Posts Tagged ‘Repeal and Replace Obamacare’

Republicans Aren’t Team Players

July 17, 2017

GOP Senators who defect from ObamaCare repeal will hurt themselves, their party and the country.

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July 16, 2017 2:17 p.m. ET

Politics is a team sport, and Republicans are playing it poorly. They have one more chance in the Senate to repeal and replace ObamaCare—possibly their last hope for a victory.

Democrats are performing like a well-coached team. Minority Leader Chuck Schumer has all 48 members of his caucus on board with saving ObamaCare at all cost. It’s been a successful strategy.

It works for one reason: Republicans are divided. Their 52-48 majority in the Senate means they can lose two votes and still prevail, since Vice President Mike Pence is the tiebreaker. After promising to get rid of ObamaCare for the past seven years, it shouldn’t be difficult.

But as many as eight Republican senators opposed the first GOP bill, forcing Majority Leader Mitch McConnell to come up with a revised version. While an improvement, it has encountered opposition too. Mr. McConnell is skillful in bringing senators together. But here his task is more difficult than usual because the dissidents don’t all agree on what’s wrong with the bill. Appeasing one senator may alienate another.

This is an example of why legislative success depends on operating as a team. You don’t abandon your team just because you don’t get everything you want (or want left out). You hold your nose and vote for an imperfect measure, sometimes merely because it’s politically beneficial and better than the alternative.

This is especially true in dumping ObamaCare. The Republican alternative is a more free-market health-care system in which people can buy the insurance they want, not what government requires.

Sticking with the team makes that possible. But too many Republicans aren’t comfortable as team players. To them, it’s shady and unprincipled to vote for something about which you have serious doubts. Democrats are more realistic and less persnickety, so they’re better at uniting.

https://www.wsj.com/articles/republicans-arent-team-players-1500229048

House passes Obamacare replacement bill

May 4, 2017

By BENJAMIN SIEGEL
ABC News

May 4, 2017, 2:25 PM ET

House Republicans have passed their ambitious plan to repeal and replace Obamacare after several fits and starts, sending the measure to the Senate, where it is expected to be significantly revised.

The bill passed the House in a narrow 217-213 vote. All Democrats opposed the bill. House Republicans will now head to the White House for a press conference.

Democrats warned that the changes will leave Americans worse off.

“Make no mistake – many people will die as a result of this bill,” Rep. Debbie Wasserman Schultz, D-Florida, said.

Republicans, who have been promising to repeal and replace Obamacare for seven years but have struggled to coalesce around a specific legislative proposal, said they planned on keeping their promise to constituents.

“Our constituents did not elect us to do what is easy. They elected us to do what is right,” Rep. Diane Black, R-Tennessee, the chair of the House Budget Committee, said on the floor.

Republicans rallied at the Capitol this morning ahead of the vote, listening to the “Rocky” theme song. House Majority Leader Kevin McCarthy, R-California, showed Republicans a photo of Gen. George Patton with an inspirational quote: “Accept the challenge so that you can feel the exhilaration of victory.”

Missouri Republican Ann Wagner emerged from the meeting “all smiles,” telling ABC News “the line of the day was out of ‘Braveheart,’ ‘Freedom!’”

“We have the votes,” McCarthy told reporters after the meeting.

While Republicans held the vote without an updated analysis of its effects from the nonpartisan Congressional Budget Office, many defended the decision to move forward without the projections.

“I know we’re doing the right thing,” freshman Rep. Brian Mast, R-Florida, an Army vet who lost both legs in Afghanistan and represents a swing district, told reporters as he left the meeting.

An earlier analysis of the bill from the CBO — before several amendments were added — projected that 24 million additional Americans would be uninsured by 2026 and that it would reduce the deficit by $337 billion, compared to the Affordable Cart Act. The bill also restructures Medicaid payments to the states, reducing federal spending.

A compromise amendment designed to attract votes would give states the ability to opt out of certain Obamacare provisions, including essential health benefits requiring coverage of mental health, prescription drugs and maternity care, among others.

The amendment would also allow states to opt out of another mandate that prevents insurers from charging consumers with pre-existing conditions more for coverage.

Even though the bill has passed the House, there are still major roadblocks ahead in the Senate, where the bill is expected to undergo significant changes.

 

House Republicans have passed their ambitious plan to repeal and replace Obamacare after several fits and starts, sending the measure to the Senate, where it is expected to be significantly revised.

The bill passed the House in a narrow 217-213 vote. All Democrats opposed the bill. House Republicans will now head to the White House for a press conference.

Democrats warned that the changes will leave Americans worse off.

“Make no mistake – many people will die as a result of this bill,” Rep. Debbie Wasserman Schultz, D-Florida, said.

Republicans, who have been promising to repeal and replace Obamacare for seven years but have struggled to coalesce around a specific legislative proposal, said they planned on keeping their promise to constituents.

“Our constituents did not elect us to do what is easy. They elected us to do what is right,” Rep. Diane Black, R-Tennessee, the chair of the House Budget Committee, said on the floor.

Republicans rallied at the Capitol this morning ahead of the vote, listening to the “Rocky” theme song. House Majority Leader Kevin McCarthy, R-California, showed Republicans a photo of Gen. George Patton with an inspirational quote: “Accept the challenge so that you can feel the exhilaration of victory.”

Missouri Republican Ann Wagner emerged from the meeting “all smiles,” telling ABC News “the line of the day was out of ‘Braveheart,’ ‘Freedom!’”

“We have the votes,” McCarthy told reporters after the meeting.

While Republicans held the vote without an updated analysis of its effects from the nonpartisan Congressional Budget Office, many defended the decision to move forward without the projections.

