GOP health-care plan: Two House panels approve legislation as Trump tweets reassurance
By Elise Viebeck, Sean Sullivan and Mike DeBonis
March 9 at 3:49 PM - The Washington Post
(Reuters)
Two key House committees have approved a Republican proposal to revise the
Affordable Care Act, giving the bill its first victories amid a backlash that
both Republican leaders and President Trump are trying to tamp down.
The House Ways and Means Committee voted 23 to 16 along party lines to
advance the American Health Care Act shortly before 4:30 a.m. Thursday after
about 18 hours of debate. The House Energy and Commerce Committee voted 31 to
23, also along party lines, to advance the bill at 1:45 p.m. after about 27
hours of debate.
gToday, the House took a decisive step forward in fulfilling a promise to the
American people that has been years in the making: repealing and replacing
Obamacare with affordable, patient-centered reforms,h Energy and Commerce
Chairman Greg Walden (R-Ore.) said following the vote.
Amid a barrage of attacks from Democrats and criticism from health-care
industry groups, President Trump sought to calm fears about the process.
gDespite what you hear in the press, healthcare is coming along great,h he tweeted
midday Thursday. gWe are talking to many groups and it will end in a beautiful
picture!h
Several hours earlier, Senate Majority Leader Mitch McConnell (R-Ky.) said
lawmakers need to see the Congressional Budget Officefs estimate of how the bill
will affect the federal deficit.
gI think we need to know that,h McConnell said at a breakfast sponsored by
Politico, adding that the CBO report could be released by Monday.
McConnell was the first in growing chorus of high-ranking Senate Republicans
to question the wisdom of moving forward on the health bill without an official
budget tally. Senate Finance Committee Chairman Orrin G. Hatch (R-Utah), whose
committee will help craft a Senate response to the House legislation, told
reporters on Thursday that he believes the CBO score is a valuable tool.
gI think itfs important,h Hatch said. gItfs the best we have.h
The comments came after the two House committees worked at breakneck speed
through the night to advance the American Health Care Act. 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 (Ark.), drew swift attention
Thursday morning when he tweeted that the House should gstart over.h
gHouse health-care bill canft pass Senate [without] major changes. To my
friends in House: pause, start over. Get it right, donft get it fast,h Cotton
wrote from his political account.
gGOP shouldnft act like Dems did in [Obamacare],h he continued. gNo excuse to
release bill Mon night, start voting Wed. With no budget estimate! What matters
in long run is better, more affordable health care for Americans, NOT House
leadersf arbitrary legislative calendar.h
In a Thursday afternoon interview with The Washington Post, Cotton threw more
cold water on both the fast pace with which House Republicans are moving ahead
on the bill and the measurefs substance, including the proposed tax credits to
help people pay for insurance.
gI donft think the Senate would vote on that bill,h he said. gThe bill that
was introduced Monday night cannot pass the Senate. And I donft think it will be
brought to the Senate for a vote.h
Cotton said many of his colleagues hold similar views. gThey might not have
spoken publicly about it, but I can tell you a number if not a majority of
Republican senators think that this process has been too breakneck, too slapdash
and they do not see a good solution for the American people coming out of the
House bill as drafted.h
Cottonfs tweet added uncertainty to the billfs fate in the Senate, should it
pass the House. Four other GOP senators in states that accepted Medicaid
expansion under the ACA, also known as Obamacare, have expressed concerns about
changing the way the program is administered.
One of those senators, Rob Portman (Ohio), reiterated his concerns Thursday
after meeting with Vice President Pence and Health and Human Services Secretary
Tom Price.
gThat concerns me if it provides less certainty for the expanded Medicaid,h
Portman said. gWefll see.h
The measure also is taking fire on the right from Sens. Ted Cruz (R-Tex.),
Rand Paul (R-Ky.) and Mike Lee (R-Utah), who say they want a more complete
repeal of the ACA.
Meanwhile, the American Action Network, a group with close ties to House
Speaker Paul D. Ryan (R-Wis.), said it would launch television ads in more than
two dozen media markets urging intransigent conservatives to support the plan.
