Facing defiance, GOP leaders press ahead on health bill

Posted March 14

— Facing mounting rank-and-file defiance, Republican leaders and the White House redoubled their efforts Tuesday to muscle legislation overhauling America's health care system through Congress following a sobering report about millions being shoved off insurance coverage.

President Donald Trump, whose strong Election Day showing in GOP regions makes him the party's ultimate Capitol Hill vote wrangler, discussed the legislation by phone with the House's two top Republicans. He also dispatched Vice President Mike Pence and health secretary Tom Price to hear GOP senators' concerns.

With leaders hoping to move the measure through the House next week so the Senate can debate it, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell acknowledged they were open to changes. Trump's spokesman affirmed a willingness to accept revisions to win support.

"This has never been a take it or leave it," said Press Secretary Sean Spicer.

The GOP bill is the party's response to seven years of promising to repeal President Barack Obama's 2010 health care overhaul. It would undo that law's individual mandate, which requires most people to have coverage, by ending the tax penalty on those who don't.

It would also provide age-based tax credits instead of the subsidies geared to income in Obama's statute, end that law's expansion of Medicaid and curb its future spending, and let insurers boost rates for seniors.

On Monday, the Congressional Budget Office said the Republican legislation would reduce the ranks of the insured by 24 million in a decade, largely by cutting Medicaid recipients and people buying individual policies. That would be more than the 20 million who've gained coverage under Obama's overhaul — and attach a big number to a problem haunting GOP governors and members of Congress whose states have benefited from "Obamacare."

"I plan to vote NO" on the GOP bill, tweeted Rep. Ileana Ros-Lehtinen, R-Fla., among a mounting number of Republicans who expressed opposition following the report's release. "As written the plan leaves too many from my #SoFla district uninsured."

The budget office report also said the measure would reduce federal deficits by $337 billion over the next decade, largely by cutting Medicaid, the health insurance program for the poor, and eliminating Obama's subsidies for low- and middle-income people. The report said that the bill's changes would result in federal subsidies that would fall to half their current size in a decade and that older, lower-earning people would be hit especially hard.

Those findings further energized Democrats, who already were unanimously opposing the GOP repeal effort.

"Of course you can have savings if you cut off millions of people from access to health care," said House Minority Leader Nancy Pelosi of California.

Pence and Price discussed the legislation over lunch with GOP senators at the Capitol. Participants said senators suggested targeting the bill's new tax credits more at lower-earning people, improving benefits for seniors and protecting the expansion of Medicaid, the federal-state program that helps lower-income people afford care.

McConnell, R-Ky., acknowledged the bill could be reshaped, saying, "It will be open to amendment in the Senate."

Ryan, R-Wis., added on the Fox News Channel, "Of course we want to listen to our members and make improvements to the bill, so long as those improvements don't make the bill harder to pass."

Criticism cascaded from both ends of the GOP political continuum, suggesting leaders face a festering problem.

Freshman Rep. John Faso, R-N.Y., from a closely divided Catskill Mountains district, said he was concerned the bill would hurt hospitals and was undecided about supporting it. He's a member of the House Budget Committee, which is expected to sign off on the bill Thursday in what Rep. Tom Cole, R-Okla., said could be "a bumpier ride" than last week's approval by two other panels.

Citing the bill's projected increase in uninsured people, Rep. Leonard Lance, R-N.J., from another close district, said he opposed the bill. Rep. Mark Amodei, R-Nev., said he was leaning no because of people losing coverage, saying of CBO's projections, "If the numbers are in the ballpark, it sounds like we've gone back to where we started after seven years."

Conservatives continued complaining the Republican measure doesn't fully repeal Obama's law, as they and Trump promised in last fall's election campaigns. Their demands include voiding the law's requirement that policies cover 10 specified benefits like mental health services, which they say drives up consumers' costs.