“I know we’re doing the right thing,” freshman Rep. Brian Mast, R-Florida, an Army vet who lost both legs in Afghanistan and represents a swing district, told reporters as he left the meeting.

An earlier analysis of the bill from the CBO — before several amendments were added — projected that 24 million additional Americans would be uninsured by 2026 and that it would reduce the deficit by $337 billion, compared to the Affordable Cart Act. The bill also restructures Medicaid payments to the states, reducing federal spending.

A compromise amendment designed to attract votes would give states the ability to opt out of certain Obamacare provisions, including essential health benefits requiring coverage of mental health, prescription drugs and maternity care, among others.

The amendment would also allow states to opt out of another mandate that prevents insurers from charging consumers with pre-existing conditions more for coverage.

Even though the bill has passed the House, there are still major roadblocks ahead in the Senate, where the bill is expected to undergo significant changes.

Includes video:

http://abcnews.go.com/Politics/house-passes-obamacare-replacement-bill/story?id=47200247

Facing Ultimatum and Division, House Republicans Plan to Vote on Health Bill

March 24, 2017

Speaker Paul Ryan Meets With President Donald Trump

House Speaker Paul Ryan, with a staffer, walks through Statuary Hall in the U.S. Capitol Friday.

House Speaker Paul Ryan, with a staffer, walks through Statuary Hall in the U.S. Capitol Friday. PHOTO: SHAWN THEW/EUROPEAN PRESSPHOTO AGENCY
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House Republicans, facing an ultimatum from President Donald Trump , are poised to vote Friday on the imperiled GOP health plan despite signs that party divisions continued to threaten its chances.

White House spokesman Sean Spicer said Friday that the vote on the bill was set for 3:30 p.m. EDT, following debate in the chamber that began this morning. House Speaker Paul Ryan was meeting Mr. Trump at the White House to “discuss a way forward” as floor debate and arm twisting on the legislation continued.

After House GOP leaders canceled a vote on the bill Thursday over fears it lacked sufficient support to pass, Republican factions met late into the night, with Mr. Trump personally calling some members to pressure them for their support. In his afternoon briefing, Mr. Spicer acknowledged the bill didn’t currently have the support needed to pass.

Because all Democrats are likely to vote against a bill that would topple key parts of their 2010 Affordable Care Act, Republicans can only afford to lose 22 votes for their bill to pass. To win the backing of the conservative House Freedom Caucus, which controls more than 20 votes, leaders have made concessions including an amendment that would repeal a requirement under the ACA that insurers provide policies that comply with federal minimum benefit standards, such as offering maternity and mental health care.

But that hardened opposition from some centrist GOP members who don’t want to move too aggressively in toppling the ACA. House leaders had started Thursday with about 30 GOP members opposing the health proposal.

As Friday wore on, more key GOP lawmakers said they wouldn’t support the bill, including Rep. Rodney Frelinghuysen (R., N.J.), chairman of the House Appropriations Committee.

“Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents in New Jersey,” Mr. Frelinghuysen said in a statement.

Another lawmaker, Rep. Dave Joyce of Ohio, who has voted for past GOP bills to repeal the ACA, tweeted his opposition, objecting to the bill’s substance and to the process followed by Republican leadership in rolling it out.

On Friday morning, the president reminded Republicans on Twitter that “this is finally your chance” to replace the ACA, widely known as Obamacare for his predecessor Barack Obama, who signed it into law.

Mr. Trump also took aim at the caucus of House conservatives, pressing them to keep to their antiabortion bona fides by supporting the bill, which would ban Medicaid funding for one year to women’s health organization Planned Parenthood Federation of America. Some of the group’s clinics provide abortion services, which aren’t funded by taxpayer dollars.

“The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!” he tweeted.

Mr. Trump, briefly responding to questions on Friday at the White House, said he didn’t think he had rushed into tackling health care and that Mr. Ryan, the driving force behind the bill, should remain in his role even if the vote fails.

“We’ll have to see what happens,” he said in response to questions about the vote.

Signs of dissent have emerged over a fast vote on the bill even though a final analysis of its impact on coverage and the budget isn’t available. Rep. Kevin Brady, chairman of the House’s tax-writing committee, said in the House Rules Committee Friday it is an uncommon situation. That committee on Friday morning passed the bill, along with some last-minute amendments added Thursday night, and will be moving it to the House floor.

“It’s unusual, but it’s unusual for the right reasons,” Mr. Brady, a Texas Republican, said. Mr. Brady said the bill won’t just serve Washington. “It will serve every state in the nation about what’s right for them…They will be surveying 50 states about what plans are right for them.”

Thursday night’s amendment also would add $15 billion in funding to help states pay for mental health and maternity care. The House Freedom Caucus met Thursday night after the amendments were added but some said they were still likely to oppose the legislation.

Republicans face intensifying criticism of their health plan in the wake of a Congressional Budget Office analysis Thursday. The report showed that with the latest changes, the legislation would reduce the federal deficit by $151 billion by 2026, compared with an earlier version that delivered a $337 billion deficit cut. It showed no meaningful change to the estimate that under the new bill, the number of Americans without health insurance would grow by 24 million people in the next decade, compared with conditions if the ACA were allowed to stand.

Defeat of the health measure would be a major blow to Mr. Trump’s image as an influential negotiator because he has become heavily involved in rallying support. Mr. Spicer on Friday emphasized the president’s efforts, saying Mr. Trump had been “working the phones and having in-person meetings” since the House bill was introduced. He said more than 120 lawmakers had visited the White House or spoken with the administration by phone in recent days.

Failure of the measure would also haunt Mr. Ryan in his efforts to get through other agenda items such as tax reform.

“The bill that’s before Congress is done,” Health and Human Services Secretary Tom Price said Friday on Fox News. “I think we’re going to be able to get this bill done today and move forward.”

