Republican health plan clears first
hurdles, fate uncertain
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[March 10, 2017]
By Susan Cornwell and Yasmeen Abutaleb
WASHINGTON (Reuters) - The Republican plan
backed by President Donald Trump to overhaul the U.S. healthcare system
cleared its first hurdles in Congress on Thursday, but its chances for
passage looked uncertain and top Republicans scrambled to bring
disgruntled conservatives aboard.
In the face of opposition by Democrats, healthcare providers and many
conservatives, two House of Representatives committees approved the
legislation that would undo much of the 2010 Affordable Care Act,
popularly known as Obamacare, moving it closer to a vote before the full
House.
The Energy and Commerce Committee voted 31-23 along party lines, with
Democrats unified against it, to back the plan after marathon
proceedings lasting 27 straight hours. Hours earlier, the tax-writing
Ways and Means Committee similarly voted 23-16 before dawn to approve it
after working 17 straight hours.
House Speaker Paul Ryan sought to bolster support among conservatives in
his own party, Senate Majority Leader Mitch McConnell said fellow
Republicans must get in a "governing mode" while Trump denied the bill
was in trouble.
"Despite what you hear in the press, healthcare is coming along great.
We are talking to many groups and it will end in a beautiful picture!"
the Republican president said on Twitter.
The bill would replace Obamacare's income-based subsidies with a system
of fixed tax credits to help people buy private insurance on the open
market, while ditching the Obamacare expansion of the Medicaid insurance
program for the poor. It would also end penalties for not having
insurance, though insurers would be given permission to impose a 30
percent surcharge on customers who let their coverage lapse for more
than two months and then seek to renew.
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Hospital stocks, which has fallen after the plan was unveiled on Monday,
ended broadly higher on Thursday, with Tenet Healthcare up 3.4 percent.
Shares of health insurers were mixed, with most large insurers modestly
higher and Medicaid-focused insurers ending negative, including Molina
Healthcare's 3.3 percent drop.
While Republicans have been itching for seven years to dismantle
Democratic former President Barack Obama's signature domestic policy
achievement, the party has failed to coalesce behind the plan put forth
by House Republican leaders.
Republicans control the White House and both houses of Congress for the
first time in a decade, but passage of the legislation was not a
foregone conclusion.
Conservative lawmakers and lobbying groups have lambasted it as too
similar to Obamacare. They have sharply criticized its proposed tax
credits as an unacceptable new government entitlement program and have
called for a quicker end to the Obamacare Medicaid expansion.
The measure is the first major legislative test for Trump and his fellow
Republicans amid questions about whether they can govern effectively
after years spent as an opposition party under Obama.
Ryan, with his shirt sleeves rolled up and using a video screen with
facts and figures, held what he called a "townhall-style" presentation
for reporters on the proposal. But his intended audience appeared to be
fellow Republicans, and he said his party must "actually make good on
our word."
"The time is now," said Ryan, who long has been the target of criticism
of some conservatives. "This is the closest we will ever get to
repealing and replacing Obamacare," Ryan added.
McConnell had a similar message, saying, "We need to get into a
governing mode and start thinking about actually achieving something
rather than just kind of sparring."
Democrats denounced the bill as a gift to the rich that would force
millions of people off of insurance rolls. Republicans said it was
needed to roll back the government's "nanny state" role in the
more-than-$3 trillion U.S. healthcare system.
"Trumpcare is a loser for just about all of America, unless you're in
the top 1 percent," Senate Democratic Leader Chuck Schumer said.
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![](../images/031017pics/news_c7.jpg)
Chairman Rep. Fred Upton (R-MI) speaks during a marathon House
Energy and Commerce Committee hearing on a potential replacement for
the Affordable Care Act on Capitol Hill in Washington March 9, 2017.
REUTERS/Aaron P. Bernstein
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The House Budget Committee next Wednesday is due to merge the
provisions approved by the two committees into one bill to be voted
on by the full House before it goes to the Senate. Republican
leaders are eyeing April for congressional passage of the bill.
'ARBITRARY LEGISLATIVE CALENDAR'
In a series of tweets early on Thursday, conservative Republican
Senator Tom Cotton urged his House colleagues to pull back, saying
their measure could not pass the Senate without major changes. "What
matters in long run is better, more affordable health care for
Americans, NOT House leaders' arbitrary legislative calendar,"
Cotton wrote.
But White House spokesman Sean Spicer expressed confidence in the
legislation's prospects. "We're not jamming this down people's
throat," Spicer said. "This bill will land on the president's desk.
He will sign it. We will repeal Obamacare."
The Brookings Institution think tank forecast that the nonpartisan
Congressional Budget Office, expected early next week to release its
closely watched assessment of the bill's cost and coverage
implications, would conclude that at least 15 million people would
lose health insurance.
Credit rating agency Standard & Poor's earlier estimated 6-10
million people could lose health insurance coverage.
Before the Energy and Commerce Committee vote, conservatives at the
request of the panel's chairman withdrew an amendment sponsored by
Republican Joe Barton that would move up by two years, to next Jan.
1, the end of the Medicaid expansion. Barton said he planned to try
to offer the amendment on the House floor.
Committee Chairman Greg Walden hailed the unanimity of Republicans
on the committee in approving the bill.
Obamacare enabled 20 million previously uninsured people to obtain
coverage. About half came from the Medicaid expansion.
The bill's proposed changes in Medicaid funding could hurt smaller,
less diverse health insurers, Fitch Ratings said, and the
unintended, unforeseen consequences of a bill this size are likely
to create uncertainty for all health insurers.
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With doctors, hospitals, seniors, health plans, Democrats, some
governors and conservative Republicans against the bill, it may not
make it out of the House, Mario Molina, chief executive of managed
care company Molina Healthcare, said in an interview.
"If it does, I think the Senate is going to slow things down and
really take a good look," Molina said. "We are going to have to hope
that the Senate is more moderate."
(Additional reporting by Susan Heavey, Doina Chiacu, Caroline Humer
and Lewis Krauskopf; Writing by Will Dunham; Editing by Lisa Von Ahn
and Tom Brown)
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