The most imminent threat GOP leaders must contend with comes from those
conservatives. The speaker can lose only 21 Republican votes if the American
Health Care Act is to pass, and opponents are promising to use that leverage to
force changes to the bill.
Pence met with two Freedom Caucus leaders Tuesday, and that same day, White
House Budget Director Mick Mulvaney — a former caucus member — spent more than
an hour at a meeting of the group. Its members have also been invited to visit
the White House next Tuesday.
On Wednesday night, Trump met with leaders from Americans for Prosperity, the
Club for Growth, FreedomWorks, the Heritage Foundation and its political arm,
Heritage Action, and the Tea Party Patriots as part of what the White House
called his gfull-court pressh on the billfs behalf.
On Capitol Hill Thursday, Ryan made a new attempt Thursday to explain the
full scope of the GOP health plan, explaining in an unusual gTED talkh-style
news conference that the pending legislation is only the first step.
The proposal, he explained, is to be followed by Trump administration
regulatory actions, as well as additional legislation that will need to win at
least some Democratic support in the Senate.
gWe as Republican have waited seven years to do this,h Ryan said. gThis is
the closest we will ever get to repealing and replacing Obamacare. The time is
here. The time is now. This is the moment.h
Senate Democrats expressed their concerns at a separate news conference,
attacking the GOP for allowing the process to take place in the gdead of nighth
while flanked by people who had benefited from the Affordable Care Act.
Sen. Debbie Stabenow (D-Mich.), who is up for reelection next year in a state
that Trump narrowly won, contrasted the speedy handling of the bill to the
process that led to the ACA, which involved 14 months of debate and hundreds of
hearings.
On the other side of the Capitol, House Minority Leader Nancy Pelosi
(D-Calif.) accused Republican leaders of seeking to hide its effects from the
public by advancing it quickly.
She highlighted a letter from four Republican committee leaders, including
Ryan, sent in June 2009 demanding that the CBO issue an analysis of the
Affordable Care Act before their panels voted on the measure. Ryan said this
week that it was acceptable and not unusual for two of the same committees to
take up the GOP legislation without a CBO analysis.
gThe facts are these: We had scores of hearings,h Pelosi said. gHours of
public markup, dozens of Republican amendments accepted.
gThey donft want the American people to see the facts,h she added. gTheyfre
always afraid of the facts.h
House Republican leaders have given little indication that they will make
anything but marginal changes to their plan, which would eliminate the
requirements that all Americans obtain coverage or pay a tax penalty and that
businesses with at least 50 employees provide insurance. The American Health
Care Act would replace income-based subsidies with refundable tax credits based
on age and income, impose a 30 percent surcharge if people buy a plan after
allowing their coverage to lapse and phase out the lawfs more generous Medicaid
funding over time.
These changes have sparked criticism from powerful health-care stakeholders.
The American Medical Association, the American Hospital Association and AARP are
among the groups that have rejected the bill.
Americafs Health Insurance Plans, the insurance industryfs largest trade
association, sent a letter Wednesday saying that although it appreciated some
elements of the plan, the proposed changes to Medicaid could produce
gunnecessary disruptions in the coverage and care beneficiaries depend on.h
Andrey Ostrovsky, the chief medical officer for Medicaid, took the unusual
step of expressing his opposition to the measure Wednesday night.
gDespite political messaging from others at [the Department of Health and
Human Services], I align with the experts,h he wrote on Twitter, citing
opposition to the bill from the AMA, the American Academy of Pediatrics and the
American Academy of Family Physicians.
Walden told reporters Wednesday that critics — including segments of the
health-care industry — were exaggerating the proposalfs potential
repercussions.
gTherefs a pretty big medical-industrial complex in America,h he said. gAnd
when you touch it, Ifve discovered, it touches back.h
Amy Goldstein, Carolyn Y. Johnson, Sean Sullivan and David Weigel contributed
to this report.