Dr. Price, a former orthopedic surgeon, said he would continue to use administrative steps to roll back the ACA even if the legislation craters in the House. He said he doesn’t expect a new CBO analysis before the vote.

If the measure does pass, Senate Majority Leader Mitch McConnell has vowed to take up the legislation swiftly, but it is expected to confront even greater obstacles in that chamber.

Write to Stephanie Armour at stephanie.armour@wsj.com and Rebecca Ballhaus at Rebecca.Ballhaus@wsj.com

Related:

Trump Says If Vote on Health-Care Bill Fails, Obamacare Stays

March 24, 2017

Last-minute negotiations and lobbying fail to lock down majority support for floor vote on Thursday

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Updated March 24, 2017 1:35 a.m. ET

WASHINGTON—Republicans prepared to take a high-stakes gamble Friday, when they are expected to bring to the House floor—at President Donald Trump’s urging—a GOP bill to replace the Affordable Care Act without knowing whether the vote will produce a victory or an embarrassing defeat.

House GOP leaders had postponed a planned vote Thursday as defections accumulated both among the most conservative lawmakers and Republican centrists,…

https://www.wsj.com/articles/gop-lawmakers-say-no-deal-yet-on-health-bill-1490291998

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Trump Tells G.O.P. It’s Now or Never, Demanding House Vote on Health Bill

WASHINGTON — President Trump issued an ultimatum on Thursday to recalcitrant Republicans to fall in line behind a broad health insurance overhaul or see their opportunity to repeal the Affordable Care Act vanish, demanding a Friday vote on a bill that appeared to lack a majority to pass.

The demand, issued by his budget director, Mick Mulvaney, in an evening meeting with House Republicans, came after a marathon day of negotiating at the White House and in the Capitol in which Mr. Trump — who has boasted of his deal-making prowess — fell short of selling members of his own party on the health plan.

House Speaker Paul D. Ryan emerged from the session and announced curtly that Mr. Trump would get his wish for a vote on Friday. Mr. Ryan refused to answer reporters’ questions about whether he expected the measure to pass.

Although the House Republicans’ closed-door meeting became a cheerleading session for the bill, their leaders braced for a showdown on the floor, knowing they were likely to be at least a handful of votes short of a majority for the health insurance bill and would need to muscle their colleagues to the last to prevail.

GRAPHIC

The Parts of the Affordable Care Act That the Republican Bill Will Keep or Discard

A comparison of the bill with key components of the Affordable Care Act.

OPEN GRAPHIC

Some conservatives were still concerned that the bill was too costly and did not do enough to roll back federal health insurance mandates. Moderates and others, meanwhile, were grappling with worries of their states’ governors and fretted that the loss of benefits would be too much for their constituents to bear.

Mr. Ryan had earlier postponed the initial House vote that was scheduled for Thursday to coincide with the seventh anniversary of the Affordable Care Act’s signing. Mr. Trump confronted the possibility of a humiliating loss on the first significant legislative push of his presidency.

Source: https://www.nytimes.com/2017/03/23/us/politics/health-republicans-vote.html?_r=0

Trump’s Ultimatum on Health Care: President Donald Trump is done negotiating, sends “very definitive, very clarifying” message, tells the House to vote Friday

March 24, 2017

Office of Management and Budget director Mick Mulvaney made clear Thursday evening that President Donald Trump is done negotiating on the hotly-debated health care bill and wants a vote on Friday.

And, if the president doesn’t get a vote to repeal and replace Obamacare, he will move on to other priorities, Mulvaney said according to a source in the room during the tense talks with GOP members. A senior administration source confirms to NBC News the “very definitive, very clarifying” message from the president and the administration’s intention to move on — should the health care bill fail to move forward — to other matters such as tax reform, trade and border security.

If the bill does not pass, the president would see it as “people in Congress breaking their promises to their constituents to repeal and replace Obamacare even with a Republican president in the White House,” the source told NBC News.

It was a long night for Trump aides who worked late to try and convince conservative House Freedom Caucus members to support the health care bill. Steve Bannon, Trump’s chief strategist and senior counselor, met with the group’s members to deliver a pointed message: stand and deliver.

Republican leadership worked to underscore the message.

Disastrous has led to higher costs & fewer options. It will only continue to get worse! We must .

“For seven and a half years, we have been promising to repeal and replace this broken law because it is collapsing and failing families,” House Speaker Paul Ryan told reporters Thursday evening. “And tomorrow we are proceeding.”

Rep. Tom Cole, R-Oklahoma, a member of the whip team, said he believed Trump’s ultimatum is “credible” and predicted the bill’s passage during Friday’s vote. He added he isn’t worried about how the Senate would respond.

Rep. Greg Walden of Oregon, the chairman of the House Energy and Commerce Committee who helped to usher the GOP health care plan through the process, agreed with Trump’s decision to cut off negotiations.

“I think it was time to have pencils down — time to move forward,” Walden told reporters Thursday night.

But those undecided in their support were not necessarily ready to move forward.

“I always think if there’s any change whatsoever that we can make the bill better than we should never stop negotiations,” said Rep. Trent Franks, an Arizona conservative who isn’t yet supporting the measure. “Now there is a time that those negotiations should stop, but let that not be arbitrary let that be on the timetable itself.”

Trump’s latest salvo comes after House Republican leaders abruptly postponed a planned vote on the GOP health care bill Thursday as they struggled to find sufficient support to pass it.

The move to delay the vote came after House conservatives said there was no deal struck on the bill following a meeting with President Trump at the White House Thursday. According to the NBC News vote count as of Thursday evening, GOP leaders were still at least eight votes short of winning enough backing for passage.

