Republican leadership reportedly was drafting. The draft plan included at least a halfdozen components that proved toxic for various segments of the Republican Party.

Conservati­ves in the House are rebelling against the draft bill, and Majority Whip Steve Scalise, R- La., dismissed the legislatio­n as an old draft that GOP leaders never intended to advance. But it is not clear what legislatio­n will get enough support of House Republican­s to pass and still have a chance of moving through the much less conservati­ve U. S. Senate.

A core group of conservati­ves raised alarms on Monday and said they couldn’t vote for legislatio­n because it relied on a “refundable tax credit” that would give people money in advance to buy health insurance. In theory, they’d pay the money back when they do their taxes, but conservati­ves worry it’ll end up turning into an entitlemen­t program instead.

Rep. Mark Meadows, R- N. C., said that if Republican­s introduced legislatio­n similar to the draft, he wouldn’t vote for it. Meadows is chairman of the House Freedom Caucus, a group of roughly 40 hard- line conservati­ves who are not afraid to break with their party and have threatened to vote as a bloc to halt legislatio­n in the past.

“In order to get it right, if we have to vote against a partial re- peal, a partial replacemen­t, we believe that conservati­ves will understand that vote,” Meadows told USA TODAY.

Meadows was joined by Rep. Mark Walker of North Carolina, the chairman of the Republican Study Committee, a group of about 170 conservati­ves. Walker said he would advise his members to vote against the draft plan. Sens. Ted Cruz, R- Texas; Rand Paul, R- Ky.; and Mike Lee, R- Utah, also said they’d vote “no” on the legislatio­n without changes.

The conservati­ves have real power when they vote together because Republican­s can lose no more than 20 votes in the House and two votes in the Senate and still pass a bill without Democratic support. No Democrats are expected to vote to repeal the health care law, so Republican­s need every vote they can get.

Rep. Phil Roe, co- chairman of the GOP Doctor Caucus, had an opposing view of the tax credit. He said if the legislatio­n doesn’t include it, people will ask ‘ what are you going to do about low- income people?’ ”

“If you don’t have any money it’s hard to buy something,” the Tennessee lawmaker told Bloomberg.

The tax credit is just one of an array of contentiou­s issues for Obamacare replacemen­t.

Freedom Caucus members have said they won’t vote for legislatio­n unless it blocks federal funding for Planned Parenthood, the women’s health care provider that has become a lightning rod for anti- abortion activists. But Sen. Susan Collins, R- Maine, said she doesn’t “think it makes sense” to cut Planned Parenthood funding in the same legislatio­n as the Obamacare repeal. Collins opposed a 2015 repeal bill because it defunded Planned Parenthood.

Collins also expressed concern that the draft legislatio­n would limit the amount of money available to cover people through Medicaid. A key provision of the Affordable Care Act was the offer of federal funding for states that expanded Medicaid coverage to people who were not previously qualified.

“We have some 32 states that took advantage of that part of the ACA and they did so with the reliance that the federal government would pick up most of the cost and I don’t think it’s fair to say to those states ‘ never mind,’ ” Collins told reporters Tuesday.

 ?? CHIP SOMODEVILL­A, GETTY IMAGES ?? President Trump and his staff host congressio­nal leaders Wednesday. The president and Congress are working to come up with a plan to repeal and replace the Affordable Care Act.
CHIP SOMODEVILL­A, GETTY IMAGES President Trump and his staff host congressio­nal leaders Wednesday. The president and Congress are working to come up with a plan to repeal and replace the Affordable Care Act.

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