GOP leaders propose health care bill changes to help older people, curb Medicaid


House Republican leaders, racing toward a planned Thursday vote on their proposed health-care overhaul, unveiled changes to the legislation late Monday that they think will win over enough members to secure its passage.

The tweaks addressed numerous GOP concerns about the legislation, ranging from the flexibility it would give states to administer their Medicaid programs to the amount of aid it would offer older Americans to buy insurance. They are the product of two weeks of negotiations that stretched from the Capitol to the White House to President Donald Trump‘s Florida resort.

The bill’s proponents also appeared to overcome a major obstacle Monday after a key group of hard-line conservatives declined to take a formal position against the bill, known as the American Health Care Act.

The House Freedom Caucus has threatened for weeks to tank the legislation drafted by House Speaker Paul Ryan, R-Wis., arguing that it does not do enough to undo the seven-year-old Affordable Care Act. Their neutrality gives the legislation a better chance of passage: If the group of about three dozen hard-right GOP members uniformly opposed the bill, it could block its passage.

Their decision not to act as a bloc frees House leaders and White House officials to persuade individual Freedom Caucus members to support the measure — a process that the Freedom Caucus’s chairman said was underway.

“They’re already whipping with a whip that’s about 10 feet long and five feet wide,” said Rep. Mark Meadows, R-N.C. “I’m trying to let my members vote the way that their constituents would want them to vote. … I think they’re all very aware of the political advantages and disadvantages.”

Attending the Freedom Caucus meeting Monday were three senators opposed to the House bill – Ted Cruz, R-Texas, Mike Lee, R-Utah, and Rand Paul, R-Ky., – who hold leverage to block the bill in their own chamber, where Republicans hold a two-seat majority. Cruz said he told the House members that the leadership strategy of pursuing distinct “phases” of legislation was a dead end and that they needed to push for changes in the present bill.

“The Senate Democrats are engaging in absolute opposition and obstruction, and it is difficult to see that changing anytime soon,” Cruz told reporters after leaving the meeting.

Trump’s visit to the Hill on Tuesday signals that GOP leaders and the president consider larger-scale talks with key blocs of House members to be essentially complete. The effort now turns toward persuading individual members to vote for the package.

Ryan credited Trump’s backing in a statement Monday: “With the president’s leadership and support for this historic legislation, we are now one step closer to keeping our promise to the American people and ending the Obamacare nightmare.”

Trump’s visit Tuesday will be his first appearance at the weekly House Republican Conference meeting since becoming president. He last privately addressed Republican lawmakers as a group at the party’s policy retreat in Philadelphia in late January and has met with small groups of members on several occasions since.

Trump won the backing of Palmer and several other conservative House members Friday when he agreed to make changes to the Medicaid portion of the bill, including giving states the option of instituting a work requirement for childless, able-bodied adults who receive the benefit. Those changes were included in the leadership-backed amendments that will be incorporated into the bill before it comes to a final vote.

To address concerns expressed by a broader swath of GOP lawmakers — conservatives and moderates alike — leaders said they hoped to change the bill to give older Americans more assistance to buy insurance.

In an extreme case laid out in a Congressional Budget Office analysis of the bill, a 64-year-old earning $26,500 a year would see yearly premiums rise from $1,700 under the ACA to $14,600 under the Republican plan.

House leaders said they intended to provide another $85 billion of aid to those between ages 50 and 64, but the amendment unveiled late Monday did not do so directly. Instead, the leaders said, it “provides the Senate flexibility to potentially enhance the tax credit” for the older cohort by adjusting an unrelated tax deduction.

That workaround, aides said, was done to ensure that the House bill would comply with Senate budget rules and to ensure that the CBO could release an updated analysis of the legislation before the Thursday vote.

But it also means that the House members who pushed for the new aid will have to trust the Senate to carry out their wishes.

The Washington Post’s Kelsey Snell contributed to this report.



Source link