The president’s latest posture came as news to Rep. Mark Meadows R-North Carolina, chairman of the conservative House Freedom Caucus, who earlier told reporters that there was no deal after the meeting, but added he was still hopeful one can be struck.

No Deal: GOP Leadership Forced to Postpone Thursday’s Health Care Vote 3:58
Video:

White House press secretary Sean Spicer said Thursday afternoon that the administration does not feel it needs a “plan B”.

House leaders and various Republican factions have worked in recent days to find a deal on the American Health Care Act, supported by Ryan, that would appease enough moderates and conservatives to win enough backing to get the legislation passed.

The moderate members, known as the “Tuesday Group”, met with President Trump at the White House Thursday evening. Meanwhile, on Capitol Hill, Ryan met with the conservative members in an effort to get consensus.

Includes video:

http://www.nbcnews.com/politics/congress/scheduled-health-care-vote-looms-house-gop-remains-short-support-n737491

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Key Bloc of Conservative Lawmakers Endorse GOP Health Plan

March 17, 2017

Comments come after meeting Friday with group of 13 Republican lawmakers

President Donald Trump speaks to Vice President Mike Pence, left, and House Republicans at the White House Friday.

President Donald Trump speaks to Vice President Mike Pence, left, and House Republicans at the White House Friday. PHOTO: MIKE THEILER / POOL/EUROPEAN PRESSPHOTO AGENCY

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Updated March 17, 2017 2:38 p.m. ET

The House Republican health-care plan picked up an important endorsement on Friday from leaders of a bloc of conservative lawmakers, after President Donald Trump agreed to back more stringent curbs on Medicaid funding and proposals to add work requirements for its beneficiaries.

“100% of the nos are yeses,” Mr. Trump said of the group of 13 lawmakers he hosted in the Oval Office Friday morning, who included leaders of the conservative Republican Study Committee. The president said that overnight his administration had worked to convince many of the people in the room to back the bill and that he was confident he had their support now. “Every single person sitting in this room is now a yes.”

Leaders of the Republican Study Committee, a caucus that includes most of the House GOP lawmakers, repeated their willingness to back the bill as they left the White House, citing Mr. Trump’s backing for block grants and support for states adding requirements that beneficiaries show they are working or attempting to do so.

It wasn’t clear how many rank-and-file members of the Republican Study Committee were on board and if the bill has the support of enough Republicans to pass the House, which is expected to vote on it Thursday. A smaller group of conservatives, the House Freedom Caucus, could yet torpedo the legislation if all members withhold their support.

“President Trump himself committed that he is all in, 100% in, for this bill,” House Majority Whip Steve Scalise (R., La.), who is in charge of rounding up lawmakers’ votes and a past leader in the committee.

Rep. Mark Walker (R., N.C.), the current chairman of the Republican Study Committee, said that lawmakers had held a conference call close to midnight to discuss the bill. He said that with commitments from the president to back block grants and work requirements in Medicaid, they were able to move “from undecided, or no, to a positive yes this morning.”

Reps Marsha Blackburn (R., Tenn.) and Mia Love (R., Utah) emphasized the bill’s existing restrictions on abortion funding as a reason for support.

Several of the group’s members said after they left the White House that they entered undecided, but that Mr. Trump won them over by agreeing to two changes. One would let states impose a work requirement on Medicaid recipients. The second would allow states to choose between receiving their federal Medicaid funding in the form of a block grant or as a per capita allotment.

“Those are significant steps forward from my conservative perspective that make the bill much more agreeable,” said Rep. Jim Banks (R., Ind.), who now plans to vote for the bill.

Mr. Trump said he supported the calls from House conservatives to restrict federal funding for Medicaid by giving states “block grants” in exchange for more leeway in how they run the program. He said he wanted states to continue to have federal help for their neediest but also the flexibility states have requested in managing the program.

In his comments Friday, Mr. Trump praised the visiting GOP House members, saying that they had been tough negotiators. Criticizing the 2010 health law is a point around which Republicans have been able to rally; the mechanics of undoing the law have been more divisive.

“It’s on a respirator,” Mr. Trump said. “Obamacare is not an alternative.”

Some lawmakers in the meeting had already publicly pledged support for the bill, including Mr. Scalise, the House Majority Whip. Members of the whip team, in charge of counting the votes, said they were getting closer to the 216 votes the bill will need to pass the chamber. The bill still has opposition from both conservative and centrist Republicans.

“It’s still in the works, but we’re getting closer and closer,” said Rep. Dennis Ross (R., Fla.).

Mr. Trump spoke after four Republican governors announced their opposition Thursday night to the House GOP legislation, another signal of the political challenges it faces from moderates within the Republican party as well as its right-wing.

The four GOP governors come from Ohio, Michigan, Nevada and Arkansas, states that expanded their Medicaid programs under the Affordable Care Act. In a letter to congressional leaders, they cited the potential for the bill to strip people of Medicaid coverage.

The bill is still likely to be amended in the Senate, where a dozen Republicans have already indicated they consider the more conservative direction it is going in the House as unacceptable. Some centrist GOP senators say the legislation needs to give more generous support to rural, older and low-income people to help them buy health insurance.

Mr. Scalise said he was unruffled by that prospect Friday morning, because his responsibility was simply to get a bill out of the House.

“If they want to make additional changes, that’s called the legislative process,” said Mr. Scalise. “We’re just happy to get this bill passed through the House, that’s what we’re focused on, and the Senate can take care of their business.”

Write to Louise Radnofsky at louise.radnofsky@wsj.com, Michelle Hackman at Michelle.Hackman@wsj.com and Kristina Peterson at kristina.peterson@wsj.com

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Trump, health secretary fight for votes as U.S. healthcare overhaul — 12 House members against the plan flipped by Trump Friday

March 17, 2017

Reuters

By Susan Cornwell and David Morgan | WASHINGTON

U.S. President Donald Trump on Friday stepped up his fight for support on Republicans’ plan to dismantle Obamacare, wooing some conservative lawmakers at the White House while legislation advanced toward a possible vote in the House of Representatives next week.

