Health Journal

House leaving town with GOP health care bill in shambles

House leaving town with GOP health care bill in shamblesHouse leaving town with GOP health care bill in shambles

WASHINGTON — House members headed home for a two-week recess Thursday with the Republican health care bill still in shambles. GOP leaders announced a modest amendment to curb some premium increases, but the party still faced sharp divisions over how to achieve their promise of repealing former President Barack Obama’s law.

Flanked by around two dozen Republican lawmakers, House Speaker Paul Ryan, R-Wis., announced the revision to the GOP bill and touted its support from conservatives and moderates.

“This brings us closer to the final agreement that we all want to achieve,” Ryan told reporters.

But Ryan conceded that “we have more work to do.” Other lawmakers not at the news conference who have expressed opposition to the overall GOP bill said the new amendment seemed unlikely to resolve their concerns.

“I favor making sure no one is denied coverage due to a pre-existing condition. So I doubt this would be enough,” said Rep. Leonard Lance, R-N.J., a moderate who has opposed the Republican legislation.

Rep. David Schweikert, R-Ariz., a sponsor of the amendment, said it was aimed at containing premiums by providing an additional $15 billion over a decade to help insurers cover the costs of seriously ill people. Such customers’ expensive care can drive up premiums for all consumers.

The money would be on top of a $100 billion fund already in the GOP bill that states could use for a variety of purposes, including high-risk insurance pools where people with medical problems can get coverage.

House Majority Leader Kevin McCarthy, R-Calif., emailed GOP lawmakers to say work on the health care bill would continue over the recess.

It said if a breakthrough occurred during the break, “We will advise members immediately and give you sufficient time to return to Washington.” But the prospects for a sudden agreement seemed remote at best.

Two weeks ago, Ryan was forced to call off a floor vote on a GOP measure to repeal much of Obama’s 2010 health care overhaul. The GOP legislation replacing it would have scaled back the federal role in health care, covering 24 million fewer people over time, while also cutting taxes for upper-income earners.

Then as now, deep differences among hardliners and moderates impeded the Republican march. Each side blames the other. The congressional recess could drain more momentum from the repeal drive although many Republicans say individually they’re not giving up.

The amendment Ryan announced Thursday does not resolve disputes that have already split Republicans.

A proposal discussed between the White House and leaders of the conservative House Freedom Caucus would let states to seek federal waivers of two insurance requirements Obama’s law established.

One forbids insurers from charging higher premiums on account of people’s medical problems or pre-existing conditions. The other spells out categories of benefits, like hospitalization and substance abuse treatment, that all insurance plans must cover.

Conservatives who want the federal government out of health care argue that those provisions have driven up premiums and decreased choice. The idea is to put states back in charge of insurance rules, reasoning that that would increase the availability of plans with lower premiums, attractive to younger, healthier customers.

Critics say eliminating those insurance requirements would raise premiums for people with serious medical problems and threaten to leave many people without coverage they need.

Meanwhile, weeks of truth-or-consequences debate on Capitol Hill may be shifting public attitudes on the ACA, which has remained divisive since Democrats passed it in 2010 without any Republican support.

Gallup said this week that the law gained majority approval for the first time, with 55 percent supporting it and 41 percent disapproving. It was the first majority for “Obamacare” since Gallup started asking the question in the same format in November 2012. It marked a major shift from five months ago when 42 percent approved and 53 percent disapproved.

Another nonpartisan survey by the Kaiser Family Foundation found relief that Congress has not managed to repeal the health law. It showed that 3 in 4 Americans want the Trump administration to make the law work. About 2 in 3 said they were glad the House GOP bill didn’t pass. But people split evenly between wanting to keep or repeal the statute.

Trump administration officials and leading GOP legislators said they are not giving up trying to find common ground between conservatives and moderates. Ryan and McCarthy met with Pence at the White House on Wednesday night to discuss their next steps on health care, an aide to Ryan said. They also talked briefly with President Donald Trump.




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