Northwest Arkansas Democrat-Gazette
Health care bill gets high and low marks
WASHINGTON — President Donald Trump and his top health official praised the new House Republican health care legislation Tuesday, even as conservative opposition complicated party leaders’ push to sell the proposal to rank-and-file lawmakers and the public.
“We’re going to do something that’s great, and I’m proud to support the replacement plan released by the House of Representatives,” Trump declared at the White House as he met with House Republicans. “We’re going to take action. There’s going to be no slowing down. There’s going to be no waiting and no more excuses by anybody.”
Health and Human Services Secretary Tom Price defended the bill from the White House briefing room.
“The president and the administration support this step, which we believe is in the right direction,” Price said. Still, he added, “This is a work in progress.”
Committee votes on the new bill are to begin today in the House, and if passed by the full House as early as next week, Senate Majority Leader Mitch McConnell, R-Ky., has promised to take
the bill immediately to the Senate floor without a hearing.
Even as some Republicans expressed doubts about the future of the bill, House Speaker Paul Ryan, R-Wis., said at an afternoon news conference, “We’ll have 218 when this thing comes to the floor, I can guarantee you that.” That’s the number of votes needed for passage.
For the overhaul to pass — assuming that no Democrats break ranks to support the bill — Republicans can lose only 21 votes in the House and two votes in the Senate.
Noting that they expect no help from Democrats, Sen. John Cornyn of Texas, the No. 2 Republican, said the decision had been made to cobble together the final draft among Republicans from both chambers.
“There’s already been a lot of consulting on a bicameral basis,” he said. “We’re not going to do this with Democrats.”
McConnell predicted congressional passage by early April.
But several key Republican lawmakers announced their opposition, and one conservative group after another torched the plan. The Club for Growth, Heritage Action for America, Americans for Prosperity and Tea Party Patriots variously derided the new bill as Obamacare Lite, Obamacare 2.0 and even RyanCare, in a dig at Ryan.
“If this warmed-over substitute for government-run health care remains unchanged, the Club for Growth will key vote against it,” said the group’s president, David McIntosh, referring to a process in which lawmakers are graded on their votes, the better to use them as ammunition on the campaign trail.
The new GOP plan would repeal the current law’s unpopular fines on people who don’t carry health insurance. It also would replace income-based subsidies, which the law provides to help millions of Americans pay premiums, with age-based tax credits that may be skimpier for people with low incomes. Those payments would phase out for higher-earning people.
The legislation also would limit future federal funding for Medicaid, which covers low- income people, about one in five Americans. And it would loosen rules that the 2010 law imposed for health plans directly purchased by individuals.
Republican supporters and opponents are all intent on reducing the role of government in health care, but some House conservatives say the new bill doesn’t go nearly far enough.
For example, they are focusing on the system of refundable tax credits that they denounce as a costly new entitlement. They’re demanding a vote on a straightforward, repeal-only bill.
An analysis written for the Republican Study Committee, a bloc of about 170 U.S. House conservatives, condemns the tax-credit provision. The staff report called the refundable tax credits “a Republican welfare entitlement.”
“Writing checks to individuals to purchase insurance is, in principle, Obamacare,” says the memo, which was obtained by Bloomberg News.
The conservative opposition is a rebuke of legislation that GOP leaders hope will fulfill seven years of promises to repeal and replace former President Barack Obama’s Patient Protection and Affordable Care Act. Those pledges played out in countless Republican campaigns for House and Senate seats, as well as in last year’s race for president. The groups uniting to oppose the new House legislation include many that sprang up to oppose the passage of “Obamacare” in the first place.
“As the bill stands today, it is Obamacare 2.0,” the billionaire Koch brothers-backed Americans for Prosperity and Freedom Partners Chamber of Commerce said in a statement. “Millions of Americans would never see the improvements in care they were promised, just as Obamacare failed to deliver on its promises.”
Republicans are pushing forward without official estimates from the Congressional Budget Office on the cost of the bill and how many people would be covered, although GOP lawmakers acknowledged that they can’t hope to match the 20 million covered under Obamacare.
Democrats say the bill would leave many people uninsured, shifting costs to states and hospital systems that act as providers of last resort. The bill also adds up to big tax cuts for the rich, cutting more than 20 taxes enacted under Obama’s heath law with the bulk of the savings going to the wealthiest Americans.
“This is a tax cut for the wealthy with some health insurance provisions tacked alongside of it,” said Senate Minority Leader Charles Schumer, D-N.Y.
Many conservatives are hardly happier.
The new legislation is “not the Obamacare replacement plan, not the Obamacare repeal plan we’ve been hoping for. This is instead a step in the wrong direction,” Sen. Mike Lee, R-Utah, said at an afternoon news conference with Sen. Rand Paul, R-Ky., and members of the House Freedom Caucus.
Caucus members command enough votes to scuttle the bill in the House, but the group’s chairman, Rep. Mark Meadows, R-N.C., struck a conciliatory tone, emphasizing that they are open to negotiation and view the leadership bill as a starting point.
“The House leadership Obamacare Lite plan has many problems,” Paul said Tuesday on Twitter. “We should be stopping mandates, taxes and entitlements not keeping them.”
Notes of caution also came from GOP governors, with Ohio Gov. John Kasich arguing that phasing out expanded Medicaid coverage without a viable alternative is “counterproductive,” and Gov. Bruce Rauner of Illinois’ saying he was “very concerned” that people will be “left in the lurch” under the House GOP plan.