Republicans remain deeply divided over their U.S. healthcare overhaul, Trump’s first major legislative initiative and one that aims to make good on his campaign pledge to repeal and replace the healthcare plan put in place by his Democratic predecessor, Barack Obama.

Trump met at the White House on Friday with 13 members of the House Republican Study Committee, a large group of conservative lawmakers seeking changes to Medicaid, the joint federal-state health insurance program for the poor.

“I’m 100 percent behind this,” Trump told reporters after the meeting.

Trump said all the lawmakers in attendance now supported the healthcare bill after previously questioning it.

“We made certain changes but frankly very little,” he said.

U.S. Health Secretary Tom Price also did his part to win over reluctant Republican lawmakers in a meeting at the Capitol.

The healthcare measure championed by House Speaker Paul Ryan passed through a key House panel on Thursday despite objections by some conservatives who consider it too similar to the 2010 law that became known as Obamacare.

The Republicans’ proposed replacement plan still faces a battle in the full House and then the Senate, despite efforts by the White House and Republican leaders to satisfy conservative opponents who are pushing for several changes.

Democrats have roundly rejected the Republicans proposal, saying it harms the poor, elderly and working families while offering tax cuts to rich Americans and companies.

Price told reporters on Friday the proposal addressed several issues important to Trump, such as maintaining insurance coverage of patients with pre-existing medical conditions.

“The president’s very supportive of this plan, thinks that it addresses his priorities,” Price said at a news conference ahead of a meeting with House Republicans to help coalesce support.

Without Democratic support, Republicans cannot afford to lose many votes from their own ranks, even though they control both chambers of Congress, as well as the White House.

Conservatives have criticized the legislation as too similar to Obama’s law. Some have said they want a quicker end to Obamacare’s expansion of Medicaid, while others are concerned about insurance costs for consumers.

Representative Mark Meadows, chairman of the conservative House Freedom Caucus, wants changes in private insurance mandates that he says will lower healthcare premiums.

But after Friday’s meeting with Price, he expressed frustration there were no commitments from leadership on any changes except a possible optional work requirement on Medicaid, which “doesn’t move the ball more than a couple yards on a very long playing field.”

He said his group has spoken with Senate Republicans about potential changes and will propose an amendment on Monday.

Several Senate Republicans also have said they would reject the measure in its current form.

Obamacare expanded insurance to about 20 million Americans but the nonpartisan Congressional Budget Office said on Monday that 14 million Americans would lose medical insurance by next year under the Republican plan.

The CBO projected 52 million people would be uninsured by 2026 if the bill became law, compared with 28 million who would not have coverage that year if the law remained unchanged.

(Additional reporting by David Morgan; Writing by Susan Heavey; Editing by Bill Trott)

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12 House members against the plan flipped by Trump Friday — President Trump himself was seen on Fox News Friday and said after he had spoken to lawmakers today, 12 House members who were inclined to vote “no” changed their vote to “yes.”

CBO analysis of Rupublican health bill could make life more interesting — Could provide ammo to critics

March 13, 2017
Secretary of Health Tom Price.  AP photo

WASHINGTON (AP) — Republicans pushing a plan to dismantle Barack Obama’s health care law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump’s promise of “insurance for everybody.”

House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured.

But Ryan and Trump administration officials vowed to move forward on their proposed “repeal and replace” plan, insisting they can work past GOP disagreements and casting the issue as one of “choice” in which consumers are freed of a government mandate to buy insurance.

“What we’re trying to achieve here is bringing down the cost of care, bringing down the cost of insurance not through government mandates and monopolies but by having more choice and competition,” Ryan, R-Wis., said on Sunday. “We’re not going to make an American do what they don’t want to do.”

The CBO’s long-awaited cost analysis of the House GOP leadership plan, including estimates on the number of people expected to be covered, will likely affect Republicans’ chances of passing the proposal.

GOP opponents from the right and center are already hardening their positions against the Trump-backed legislation. House conservatives vowed to block the bill as “Obamacare Lite” unless there are more restrictions, even as a Republican, Sen. Tom Cotton, R-Ark., warned the plan would never pass as is due to opposition from moderates.

“Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote,” Cotton said. “If they vote for this bill, they’re going to put the House majority at risk next year.”

The GOP legislation would eliminate the current mandate that nearly all people in the United States carry insurance or face fines. It would use tax credits to help consumers buy health coverage, expand health savings accounts, phase out an expansion of Medicaid and cap that program for the future, end some requirements for health plans under Obama’s law, and scrap a number of taxes.

During the presidential campaign and as recently as January, Trump repeatedly stressed his support for universal health coverage, saying his plan to replace the Affordable Care Act would provide “insurance for everybody.”

On Sunday, his aides took pains to explain that a CBO finding of fewer people covered would not necessarily mean that fewer people will be covered.

“If the CBO was right about Obamacare to begin with, there’d be 8 million more people on Obamacare today than there actually are,” said Mick Mulvaney, director of the White House Office of Management and Budget, disputing the accuracy of CBO data. “Sometimes we ask them to do stuff they’re not capable of doing, and estimating the impact of a bill of this size probably isn’t the best use of their time.”

Health Secretary Tom Price said he “firmly” believed that “nobody will be worse off financially” under the Republicans’ health care overhaul. He said people will have choices as they select the kind of coverage they want as opposed to what the government forces them to buy. In actuality, tax credits in Republican legislation being debated in the House may not be as generous to older people as what is in the current law.