"Ultimately it will be President Trump that saves this deal," said Rep. Mark Meadows, R-N.C., head of the hard-line conservative House Freedom Caucus.

No. 3 Senate leader John Thune, R-S.D., said he will propose devoting more of the GOP tax credit to lower-earning people. It would currently begin phasing out for people earning $75,000 annually.

"It'd be nice to add it to the House bill, but if necessary it'd be in the Senate," Thune said.


AP reporters Alison Noon in Reno, Nevada, Steve Peoples in New York, and Ken Thomas and Kevin Freking in Washington contributed to this report.


This story has been corrected to show Trump called top Republicans in the House, not Congress.


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  • Jim Thomas Mar 14, 4:21 p.m.
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    Just remember who was sitting on Trump's left when he hosted the Health Insurance Company Execs recently at the White House...BCBSNC CEO. Have to think the Health Ins. Cos. like the new plan. As an ACA insured citizen, I have to say it's been great. I certainly have no complaints about the cost even if it has gone up for me more than 50% over 3 years. The problem is if the new plan is not passed and implemented, there will probably be no insurance companies offering coverage in NC next year. In 3 years NC has gone from 3 companies offering coverage to just 1...BCBSNC.

  • Robert Richardson Mar 14, 3:47 p.m.
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    View quoted thread

    So, you won't have a problem paying close to what you are now with less coverage. LOL

  • Henry Davis Mar 14, 1:57 p.m.
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    Anything is better than what obamma forced us to buy.

  • Jim Smith Mar 14, 1:36 p.m.
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    View quoted thread

    I agree! I've said this from the beginning!

  • Jim Smith Mar 14, 1:34 p.m.
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    The Establishment Republicans had 8 years to come up with something better and failed to do it. Rand Paul has a well thought out plan that is much better than "Obamacare Lite" and would have been a much better starting point than the garbage they are trying to feed us now. The Republicans have a unique opportunity and are going to blow it. 30% penalties that go to insurance companies? Ridiculous and a kickback. Seniors pay 5x the premium of their younger counterparts? Obamacare was capped at 3x. This current bill is unsustainable. They are running out of time. It seems that the lobbyist culture and political posturing is going to crush this opportunity when they had a great scaffolding/structure in Rand Paul's bill to move forward with the American people as a starting point and may fail miserably if they don't come to their senses.

  • Albert Furter Mar 14, 1:24 p.m.
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    Of course, a cop-out is always hard to sweet talk. What the GOP is trying to sell to the public is the fact that the "replacement" plan, while throwing millions of Americans under the bus, is cheaper and therefore more American. So, deal with it.
    BTW, whoever thinks that Medicaid is not a government program needs to retake their civics class.

  • New Holland Mar 14, 1:14 p.m.
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    something i saw that show the top %1 would save an average of 197k in the part of the bill that has the tax cuts in it.

  • Mike Trekker Mar 14, 12:55 p.m.
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    Anna you bring up a very good point. It cost my employee's $392.00 a month to cover their entire family, annually $4704.00. An average annual physical costs $168.00, for a family of four that would be $672.00 a year. Let's throw in two average ER visits at $1233.00 a piece. That would be $3,138.00. You would be better served to have catastrophe insurance, for big ticket medical bills and to be allowed Health Savings Accounts for preventative care. That would be fair to all, and drive down insurance premiums. Plus for the uninsured who are legal Americans, just expand Medicare. Plus write a provision that the government would underwrite those who are uninsurable, with the insurance companies. This is not rocket science BUT government programs do not benefit you, but the Washington establishment.

  • Clarence Drumgoole Mar 14, 12:18 p.m.
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    Trump lied again! Nightmare Healthcare.Gov

  • Anna Temple Mar 14, 9:16 a.m.
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    Why do so many of us require expensive healthcare and who should pay for it? How many medications do we average per person and why. When we get sick and we have no coverage and we need a new kidney and get it, who should pay? Do we all deserve a kidney even if we are homeless?