Ryan: Health bill must do more for older Americans

The Republican healthcare plan moving rapidly toward a crucial House vote this week is likely to be changed to give older Americans more assistance to buy insurance, Speaker Paul Ryan said Sunday.

“We think that we should be offering even more assistance than what the bill currently does,” Ryan, RWis., said in a “Fox News Sunday” interview, in which he confirmed that House leaders are eyeing a Thursday vote on its passage.

Meanwhile, a key conservative senator said White House officials were continuing to negotiate through the weekend on even more dramatic revisions to the bill in hopes of winning over hard-liners who have threatened to tank the legislation.

Sen. Ted Cruz, R-Texas, said he and two other conservative leaders — Sen. Mike Lee, R-Utah, and Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus — met at President Donald Trump’s Mar-a-Lago resort in Florida in an attempt “to fix this bill.”

“I cannot vote for any bill that keeps premiums rising,” Cruz said, echoing the concerns of other hard-line lawmakers who want the legislation to undo more of the Affordable Care Act’s insurance mandates. “President Trump said this is one big, fat negotiation. Here is the central prize: If we lower premiums, and hopefully lower them a lot, that is a victory for the American people.”

Speaking about the negotiations Sunday on ABC’s “This Week,” Health and Human Services Secretary Tom Price said, “It’s a fine needle that needs to be threaded, no doubt about it.”

Ryan’s declaration that more would be done to help older Americans came after a third House moderate said Saturday that he could not support the bill “in its current form.”

Rep. Brian Fitzpatrick, R-Pa., said in a Facebook post that he was concerned that the legislation would roll back efforts to prevent and treat opioid abuse.

But he said that was one concern of many, and lawmakers from across the GOP’s ideological spectrum have expressed fears that the American Health Care Act will not drive down prices. Reps. Ileana RosLehtinen, R-Fla., and Leonard Lance, R-N.J., have cited that concern in announcing their opposition to the bill, and several other moderates remain undecided.

Those fears were stoked last week by a Congressional Budget Office analysis that forecasted a shortterm increase in premiums under the GOP law, and while premiums are expected to drop by roughly 10 percent over a 10-year period, some older and lowincome people would face massive premium increases.

Those over 50 but not yet 65 represent a major consideration in any alternative to the ACA. That age group tends to have more medical issues than younger adults and, thus, higher insurance costs, and the ACA forbids insurers to charge their oldest customers more than three times their rates for young adults.

But House Republicans want to eliminate that feature of the law, and the GOP bill would allow a 5-to-1 ratio as part of an attempt to attract more of the younger, healthier customers whom insurers want.

In an extreme case laid out in the CBO report, a 64-year-old earning $26,500 a year would see yearly premiums rise from $1,700 under the ACA to $14,600 under the Republican plan.

Ryan questioned that analysis, suggesting that administrative actions taken by the Trump administration would further lower premiums. But he acknowledged that the GOP bill would probably have to change. “We believe we should have even more assistance, and that’s one of the things we’re looking at for that person in the 50s and 60s because they experience higher health-care costs,” he said.

But Sen. Rand Paul, RKy., said on “This Week” that the bill was still short of a majority.

J. SCOTT APPLEWHITE/AP House Speaker Paul Ryan says the GOP likely will change its health bill for the sake of people in their 50s and 60s.