Gary Cohn, Trump’s chief economic adviser, described past CBO analyses as “meaningless.”

“We are offering coverage to everyone,” he said. “If you are on Medicaid today, you’re going to stay on Medicaid. If you are covered under an employee-sponsored plan, you’re going to be continued to be covered under an employee-sponsored plan. If you fall into that middle group, we’re going to provide tax credit so you can go out and buy a plan.”

House conservatives weren’t buying it.

Rep. Jim Jordan, R-Ohio, a co-founder of the House Freedom Caucus, criticized the plan as an unacceptable form of “Obamacare Lite.” He and other caucus members want a quicker phase-out of Medicaid benefits and are opposed to proposed refundable tax credits as a new entitlement that will add to government costs.

Members of the caucus will meet with White House officials on Tuesday. They expressed hope that Trump is sincere in expressing a willingness to negotiate changes, criticizing Ryan for his “take it or leave it” stance.

“I’m not for this plan and I think there’s lot of opposition to this plan in the House and Senate,” Jordan said. “Either work with us or you don’t end up getting the votes. That’s the real choice here.”

But pressuring the White House on the opposite side were moderate Republican governors and senators, who said Trump needed to allow for continuing Medicaid coverage for the poor.

“It’s not like we love Obamacare. It means don’t throw the baby out with the bathwater,” said Ohio Gov. John Kasich, a Republican. “Don’t kill Medicaid expansion. And you’ve got to fix the exchange, but you have to have an ability to subsidize people at lower income levels.”

“We need to have Democrats involved so that what we do is going to be not only significant but will last,” Kasich added.

Ryan spoke on CBS’ “Face the Nation,” Price and Kasich appeared on NBC’s “Meet the Press,” Mulvaney spoke on ABC’s “This Week” and CNN’s “State of the Union,” Cotton was on ABC’s “This Week,” and Jordan and Cohn appeared on “Fox News Sunday.”

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Follow Hope Yen on Twitter at https://twitter.com/hopeyen1

Republican health bill unlikely to settle passionate health care debate — “There are almost never calls to decrease government role in providing pay-outs to its citizens.”

March 7, 2017

The Associated Press

By RICARDO ALONSO-ZALDIVAR and ALAN FRAM

WASHINGTON (AP) — The nation’s passionate debate about the role of government in providing health care for citizens and paying the costs is unlikely to be settled by the legislation newly revealed by House Republicans.

With Republicans now controlling the White House and both chambers of Congress, the bill would drive government policy down routes long advocated by conservatives. The course correction would take at least two years to get rolling, and probably longer to show definitive results. If it falls short, it would give rise to a fresh set of health care grievances.

The Republican legislation would limit future federal funding for Medicaid, which covers low-income people, about 1 in 5 Americans. And it would loosen rules that former President Barack Obama’s law imposed for health plans directly purchased by individuals, while also scaling back insurance subsidies.

Republicans say their solutions would make Medicaid more cost-efficient without punishing the poor and disabled, while spurring private insurers to offer attractive products for the estimated 20 million consumers in the market for individual policies.

But Democrats say the bill would make many people uninsured, shifting costs to states and hospital systems that act as providers of last resort. Individual policy holders might be able to find low-premium plans, only to be exposed to higher deductibles and copayments.

There are no easy answers, said Dan Mendelson, CEO of the consulting firm Avalere Health. “Health care is expensive and it becomes more expensive every year,” he said. “Under the GOP plan, it will be more expensive every year just like it was under the Democratic plan.”

Nonetheless, he called the Republican proposal a feasible alternative.

Over the next few days, stakeholders will be dissecting the GOP proposal, which may become the second major shift on health care policy in less than a decade. Democratic and Republican governors, hospital executives, physician groups, insurers, drug makers and consumer groups will have their say. The bill will be measured against expansive promises that President Donald Trump made during the campaign.

Trump “made a lot of promises about making sure that people would not lose coverage and that costs would be lower,” said Ron Pollack, head of the liberal advocacy group Families USA. “This does the exact opposite of what he has promised.”

House committees planned to begin voting on the legislation Wednesday, launching what could be the year’s defining battle in Congress and capping seven years of GOP vows to repeal the 2010 Affordable Care Act. It’s unclear if Republicans can manage to overcome divisions within their own party and deliver a final product.

The plan would repeal the unpopular “Obamacare” fines on people who don’t carry health insurance. It would replace income-based subsidies 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 bill would continue Obama’s expansion of Medicaid to additional low-earning Americans until 2020. Beginning then, states adding Medicaid recipients would no longer receive the additional federal funds the statute has provided. Of even greater consequence, total federal Medicaid funding would be limited according to a formula taking into account enrollment and costs in each state.

Republicans said they don’t have official coverage estimates yet, but aides from both parties and nonpartisan analysts have said they expect those numbers to be lower.

House Speaker Paul Ryan, R-Wis., said the bill would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance.”

Solid opposition from Democrats is a given. House Minority Leader Nancy Pelosi, D-Calif., said, “Republicans have decided that affordable health care should be the privilege of the wealthy, not the right of every family in America.”

Senate Finance Committee Chairman Orrin Hatch, R-Utah, wouldn’t rule out changes by his chamber, where significant numbers of moderate Republicans have expressed concerns that the measure could leave too many voters without coverage.

Thirty-one states and the District of Columbia opted to expand Medicaid coverage under the Obama-era law to an estimated 11 million people. Around half those states have GOP governors, who are largely reluctant to see that spending curtailed.

In another feature that could alienate moderate Republicans, the measure would block for one year federal payments to Planned Parenthood, the women’s health organization long opposed by many in the party because it provides abortions.

A series of tax increases used to finance the Obama overhaul’s coverage expansion would be repealed as of 2018.

