Pulling in different directions, Republicans are striving to get traction for a healthcare overhaul in danger of being dragged down by intra-party differences.
Some Republican governors weighed in on Thursday evening in a letter to congressional leaders saying that the House of Representatives’ bill gives them almost no new flexibility and lacks sufficient resources to protect the vulnerable.
It landed as Republican moderates and conservatives in the House remained split, and senators expressed reservations. Democrats are united in fierce opposition.
Photo: Reuters
US President Donald Trump, whose administration initially embraced the House healthcare bill, has lately called it “very preliminary,” adding that “we will take care of our people or I’m not signing it.”
US Health and Human Services Secretary Tom Price was scheduled yesterday morning to meet with the restive House Republican caucus.
Although the House bill has cleared three committees, some lawmakers can visualize scenarios where things come apart.
Republican Representative Bill Flores said it is important to get the legislation passed before Congress leaves for a two-week spring recess next month.
“That’s never healthy to let something sit out there too long because pretty soon you have a carcass left,” he said.
The House bill — called the American Health Care Act — would repeal major elements of former US president Barack Obama’s law, create a new, leaner system of tax credits for health insurance, and cap future federal spending on Medicaid for low-income people.
It would also reverse tax increases on wealth Americans used to finance Obama’s Affordable Care Act.
Critics say it would make health insurance more expensive for individuals, especially older adults and those with modest incomes.
An analysis by the nonpartisan Congressional Budget Office found that 24 million people would lose their health insurance over a decade, although the bill would also reduce the deficit.
In the Senate, Republican Senator Susan Collins told a newspaper in Maine, the Portland Press Herald: “This is not a bill I could support in its current form.”
She joined colleagues Rand Paul and Mike Lee in opposing the legislation, while other Republican senators, including Tom Cotton and Ted Cruz, have expressed deep misgivings.
Collins’ opposition leaves the bill short of the support it needs in the Senate unless it changes, since Republican leaders can only lose two votes.
In another warning signal, four Republican governors on Thursday wrote to congressional leaders saying the bill’s approach to Medicaid would not work for states.
Medicaid covers more than 70 million people, and its future is expected to be a central issue in the Senate.
“It provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out and shifts significant new costs to states,” wrote governors John Kasich of Ohio, Rick Snyder of Michigan, Brian Sandoval of Nevada and Asa Hutchinson of Arkansas.
Saying they represent most Republican governors, the four submitted a nine-page proposal that gives states more options to overhaul Medicaid and modifies the shift to federal spending limits envisioned by the House.
The governors said they support the goal of repealing “Obamacare,” but want to avoid collateral damage.
Despite open turmoil, House Speaker Paul Ryan tried to strike an optimistic tone as he addressed reporters on Thursday at his weekly press briefing.
“We feel like we’re making great strides and great progress on getting a bill that can pass,” Ryan said.
A White House official said the plan is for a House floor vote on Thursday next week — the seven-year anniversary of the Obama law.
However, Ryan did not commit to a timetable for passage, and he has acknowledged that the bill needs changes to pass.
Only last week, Ryan was pledging action sometime next week by the House Rules Committee — the precursor to a floor vote — and confidently predicting the bill would have the votes to pass.
Instead, Ryan spent part of his news conference disputing suggestions that he and Trump are at odds over the healthcare bill, rumblings that originate with Ryan’s very reluctant support for Trump during the presidential campaign.
“There is no intrigue, palace intrigue, divisions between the principals ... there really is no schism whatsoever,” Ryan said. “I’m excited at the fact that we have a president who likes closing deals.”
However, some conservatives, having ousted the last House speaker, were beginning to grumble openly about Ryan’s leadership.
By many accounts Trump has been closely involved in negotiations on the bill, including calling Budget Committee members ahead of the vote on Thursday.
The committee vote was 19 to 17, with Republican Representatives David Brat, Gary Palmer and Mark Sanford — all members of the conservative House Freedom Caucus — joining the panel’s Democrats in voting against it.
The trio consider it too similar to the Obamacare law it is intended to replace.
The close vote illustrated the problems Republican leaders may encounter in corralling enough votes in their party to win passage on the House floor amid unified Democratic opposition.
The measure now goes to the Rules Committee before reaching the House floor.
Additional reporting by Reuters
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