Republicans revamp health bill, boost
benefits to older Americans
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[March 20, 2017]
By Susan Cornwell and Valerie Volcovici
WASHINGTON (Reuters) - U.S. House
Republicans are working on changes to their healthcare overhaul bill to
provide more generous tax credits for older Americans and add a work
requirement for the Medicaid program for the poor, House Speaker Paul
Ryan said on Sunday.
Ryan said Republican leaders still planned to bring the healthcare bill
to a vote on the House of Representatives floor on Thursday. Speaking on
the "Fox News Sunday" television program, he said leaders were working
to address concerns that had been raised by rank-and-file Republicans to
the legislation.
Republicans remain deeply divided over the healthcare overhaul, which is
President Donald Trump's first major legislative initiative. It aims to
fulfill his campaign pledge to repeal and replace the Affordable Care
Act, popularly known as Obamacare, the signature healthcare program of
his Democratic predecessor, Barack Obama.
Democrats say the Republican plan could throw millions off health
insurance and hurt the elderly, poor and working families while giving
tax cuts to the rich.
"We think we should be offering even more assistance than the bill
currently does" for lower-income people age 50 to 64, Ryan, the top
Republican in Congress, said of the tax credits for health insurance
that are proposed in the legislation.
Ryan also said Republicans were working on changes that would allow
federal block grants to states for Medicaid and permit states to impose
a work requirement for able-bodied Medicaid recipients.
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Trump told reporters in a brief conversation aboard Air Force One that
he had meetings about healthcare reform in Florida at the weekend and
that the effort to sell the proposal was going well.
He has been wooing lawmakers to vote for the bill and won the backing of
a dozen conservative lawmakers on Friday after an Oval Office meeting in
which the president endorsed a work requirement and block-grant option
for Medicaid.
Trump is set to meet Ezekiel Emanuel, a health policy special adviser
under Obama who helped shape the Affordable Care Acton, at the White
House on Monday, along with Ryan and Health and Human Services Secretary
Tom Price.
Block grants would give states a set amount of money to cover people on
the Medicaid program and provide flexibility in spending decisions.
However, there is no guarantee funding would keep up with future
demands.
"TRYING TO FIX BILL"
While Ryan said he felt "very good" about the health bill's prospects in
the House, a leading conservative lawmaker, Representative Mark Meadows,
told the C-Span "Newsmakers" program that there were currently 40
Republican "no" votes in the House. Republicans hold a majority in the
chamber but cannot afford to have more than 21 defections for the
measure to pass.
Meadows and two other Republican opponents of the bill, Senators Mike
Lee of Utah and Ted Cruz of Texas, met at Trump's Mar-a-Lago estate in
Florida on Saturday "negotiating with the president's team, trying to
fix this bill," Cruz told CBS' "Face the Nation."
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![](../images/032017pics/news_a1.jpg)
Speaker of the House Paul Ryan (R-WI) speaks to the media on Capitol
Hill in Washington, U.S., March 16, 2017. REUTERS/Joshua Roberts
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North Carolina Republican Meadows said the changes being considered
for the Medicaid program would not go far enough if they left it up
to states to decide whether to put in place a work requirement.
Price acknowledged the tough negotiations, telling ABC's "This
Week": "It's a fine needle that needs to be thread, there's no doubt
about it."
The healthcare bill would face significant challenges in the Senate
even if it were to pass the House.
Senator Tom Cotton, a conservative Arkansas Republican, said the
bill would not reduce premiums for people on the private insurance
market. "It's fixable, but it's going to take a lot of work," Cotton
said on CNN's "State of the Union."
Moderate Republicans have also expressed concerns about the bill,
and their worries are often not the same as that of conservatives.
Speaking on NBC's "Meet the Press," Republican Senator Susan Collins
of Maine worried the bill would harm older Americans, and shift
Medicaid costs to states - something critics say a block-grant
approach would only make worse.
Collins said coverage issues must also be dealt with, citing a
report from the Congressional Budget Office that said 14 million
people would lose health coverage under the House bill over the next
year and 24 million over the next decade.
Affordability has been one of the bigger concerns that insurers and
hospital groups have raised about the legislation. To the extent
that a change in tax credits makes healthcare more affordable for
some people, insurers and hospitals could stand to benefit.
The BlueCross BlueShield Association emphasized the need for the
replacement to be affordable when the draft of the healthcare bill
was released earlier this month. The association represents BCBS
insurers that cover the vast majority of the roughly 10 million
people enrolled in 2017 Obamacare plans.
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(Additional reporting by David Shepardson in Washington and Roberta
Rampton in West Palm Beach, Fla.; Editing by Phil Berlowitz, Peter
Cooney and Paul Tait)
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