In a last-minute change to satisfy conservative lawmakers, business and unions, Republicans dropped a plan pushed by Ryan to impose a first-ever tax on the most generous employer-provided health plans. Instead, a similar tax imposed by Obama’s law on expensive plans set to take effect in 2020 would now begin in 2025.

Popular consumer protections in the Obama law would be retained, such as insurance safeguards for people with pre-existing medical problems, and parents’ ability to keep young adult children on their insurance until age 26.

To prod healthier people to buy policies, insurers would boost premiums by 30 percent for consumers who let insurance lapse.

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Associated Press writers Mary Clare Jalonick and Andrew Taylor contributed to this report

A former HHS official told Peace and Freedom: “There are almost never calls to decrease the government’s role in providing pay-outs to its citizens.”

Related:

House Republicans Releases Plan to Repeal, Replace Obamacare

March 7, 2017

Proposed legislation would dismantle much of Affordable Care Act, create refundable tax credit tied to age and income

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Updated March 6, 2017 10:04 p.m. ET

House Republicans on Monday released a detailed proposal that marks their first attempt in the new Congress to unite fractious GOP members behind a plan to replace the Affordable Care Act and deliver on a central campaign promise by Republicans.

The proposed legislation dismantles much of the 2010 law known as Obamacare and creates a new, refundable tax credit tied to an individual’s age and income aimed at helping Americans buy insurance if they don’t get it at work. The tax credits would replace the subsidies that the Affordable Care Act gave to a narrower set of lower-income people to help them afford insurance policies.

President Donald Trump has laid out an ambitious agenda to overhaul health care, taxes and infrastructure, but internal disputes within the Republican party could slow down or possibly derail his plans. WSJ’s Shelby Holliday reports. Photo: Evan Vucci/Associated Press

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The bill would end the mandate under the Affordable Care Act that individuals buy insurance or else pay a penalty, as well as the requirement that larger businesses offer insurance to their employees. It also ends increased federal funding in 2020 for the law’s expansion of Medicaid coverage for low-income individuals.

In a provision sure to be controversial in the Senate, the House proposal bars federal funding for the Planned Parenthood Federation of America, which provides health services to women. The proposal retreats from earlier drafts in basing the tax credits on individuals’ income and age, with the refundable credits phasing out for people who earn $75,000 annually. Earlier versions would have provided the credit regardless of income, an element that many conservative House lawmakers opposed.

Read the rest:

An expanded version of this report appears on WSJ.com.

https://www.wsj.com/articles/house-gop-releases-plan-to-repeal-replace-health-law-1488842133

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House Republicans release long-awaited plan to replace Obamacare

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Here’s what’s in the House Republicans’ plan to repeal the ACA
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House Republicans on March 6 released legislation that would repeal and replace the Affordable Care Act. Here’s what you need to know about the plan. (Bastien Inzaurralde/The Washington Post)
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The Washington Post
March 6 at 10:03 PM
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House Republicans on Monday released long-anticipated legislation to supplant the Affordable Care Act with a more conservative vision for the nation’s health-care system, replacing federal insurance subsidies with a new form of individual tax credits and grants to help states shape their own policies.
.Under two bills drafted by separate House committees, the government would no longer penalize Americans for failing to have health insurance but would try to encourage people to maintain coverage by allowing insurers to impose a surcharge of 30 percent for those who have a gap between health plans.

The legislation would preserve two of the most popular features of the 2010 health-care law, letting young adults stay on their parents’ health plans until age 26 and forbidding insurers to deny coverage or charge more to people with preexisting medical problems. It would also target Planned Parenthood, rendering the women’s health organization ineligible for Medicaid reimbursements or federal family planning grants — a key priority for antiabortion groups.

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The debate, starting in House committees this week, is a remarkable moment in government health-care policymaking. The Affordable Care Act, former president Barack Obama’s signature domestic policy achievement passed in 2010 with only Democratic support, ushered in the most significant expansion of insurance coverage since the creation of Medicare and Medicaid as part of President Lyndon B. Johnson’s Great Society programs of the mid-1960s.

There is no precedent for Congress to reverse a major program of social benefits once it has taken effect and reached millions of Americans.

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President Trump, Vice President Pence and House Speaker Paul Ryan (R-Wis.) keep saying a plan to repeal and replace Obamacare will be released soon, but few details have been released so far. Here’s what they’ve said. (Video: Sarah Parnass/Photo: Jonathan Newton/The Washington Post)
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Taken together, the bills introduced Monday night represent the Republicans’ first attempt — and best shot to date, with an ally in the White House — to translate seven years of talking points about demolishing the ACA into action.

At the same time, major aspects of the plans, notably the strategy for tax credits and Medicaid, reflect the treacherous terrain that Republicans face to win enough votes within their own conferences in the GOP-controlled House and Senate.

The bills must address concerns of both conservatives worried about the cost of the overhaul and worries that it might in effect enshrine a new federal entitlement, as well as more moderate members who want to ensure that their constituents retain access to affordable health care, including those who received Medicaid coverage under the ACA.

Even so, signs emerged on Monday that Republicans in Congress’s upper chamber could balk either at the cost of the proposal or if it leaves swaths of the country without insurance coverage.

Sen. Rand Paul (R-Ky.), one of at least three conservative senators who opposes the plan to provide income-based tax credits, tweeted: “Still have not seen an official version of the House Obamacare replacement bill, but from media reports this sure looks like Obamacare Lite!”

And four key Republican senators, all from states that opted to expand Medicaid under the ACA, said they would oppose any new plan that would leave millions of Americans uninsured.

“We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states,” Sens. Rob Portman (Ohio), Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (Alaska) wrote in a letter to Senate Majority Leader Mitch McConnell (R-Ky.).

