Trump OKs fixes to bill
President endorses Medicaid curbs; Ryan eyes vote next week.
President Donald Trump signed on to a pair of changes to the House Republican health plan and declared “100 percent” backing for it Friday, moving to consolidate support among GOP lawmakers in hopes of moving it through the House next week.
In a meeting with members of the conservative Republican Study Committee, Trump endorsed two provisions affecting Medicaid, the federal health program for the poor and disabled that would see $880 billion in cuts over the next decade under the current GOP plan.
One would allow states to impose work requirements on childless adults receiving benefits under the program; another would allow them to accept a fixed “block grant” in lieu of the perperson reimbursement they now receive.
“I want to let the world know: I am 100 percent in favor,” Trump said. “These folks were no’s, mostly no’s yesterday, and now every single one is a yes.”
Rep. Mark Walker, R-N.C., the RSC’s chairman, said Trump personally asked each of the dozen RSC members who gathered with him in the Oval Office to vote for the bill.
“The president asked us specifically: Would we support him on this American Health Care Act” if the changes were made, Walker said. “We all agreed, to a man.”
More than half of House Republicans belong to the RSC, and while the endorsement of those who attended the White House meeting Friday does not bind the entire group to supporting the bill, it is a clear sign that the measure is gaining support among rank-and-file Republicans.
The bill had been under attack by both conservatives and moderates in recent days, forcing House Speaker Paul Ryan, R-Wis., to allow changes to the carefully crafted legislation to keep it on track for House passage next week. Some Republican senators have raised major concerns about the Medicaid cuts proposed in the bill, but House leaders first need to address rank-and-file conservatives in the House who generally support further scaling back the program.
Rep. Pete Sessions, RTexas, the House Rules Committee chairman, said he expects the legislation to come up before his committee Wednesday, a prelimi- nary step before the package reaches the floor.
“These changes definitely strengthen our number, but also show that President Trump’s all in now,” said House Majority Whip Steve Scalise, R-La., the top GOP vote-counter.
The changes may not be enough for everyone, however.
A small but important group of hard-line conservatives remained engaged in a parallel negotiation with the White House and some senators in a bid to force more revisions to the bill.
Rep. Mark Meadows, R-N.C., chairman of the House Freedom Caucus, said Friday that he can personally count about 12 senators and more than 40 congressmen who he expects would oppose the House GOP bill. He said those votes, combined with another large bloc of undecided members, guarantee the legislation cannot pass the House in its current format.
“There’s not anywhere close to the votes,” Meadows said in a Friday interview on C-SPAN’s “Newsmakers.” “I can assure you that this bill needs to be changed.”
Meadows said he is in talks with congressmen and senators, including Sens. Ted Cruz, R-Texas, Mike Lee, R-Utah, and Steve Daines, R-Mont., to craft several amendments to the leadership proposal. Those changes, he said, could be unveiled as soon as Monday.
The Rules Committee controls how the bill is presented and debated on the floor, and it can change the bill before it is offered for a floor vote. Any changes negotiated by leadership to win its passage are expected to come before Rules for a vote on whether they should be included in the final measure.
It is possible that there will be more changes beyond the ones endorsed Friday by Trump. Those changes would move the bill in a more conservative direction and could potentially further reduce federal spending but also further increase the number of uninsured Americans.
In a private meeting with lawmakers Friday morning, Ryan said leaders were entertaining changes to the structure of tax credits offered to individuals buying insurance under the GOP plan, known as the American Health Care Act.
That comes after numerous Republicans across the ideological spectrum raised concerns about a Congressional Budget Office analysis that estimated about an eightfold increase in premiums for a 64-year-old making about $25,000 a year.
Leaders also discussed other tweaks to the bill's handling of Medicaid, according to multiple members in the room.
Some Republicans are continuing to push for an earlier phase-out of the Affordable Care Act’s expansion of the Medicaid program from the 2020 deadline proposed in the current bill. But several said that change is unlikely given resistance from moderate House Republicans.
Meadows suggested that the relatively minor changes backed by Trump will placate the bill’s most stri- dent critics. Early Friday, before Trump made his comments, Meadows explained that giving states the option of a Medicaid work requirement “doesn’t move the ball more than a couple yards” toward the caucus’ goal.
Nonetheless, conservatives have begun to back away from their urgent demands that House leaders scrap the legislation and start fresh.
Meadows declined to specify what his negotiations could ultimately yield — but the talks include efforts to eliminate specific minimum coverage requirements for insurers and add mandatory work requirements for those covered under Medicaid. He also mentioned concerns over the structure of the tax credits.