Toronto Star

Not all aboard on health-care overhaul

Four GOP senators believe changes to Obamacare don’t go far enough, as vote looms

- RICARDO ALONSO-ZALDIVAR AND ALAN FRAM THE ASSOCIATED PRESS

WASHINGTON— Senate Republican­s launched their plan for shrivellin­g Barack Obama’s health-care law Thursday, edging a step closer to their dream of repeal with a bill that would slice and reshape Medicaid for the poor, relax rules on insurers and end tax increases on higher earners that have helped finance expanded coverage for millions.

Four conservati­ve GOP senators quickly announced initial opposition to the measure and others were evasive, raising the spectre of a jarring rejection by the Republican-controlled body. But Republican Senate Majority Leader Mitch McConnell indicated he was open to discussion and seemed determined to muscle the measure through his chamber next week.

Release of the 142-page proposal ended the long wait for one of the most closely guarded bills in years. McConnell stitched it together behind closed doors, potentiall­y moving U.S. President Donald Trump and the GOP a step closer to achieving perhaps their greatest goal — repealing former president Obama’s 2010 statute, his proudest domestic legacy.

At the White House, Trump spoke of a bill “with heart.” On Facebook, Obama said at the heart of the bill was “fundamenta­l meanness.”

The bill would end Obama’s tax penalties on people who don’t buy insurance — effectivel­y ending the so-called individual mandate — and on larger companies that don’t offer coverage to their workers. It would provide less generous subsidies for people than Obama’s law but provide billions to states and insurance companies to buttress markets that in some areas have been abandoned by insurers.

McConnell must navigate a narrow route in which defections by just three of the 52 Republican senators would doom the legislatio­n. He and others said the measure would make health insurance more affordable and banish Obama coverage requiremen­ts some people find onerous.

“We have to act,” McConnell said. “Because Obamacare is a direct attack on the middle class, and American families deserve better than its failing status quo.”

Democrats said the measure would result in skimpier policies and higher out-of-pocket costs for many and erode gains made under Obama that saw roughly 20 million additional Americans gain coverage.

“We live in the wealthiest country on Earth. Surely we can do better than what the Republican health care bill promises,” said Democratic Senate Minority Leader Chuck Schumer.

Four conservati­ve senators expressed opposition but openness to talks: Ted Cruz of Texas, Kentucky’s Rand Paul, Mike Lee of Utah and Ron Johnson from Wisconsin. They said the measure falls short, missing “the most important promise that we made to Americans: to repeal Obamacare and lower their healthcare costs.”

On the other hand, Sens. Dean Heller of Nevada, facing a competitiv­e 2018 re-election battle, and Shelley Moore Capito of West Virginia expressed concerns about the bill’s Medicaid cuts. And Susan Collins of Maine reiterated her opposition to language blocking federal money for Planned Parenthood, which many Republican­s oppose because it provides abortions.

At the White House, Trump called Democrats “obstructio­nists” for opposing the measure and added, “We’ll hopefully get something done and it will be something with heart and very meaningful.” Obama was more than skeptical. “If there’s a chance you might get sick, get old or start a family, this bill will do you harm,” he wrote. He said “small tweaks” during the upcoming debate “cannot change the fundamenta­l meanness at the core of this legislatio­n.”

The House approved its version of the bill last month. Though Trump lauded its passage in a Rose Garden ceremony, he called the House measure “mean” last week.

The non-partisan Congressio­nal Budget Office said under the House bill, 23 million fewer people would have coverage by 2026. The budget office analysis of the Senate measure — which contains broadly similar cuts to Medicaid, a program that provides health care for 74 million Americans — is expected early next week.

 ?? JACQUELYN MARTIN/THE ASSOCIATED PRESS ?? U.S. Senate Majority Leader Mitch McConnell, followed by Majority Whip John Cornyn, leaves a Republican meeting on health care on Thursday.
JACQUELYN MARTIN/THE ASSOCIATED PRESS U.S. Senate Majority Leader Mitch McConnell, followed by Majority Whip John Cornyn, leaves a Republican meeting on health care on Thursday.

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