Two Americans: One saved by Obamacare, the other left behind

The four senators were split on exactly what proposals would meet their standards, but with 52 Republicans, McConnell would not have enough votes to pass repeal without the support of at least two of them.

Democrats, meanwhile, have given no indication that they intend to work with Republicans, and top party leaders decried the GOP plan Monday as a betrayal of everyday Americans. “Trumpcare doesn’t replace the Affordable Care Act, it forces millions of Americans to pay more for less care,” said Senate Minority Leader Charles E. Schumer (D-N.Y.).

In particular, the plan to target Planned Parenthood has already generated fierce pushback from Democrats and doubts from some Republicans who have noted that federal funds are already barred from funding abortions and that Planned Parenthood provides routine medical care to millions of American women.

The tax credits outlined by the Ways and Means Committee’s portion of the legislation incorporate an approach that Republicans have long criticized: income-based aid to help Americans afford health coverage.

Until now, the GOP had been intending to veer away from the ACA subsidies that help poor and middle-class people obtain insurance, insisting that the size of tax credits with which they planned to replace the subsidies should be based entirely on people’s ages and not their incomes. But the drafts issued Monday proposed refundable tax credits that would hinge on earnings as well as age — providing bigger credits for older and poorer Americans.

This big pivot, developed by the Ways and Means Committee under the guidance of House Speaker Paul D. Ryan (R-Wis.), stems from a combination of problems that were arising with the idea of age-only credits that would have been available to any individual or family buying insurance on their own, no matter how affluent.

The Republican plan would offer tax credits ranging from $2,000 per year for those under 30 to $4,000 per year for those over 60. The full credit would be available for individuals earning up to $75,000 a year and up to $150,000 for married couples filing jointly. The credits would phase out for individuals earning more — for each $1,000 in additional income, a person would be entitled to $100 less in credit, meaning a 61-year old could make up to $115,000 and still receive some credit.

The income-based phase-out of the credit allows the GOP plan to be funded without taxes on employer-provided insurance that had been considered earlier in the drafting process. In addition, the latest proposal would delay the ACA’s “Cadillac” tax, a levy on the most generous employer-provided health plans, until 2025. It also retains the tax exclusion for premiums paid for employer-provided health plans.

Estimates from congressional budget analysts and the White House’s Office of Management and Budget kept showing that the credits would be both too small to provide enough help to lower-income people and too expensive overall for a GOP determined to slash federal spending that the ACA has required.

Those analysts have not had time to assess how this new configuration would affect federal spending or the number of people with insurance coverage.

While the number of Americans who can afford health insurance has never been the priority for the GOP that it is for Democrats, President Trump has made clear that he is sensitive to any changes that would strand large numbers of people who gained coverage under the ACA.

Compared with the ACA’s subsidies, the tax credits would go to more people but provide less financial help to lower-income people, according to Larry Levitt, senior vice president of the Kaiser Family Foundation.

Meanwhile, the portion of the legislation drafted by the Energy and Commerce Committee would substantially redesign Medicaid in a way that attempts to balance the GOP’s antipathy toward the ACA’s expansion of the program against the concerns of a significant cadre of Republican governors — and the lawmakers from their states — who fear losing millions of dollars that the law has funneled to help insure low-income residents.

Medicaid would be converted from its current form of entitlement to anyone eligible into a per capita cap on funding to states, depending on how many people they had enrolled. In states that expanded Medicaid under the ACA, the government for now would continue paying for virtually the entire cost of the expansion.

Thirty-one states, plus the District of Columbia, have adopted that expansion. Starting in 2020, however, the GOP plan would restrict the government’s generous Medicaid payment — 90 percent of the cost of covering people in the expansion group — only to people who were in the program as of then. States would keep getting that amount of federal help for each of those people as long as they remained eligible, with the idea that most people on Medicaid drop off after a few years.

For the other 19 states that did not expand Medicaid, the legislation would provide $10 billion spread over five years. States could use that money to subsidize hospitals and other providers of care that treat many poor patients.

While members of the two committees working on the replacement drafts were determined to begin considering legislation this week, final work on them was still underway over the weekend and Monday, according to three individuals with knowledge of the process.

The change in thinking about tax credits emerged since Friday, when a White House meeting chaired by Budget Director Mick Mulvaney and attended by key GOP congressional figures was called to finalize key provisions.

At the same time, the shift to take income into account could create a potentially difficult ripple effect for Republicans, who regard a reduction in the federal government’s role in health care as a central reason to abandon the sprawling 2010 health care law. One motivation for the GOP thinking that credits could depend only on age was that the Internal Revenue Service would no longer have needed to verify the eligibility of people for financial help, as it has for ACA subsidies. If income is taken into account, the IRS would still need to be involved.

Coming out of a closed-door GOP conference meeting last week, several House Republicans expressed concerns that the committees might start to work on the legislation without a complete fiscal assessment. To be eligible for special budget rules known as “reconciliation” — allowing bills to pass in the Senate by a simple majority — the legislation cannot increase the deficit after its first 10 years in effect.

Several House GOP aides involved in drafting the legislation could not say when the Congressional Budget Office would provide its formal analysis of the bill, but the two committees of jurisdiction are poised to advance the bill without it. One said committees “regularly go through the markup process without a formal CBO score.”

But House Minority Leader Nancy Pelosi (D-Calif.) said Monday that Republicans should not move the legislation through committees without the CBO analysis: “The American people deserve to see what Republicans are trying to do to their health care.”

https://www.washingtonpost.com/powerpost/new-details-emerge-on-gop-plans-to-repeal-and-replace-obamacare/2017/03/06/04751e3e-028f-11e7-ad5b-d22680e18d10_story.html?utm_term=.6e8a0d85798d