Republican unity frays in Obamacare repeal debate

WASHINGTON: Republican leaders and the White House presented a united front Friday in their bid to ditch Obamacare, but the replacement plan — still incomplete, still hidden from public view — is meeting increasing pushback from rank-and-file conservatives.

With Democrats of a single mind to keep the landmark health-care reforms in place, US President Donald Trump and House Speaker Paul Ryan can ill afford an open revolt within the very party that has waged war on the Affordable Care Act (ACA) for the past seven years.

But as public support for the law grows, and several Republican governors who expanded the low-income Medicaid programme through Obamacare warn that the plan could leave their state budgets underwater, Republican leaders find themselves in a pickle over how to proceed.

Trump laid out a framework for his ‘repeal-and-replace’ plan during his maiden speech before Congress on Tuesday, when he expressed support for Ryan’s call to use tax credits to help Americans purchase their own health-insurance coverage once Obamacare is dead and buried.

That did not sit well with several GOP conservatives like Senator Rand Paul, who said tax credits are just a reworked version of the ACA’s existing subsidies.

“I don’t think we can dress up Democrat ideas and put a Republican stamp on them,” he said.

Republicans base their reforms on several objectives: increasing competition, reducing cost, and expanding choices in part by allowing insurance purchases across state lines.

But they also must contend with inconvenient truths about the law. An additional 20 million more Americans are now covered under Obamacare, and insurance companies are barred from refusing coverage to people due to pre-existing conditions. Children can also now remain on their parents’ plan until age 26.

Trump has said he wants an orderly transition to ensure no one gets bumped off coverage, and that the provision on pre-existing conditions be kept part of any new law.

The plan’s crafters must find ways to meet those challenges, while scrapping the so-called individual mandate requiring people to buy health insurance — a key element that was intended to help cover those costs. — AFP