The Public Pulse: Republicans now own health care mess

Phillip Butler
March 18, 2017

House speaker Paul Ryan declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty.

"I just want to let the world know I am 100 percent in favor" of the measure and the changes, Trump said at the White House after meeting around a dozen House lawmakers and shaking hands on revisions.

The leader of the hard-line conservative House Freedom Caucus - whose members want to curb Medicaid, reduce a new tax credit and eliminate requirements on insurers - said there's been little give from House leaders. He said that an optional work requirement for Medicaid "doesn't move the ball more than a couple yards on a very long playing field".

Across the Capitol, Sen. Moderate Republicans like Ileana Ros-Lehtinen, R-Fla., have announced their opposition, and the changes agreed to by the president are likely to harden that opposition.

During the RSC meeting at the White House, Health Secretary Tom Price reminded members that the administration is fully behind the House's bill and that he remains committed to making rule changes at administrative level to help Republicans settles some of their concerns.

The House Budget Committee narrowly voted Thursday to advance the troubled Republican health bill, with defections by three GOP conservatives underscoring the obstacles party leaders face in maneuvering to avoid a stinging setback to their showpiece legislation after seven years of promises to repeal and replace "Obamacare".

The House bill would create new, leaner tax credits for health insurance, cap federal spending on Medicaid for low-income people and reverse tax increases on wealthy Americans used to finance Obama's statute. Part of that choice is an eventual gutting of the current Medicaid system by replacing it with a federal system that provides limited block grants for states to administer.

President Trump had a pretty rough week, watching his "latest travel ban blocked yet again by a judge, his health-care bill start to fall apart, and his wiretapping claims debunked", even by members of his own party, Seth Meyers said on Thursday's Late Night. "But they also show that President Trump is all-in now", a help in winning converts.

Republican leaders in the House and Senate have been pointedly urging their ranks to think about the need to govern, after serving nearly exclusively as an opposition party for eight years under Obama.

Ryan insisted to reporters that the bill was still on a path to pass the House and that Republicans have been working "hand in glove" with the White House on the repeal plan.

The House's top vote counter still recognizes that there's work to do, however.

Conservatives want to end Obama's expansion of Medicaid next year, not in 2020 as the bill proposes. Centrist Republicans remained wary of a bill they fear will yank many constituents from coverage.

Snyder has outlined his goals for Medicaid reform in private meetings this year with members of Congress during trips to Washington, D.C. But the plan sent to Ryan and McConnell is the first comprehensive look at what he and other GOP governors have pushed for behind closed doors.

Still, Rep. Larry Bucshon, R-Ind., said there's a big difference between requiring a surcharge for lapsed coverage and finding the uninsured.

The job of the whip team has only been made more hard this week by a non-partisan Congressional Budget Office score showing that 24 million more Americans could be uninsured in the next decade if the Republican bill to repeal Obamacare is passed.

Heller joined three other GOP senators in opposing the bill: Susan Collins of Maine, Rand Paul of Kentucky and Mike Lee of Utah. Tom Cotton (R-Ark.) also publicly opposed it.

Other reports by Ligue1talk

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