USA TODAY International Edition
Critics in GOP revolt on health care bill
Conservatives say it leaves too much of Obamacare intact
The new Republican legislation to repeal and replace Obamacare was welcomed Tuesday with a torrent of criticism from conservatives in Congress and outside advocacy groups, which could imperil its chances of passage on the expedited schedule congressional leaders set out.
House Speaker Paul Ryan, RWis., was undeterred. “We’ll have 218 when this thing comes to the floor, I guarantee it,” he said, referring to the number of votes required for legislation to pass through the House.
Conservative Republicans in the House and Senate attacked the bill for creating what they said was basically a new entitlement program and for leaving too much of Obamacare and its taxes in place.
“This is not the Obamacare repeal bill we’ve been waiting for. It is a missed opportunity and a step in the wrong direction,” said Sen. Mike Lee, R- Utah.
Lee and Sen. Rand Paul, RKy., joined a news conference of House conservatives Tuesday to denounce the bill offered by Republican leadership. Rep. Mark Meadows, R- N. C., and other members of the House Freedom Caucus — a bloc of about 40 of the most fiscally conservative House Republicans — took turns raising concerns about the bill, and Rep. Jim Jordan, R- Ohio, said he would offer an alternative bill Wednesday that would simply repeal the Affordable Care Act.
“In simple terms, I don’t think we promised the voters we’d repeal it, but we’re gonna
keep taxes in place. We’re gonna repeal it, but we’re gonna keep Medicaid expansion in place for four years, and we’re gonna repeal it but start a new entitlement with a fancy name of ‘ advanceable refundable tax credits,’ ” Jordan told USA TODAY. “I don’t believe this is actually going to bring down the cost of treatment. I don’t know that this is going to bring back affordable insurance.”
Influential conservative advocacy groups urged their allies in Congress to reject the bill.
Michael Needham, CEO of Heritage Action, the advocacy arm of the conservative think tank the Heritage Foundation, issued a blistering review of the draft bill Tuesday morning: “In many ways, the House Republican proposal released last night not only accepts the flawed progressive premises of Obamacare but expands upon them.”
Needham echoed conservative calls for a full repeal, then a conversation about how to move forward on a replacement.
The conservative Club for Growth and the libertarianminded FreedomWorks group also came out against the GOP bill Tuesday, along with the Tea Party Patriots.
“They all ran as conservative Republicans and said ‘ We’re going to get rid of Obamacare.’ They need to do it. And then instead of building Ryancare, that’s Obamacare lite, they need to build a Republican- principled bill, and then they should all vote for it,” Club for Growth President David McIntosh told USA TODAY. He said his group would make sure voters knew which lawmakers didn’t back a conservative plan.
Meadows said he met with Vice President Pence and was confident the legislation eventually would have a conservative stamp.
“The bill that was introduced last night is still open for negotiation,” Meadows said. “We took that as very encouraging news.”
President Trump tweeted Tuesday morning that the bill had been released “for negotiation,” but Ryan suggested there was not much room to make changes. He said critics would come to understand that the repeal bill is just the first part of a three- phase process for replacing Obamacare.
The first phase is to use a budget procedure that allows for a simple majority to pass the bill in the Senate rather than the usual 60 votes. Republicans could pass it with no Democratic support.
The second phase would be rules that Health and Human Services Secretary Tom Price would produce to deregulate the insurance marketplace.
The third phase would be additional replacement bills that couldn’t be pushed through using the streamlined budget procedure, such as allowing insurers to sell across state lines and capping medical liability. Those bills would require Democratic support in the Senate.
“We’re going to do something that is great,” Trump said during a meeting with House Republicans who will be in charge of rounding up votes for a health care bill. “It’s a complicated process, but actually it’s very simple. It’s called good health care.”
The House Ways and Means Committee is scheduled to begin voting on the bill Wednesday morning; the Energy and Commerce Committee will also take up the bill this week.
Senate Majority Leader Mitch McConnell, R- Ky., said he believes Congress can pass the bill before lawmakers depart for their recess in April.
In the White House briefing room Tuesday, Price — who was until a month ago a leading conservative in the House — said the House plan includes the four principles the administration seeks: affordability, accessibility, encouragement of innovation and empowering of patients.
“The goal of all of this is patient- centered health care,” Price said. He said the White House would work with critics to address their concerns.
In the Senate, where Republicans hold a slim majority of 52 seats, GOP leaders are in danger of losing the support of moderate Republican senators from states that expanded their Medicaid programs for low- income residents with help from the federal government as part of Obamacare. Under the proposed American Health Care Act, people who live in the states that expanded Medicaid would be able to enroll in the program for three more years, until Jan. 1, 2020.
Sen. Roy Blunt, R- Mo., was not confident about the bill’s ability to pass in its current form Tuesday. “I think the nucleus of the plan is clearly there, and the president says it’s negotiable, and so do House members,” he told radio station KMBZ in an interview that was first reported by CNN. “So I’ll be interested to be a part of that negotiation as we work toward a majority in the House and Senate that puts a bill on the president’s desk.”
“The House Republican proposal ... not only accepts the flawed progressive premises of Obamacare but expands upon them.” Michael Needham, CEO of Heritage Action