Republican health plan overcomes first hurdles, fate is uncertain

© Reuters. Representative Joseph Kennedy (D-MA), Representative Pete Aguilar (D-CA), Representative Debbie Dingell (D-MI) and Representative Scott Peters (D-CA) speak during a marathon hearing of the Energy and Commerce Committee of the House of Representatives is a possible replacement for the Affordable Care Act

By Susan Cornwell and Yasmeen Abutaleb

WASHINGTON (Reuters) – The Republican plan backed by President Donald Trump to reform the US healthcare system removed its first hurdles in Congress on Thursday, but its chances of approval looked uncertain and top Republicans rushed to onboard. disgruntled conservatives.

Faced with opposition from Democrats, health care providers and many conservatives, two committees of the House of Representatives approved legislation that would nullify much of the Law Affordable Care 2010, popularly known as Obamacare, bringing it to a vote before the plenary session of the House.

The Energy and Commerce Committee voted 31-23 along party lines, with Democrats unified against it, to back the plan after marathon proceedings that lasted 27 hours straight. Hours earlier, the Tax Drafting Ways and Means Committee also voted 23-16 before dawn to approve it after working 17 hours straight.

House Speaker Paul Ryan sought to bolster support among conservatives in his own party, Senate Majority Leader Mitch McConnell said his fellow Republicans should adopt a “mode of government,” while that Trump denied the bill had problems.

“Despite what they hear in the press, the medical care is going very well. We are talking to many groups and it will end with a beautiful image.” said the Republican president 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 getting rid of Obamacare’s expansion of the Medicaid insurance program for the poor. It would also end penalties for not having insurance, although insurers would be allowed to impose a 30 percent surcharge on customers who let their coverage expire for more than two months and then seek to renew it.

Shares of hospitals, which have fallen after the plan was unveiled on Monday, ended broadly higher on Thursday, with Tenet Healthcare (NYSE 🙂 climbing 3.4 percent. Shares of health insurers were mixed, with most large insurers modestly higher and Medicaid-focused insurers finished negatively, including a 3.3 percent drop for Molina Healthcare.

While Republicans have been eager for seven years to dismantle the iconic domestic policy achievement of former Democratic President Barack Obama, the party has failed to join the plan put forward 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 lobbyists have criticized it as too similar to Obamacare. They have harshly criticized their proposed tax credits as an unacceptable new government rights program and called for a quicker end to the expansion of Obamacare Medicaid.

The measure is the first major legislative test for Trump and his fellow Republicans amid questions about whether they can govern effectively after years as an opposition party under Obama.

Ryan, with his shirt sleeves rolled up and using a video screen with facts and figures, gave what he called a “town hall-style” presentation to reporters on the proposal. But his target audience appeared to be fellow Republicans, and he said his party must “really keep our word.”

“The time is now,” said Ryan, who has long been the target of criticism from some conservatives. “This is the closest we will get to repealing and replacing Obamacare,” Ryan added.

McConnell had a similar message, saying, “We need to get into a mode of government and start thinking about accomplishing something rather than just some kind of combat.”

Democrats denounced the bill as a gift to the rich that would force millions of people off the insurance lists. Republicans said there was a need to roll back the government’s “nanny state” role in the more than $ 3 trillion US healthcare system.

“Trumpcare is a loser for almost the entire United States, unless it is in the top 1 percent,” said Senate Democratic leader Chuck Schumer.

The Budget Committee of the House of Representatives next Wednesday will merge the provisions approved by the two committees into a bill that will be voted on by the full House before it reaches the Senate. Republican leaders are looking to April for approval of the bill by Congress.


In a series of tweets early Thursday, conservative Republican Sen. Tom Cotton urged his House colleagues to stand down, saying his measure could not pass the Senate without major changes. “What matters in the long run is better and more affordable healthcare for Americans, NOT the arbitrary legislative schedule of House leaders,” Cotton wrote.

But White House spokesman Sean Spicer expressed confidence in the prospects for the legislation. “We are not putting this down people’s throats,” 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 Congressional Budget Office, which is expected early next week to release its closely monitored cost assessment and coverage implications of the bill, would conclude. that at least 15 million people would lose their health insurance.

Credit rating agency Standard & Poor’s previously estimated that 6-10 million people could lose health insurance coverage.

Before the Energy and Commerce Committee vote, the Conservatives, at the request of the panel chairman, withdrew an amendment sponsored by Republican Joe Barton that would advance two years, until next January 1, the end of the Medicaid expansion. Barton said he planned to try to offer the amendment in the House.

Committee chair Greg Walden praised the unanimity of Republicans on the committee to pass the bill.

Obamacare enabled 20 million previously uninsured people to get coverage. About half came from the expansion of Medicaid.

The proposed bill’s changes to Medicaid funding could hurt smaller and less diverse health insurers, Fitch Ratings said, and the unintended and unintended consequences of a bill of this size are likely to create uncertainty for all companies. health insurers.

With doctors, hospitals, seniors, health plans, Democrats, some governors and conservative Republicans against the bill, it may not make it out of the House, said Mario Molina, CEO of managed care company Molina Healthcare. , In an interview.

“If it does, I think the Senate is going to slow things down and really take a good look at it,” Molina said. “We will have to wait for the Senate to be more moderate.”