GOP's plan advances despite criticism
WASHINGTON — A Republican proposal to revise the Affordable Care Act claimed its first major victories Thursday amid a backlash that both Republican leaders and President Donald Trump spent the day trying to tamp down.
Trump met with several conservative critics of the plan, signaling both a willingness to negotiate its details and that it does not yet have enough votes to
emerge from the House. More acknowledgment of the proposal’s problems came from Senate Republicans, who suggested Thursday that the measure is moving too quickly through the House and in a form unlikely to succeed once it moves to the upper chamber.
Yet the plan emerged from two key House committees Thursday, and House Speaker Paul Ryan, R- Wis., its top booster, insisted that the pending legislation represents the “only chance we’re going to get” to fulfill the GOP’s longstanding promise to undo President Barack Obama’s Affordable Care Act.
The GOP proposal cleared the Ways and Means and the Energy and Commerce committees on party-line votes after marathon sessions that lasted through Wednesday night and into Thursday. It now heads to yet another panel, the Budget Committee, and it remains on track to land on the House floor by month’s end.
But the proposal faces challenges with both GOP conservatives and moderates, in addition to Democrats, many of whom questioned the lightningfast process and raising dueling
qualms about its policy provisions.
Even Senate Majority Leader Mitch McConnell, R-Ky., appeared to echo a Democratic attack on the House legislation, saying lawmakers need to see the nonpartisan Congressional Budget Office estimate of how the bill will affect the federal deficit and the number of insured Americans.
“I think we need to know that,” McConnell said, adding that the report could be released by Monday.
Trump and Ryan have adopted diverging approaches to critics of the overhaul. While Trump has endorsed the legislation, he has expressed a willingness to make deals with its critics in recent days, while Ryan has emphasized the precarious nature of the legislation that House leaders have drafted, all but ruling out substantial changes to the bill before it comes up for a final vote.
At an unusual Thursday news conference carried live on cable news channels, a shirtsleeved Ryan gave a 23- minute presentation. Republicans, he said, face a “binary choice” — vote for the House bill, or let the ACA survive.
“We as Republicans have been waiting seven years to do this,” Ryan said. “This is the closest we will ever get to repealing and
replacing Obamacare. The time is here. The time is now. This is the moment.”
Hours later, leaders of the hard- right House Freedom Caucus visited the White House and made a personal case to Trump to modify the legislation — changes that Ryan and other House leaders believe would imperil it by alienating moderate Republicans.
“I didn’t hear anything that said it’s a binary choice at the White House today,” said Rep. Mark Meadows, R-N.C., the Freedom Caucus chairman.
Meadows declined to detail the changes he and other conservatives are seeking, but they have leveled three broad objections to the Ryan-backed bill: that the system of tax credits it creates constitutes a new government entitlement, that it does not do enough to curtail the ACA’s Medicaid expansion and that it largely leaves the ACA’s insurance coverage mandates in place.
Another influential House conservative group, the Republican Study Committee, proposed amendments to the Medicaid portion of the GOP plan that would wind down the ACA Medicaid expansion beginning in 2018 rather than 2020, and also require “able-bodied, childless adults” to
seek work in exchange for Medicaid benefits.
Trump sought to calm fears about the process in an afternoon tweet: “Despite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!”
The accelerated pace has drawn criticism from Democrats, who contrasted it with the lengthy deliberations that took place before passage of the Affordable Care Act, as well as from some Republicans.
One of those Republicans, Sen. Tom Cotton of Arkansas, tweeted early Thursday morning that the House should “start over.”
“Get it right, don’t get it fast,” Cotton wrote from his political account.
Four other GOP senators in states that accepted Medicaid expansion under Obamacare have expressed concerns about changing the way the program is administered.
One of those senators, Ohio’s Rob Portman, reiterated his concerns Thursday after meeting with Vice President Mike Pence and Health and Human Services Secretary Tom Price.
“That concerns me if it provides less certainty for the expanded Medicaid,” Portman said. “We’ll see.”