A Republican proposal to revise the Affordable Care Act claimed its first major victories Thursday amid a backlash that both Republican leaders and President Trump spent the day trying to tamp down.
Trump met with conservative critics of the plan, signaling both a willingness to negotiate its details and that it does not yet have enough votes to emerge from the House. More acknowledgment of the proposal’s problems came from Senate Republicans, who suggested Thursday that the measure is moving too quickly through the House and in a form unlikely to succeed if it gets to the upper chamber.
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One of the most controversial provisions (for conservatives) of the American Health Care Act (aka Obamacare repeal and replace) is the creation of an advanceable, refundable tax credit for individuals to purchase health insurance. It would be available to anyone not offered health insurance at work, or eligible for Medicare or Medicaid. It would be bigger for older folks and smaller for younger folks. It would means test starting at $75,000 ($150,000 for married couples). The credit would be available month to month to offset health insurance premiums as a direct offset. It is paid for by repealing Obamacare.
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Our health-care system is broken. It was inefficient before Obamacare, and Obamacare’s Washington-knows-best-mandates made it many times worse. The American people have suffered as a result. We can’t return to the pre-Obamacare status quo, because Americans need more access to health care. But we also can’t leave the American people tied to a sinking Obamacare ship, forced to face higher annual premiums and fewer provider choices. We need relief based on clear principles: Government shouldn’t dictate our health-care choices, health care should be driven by market principles, and we must help those who truly need our help.
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Republicans have a point that their Obamacare replacement plan is particularly hard for the Congressional Budget Office to score, budget experts say.
The bill, which Democrats are sharply criticizing for its lack of a CBO score, gives states much more leeway in how they would provide — or not provide — health insurance for people. And predicting how states will behave over the next decade is a time-consuming and tricky task for the agency.
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The House GOP’s bill to reform health care is hardly a surprise: Its key elements were part of the “Better Way” agenda championed last year by Speaker Paul Ryan. Republican lawmakers discussed the principles in several special conference meetings. The legislation was then written from the bottom up by the appropriate committees instead of being imposed from the top down.
The bill would repeal much of President Obama’s framework for government-run, highly prescriptive, one-size-fits-all health care. In its place would stand conservative reforms to unleash market forces, give consumers choice, and return power to the states.
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Leaders of conservative groups that oppose the House Republicans’ health-care bill met with President Trump at the White House on Wednesday night, part of a high-profile effort to quiet anger from the right. In the process, the conservatives heard the president and his team express some openness to tweaks to the bill that go further than House or Senate leaders might accept.
Trump and his team did not outright reject changes on at least three components of the GOP’s American Health Care Act, said some of the meeting’s attendees, speaking on the condition of anonymity. One idea was accelerating the timetable for key changes to Medicaid under the House GOP plan from 2020 to 2018.
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On Monday evening, House Republican leaders unveiled their long-awaited Obamacare replacement, entitled the American Health Care Act. The plan was swiftly panned by observers from all over the ideological spectrum. But there was one group whose complaints made the least sense: GOP hard-liners who believe that any attempt to provide financial assistance to the uninsured amounts to “Obamacare Lite.”
It was a phrase we heard over and over on Tuesday. “This is Obamacare Lite,” said Sen. Rand Paul (Ky.). FreedomWorks, a conservative activist group, used the same epithet. Rep. Justin Amash (Mich.) called the AHCA “Obamacare 2.0.”
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After an 18-hour session, the House Ways and Means Committee has become the first to approve the Republicans’ Obamacare repeal bill.
White House and Republican congressional leaders had sought to fast track the legislation through Congress. Democrats made clear it wouldn’t be easy — dragging out a grueling day of committee sessions well into the early morning hours. The House Energy and Commerce Committee is still debating.
Opposition to the Republican health care bill had strengthened Wednesday, as key industry groups that had supported Obamacare said the replacement backed by President Donald Trump could harm vulnerable Americans.
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The Republican House health-insurance reform bill would replace Obamacare with a more consumer-driven system. Rather than having many provisions take effect in 2020, Congress should pass it soon and make it effective next year. But it is getting attacked from both the right and the left. What’s missing from the news coverage is improvements in the new bill. Here are six:
1. No employer mandate.
2. Refundable tax credits to buy health insurance.
3. Expansion of HSAs and FSAs.
4. Move Medicaid patients to regular coverage.
5. Lower costs for the young.
6. Incentives to keep coverage.
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Galen Institute President Grace-Marie Turner is a veteran of Washington health-care debates and was a fierce opponent of the Clinton health-care reform effort in the 1990s and Obamacare since 2009. She is encouraged by what she sees in the American Health Care Act and says the realities on Capitol Hill force this kind of legislation.
“It’s a first step. They’re pushing as far as they can with the process they have to go through. They do not expect any Democrats, in the House or the Senate, to vote for this. That means they have to do this through a particularly difficult process called reconciliation that limits the kinds of things you can repeal,” Turner told WND and Radio America.
“They can’t repeal everything in the law through this process, because it has to have direct spending and budget implications. They’re doing as much as they can and they have plans to go forward with other pieces of legislation, for example, that will allow people to purchase health insurance across state lines. That’s not possible through this particular pathway.”
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