{"id":20589,"date":"2017-01-28T05:42:50","date_gmt":"2017-01-28T05:42:50","guid":{"rendered":"http:\/\/www.biphoo.com\/bipnews\/?p=20589"},"modified":"2017-01-28T05:42:50","modified_gmt":"2017-01-28T05:42:50","slug":"in-private-republican-lawmakers-agonize-over-health-law-repeal","status":"publish","type":"post","link":"https:\/\/www.biphoo.com\/bipnews\/news\/in-private-republican-lawmakers-agonize-over-health-law-repeal.html","title":{"rendered":"In Private, Republican Lawmakers Agonize Over Health Law Repeal"},"content":{"rendered":"
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In Private, Republican Lawmakers Agonize Over Health Law Repeal<\/span><\/strong><\/span><\/h2>\n

In Private, Republican Lawmakers Agonize Over Health Law Repeal:-<\/strong> Congressional Republicans, meeting behind closed doors this week in Philadelphia, expressed grave concerns about dismantling the Affordable Care Act on the urgent timetable demanded by President Trump, fretting that, among other things, they could wreck insurance markets and be saddled with a politically disastrous \u201cTrumpcare.\u201d<\/span><\/p>\n

An audio recording of a session at their annual retreat, obtained by The New York Times, shows Republicans in disarray, far from agreement on health policy, and still searching for something to replace former President Barack Obama\u2019s health care law. While their leaders called for swift action to rescue consumers from the Affordable Care Act, some backbench Republicans worried about potential pitfalls.<\/span><\/p>\n

\u201cWe had better be sure that we are prepared to live with the market being created,\u201d said Representative Tom McClintock of California, because \u201cthat\u2019s going to be called Trumpcare.\u201d<\/span><\/p>\n

He added, \u201cRepublicans will own it lock, stock and barrel, and we\u2019ll be judged on that.\u201d<\/span><\/p>\n

When Democrats were writing the Affordable Care Act seven years ago, their primary goal was to provide health insurance to more people, an ambition that the Obama administration went to great lengths to fulfill as it enrolled millions of people in Medicaid or private health plans.<\/span><\/p>\n

Now, as Republicans try to devise a replacement for the law, they have set a nearly impossible standard for themselves: They have promised that none of the 20 million people who gained coverage through the Affordable Care Act will lose it if the law is repealed, even as they lift its mandates and penalties, pull back the tax increases that pay for it and pledge to enact a new program that will be cheaper for taxpayers and consumers.<\/span><\/p>\n

In their private session, the recording of which was first reported on by The Washington Post, Republicans revealed that they understood the predicament they had largely created for themselves.<\/span><\/p>\n

\u201cI recognize that we can\u2019t keep Obama\u2019s promises,\u201d Representative Tom MacArthur of New Jersey said. \u201cThey were wrong to begin with, and the system can\u2019t be sustained.\u201d He worried aloud about the possibility that some people could lose insurance as the law is unwound.<\/span><\/p>\n

\u201cWe\u2019re telling those people that we\u2019re not going to pull the rug out from under them, and if we do this too fast, we are, in fact, going to pull the rug out from under them,\u201d Mr. MacArthur said. After giving states the choice to expand Medicaid under the law, he said, reversing that expansion too quickly would run the risk of pulling a \u201cbait and switch with the states.\u201d<\/span><\/p>\n

The lawmakers\u2019 concerns contrasted with the confidence that Republican leaders and President Trump have expressed as they rush to replace Mr. Obama\u2019s signature domestic achievement, also known as Obamacare. Congress this month approved a budget blueprint that clears the way for quick action to repeal major provisions of the law, and Mr. Trump has said Congress should repeal and replace the law at the same time, putting pressure on lawmakers to agree on an alternative.<\/span><\/p>\n

That budget measure created an aspirational deadline to draft repeal legislation by Jan. 27, a day that came and went.<\/span><\/p>\n

Privately, Republicans made clear they understand the risks they are running. At their session this week, they voiced concern that their efforts to undo the law could have harmful consequences, such as inadvertently destabilizing insurance markets \u2014 a concern shared by Democrats and insurers.<\/span><\/p>\n

Under Senate rules, the Senate could vote to repeal major provisions of the Affordable Care Act using fast-track procedures that neutralize the threat of a Democratic filibuster. \u201cWe can repeal parts of it,\u201d Mr. McClintock said, \u201cand the parts that remain, I\u2019m concerned, could make the market even more dysfunctional.\u201d<\/span><\/p>\n

Republican leaders tried to reassure anxious backbenchers, making the same points in private as they have in public.<\/span><\/p>\n

\u201cWe don\u2019t own Obamacare,\u201d said Senator John Barrasso of Wyoming, the chairman of the Senate Republican Policy Committee, adding: \u201cWe are the rescue party. We campaigned to provide relief and help repair the damage.\u201d<\/span><\/p>\n

Republican leaders have predicted that Democrats will come to the table to help draft a replacement once it becomes clear that the health law will be repealed. But some rank-and-file members were not so sure.<\/span><\/p>\n

Representative John Katko of New York wondered what Republicans would do \u201cif we can\u2019t get anything out of the Democrats.\u201d<\/span><\/p>\n

Another New York Republican, Representative John J. Faso, warned colleagues they were playing with fire if they cut off funds for Planned Parenthood clinics, as Speaker Paul D. Ryan has said Republicans intend to do.<\/span><\/p>\n

\u201cHealth insurance is going to be tough enough for us to deal with, without allowing millions of people on social media to come to Planned Parenthood\u2019s defense,\u201d Mr. Faso said. He wanted to know from the administration that \u201cwe\u2019re not going to have a tweet from the president\u201d saying \u201cwe should protect Planned Parenthood.\u201d<\/span><\/p>\n

\u201dWe\u2019re making a grave mistake including this Planned Parenthood provision in a health care bill,\u201d he said.<\/span><\/p>\n

For many Republicans, coverage and cost are still the most important issues. Estimates of the number of people who will gain or lose coverage will affect the outlook for any proposal to dismantle and replace the 2010 law. If the Congressional Budget Office, the nonpartisan scorekeeper on Capitol Hill, concludes that a significant number of people could lose coverage under a Republican plan, opposition from lawmakers \u2014 including Republicans \u2014 could jeopardize passage.<\/span><\/p>\n

Before Mr. Trump stepped into the debate with his call for \u201cinsurance for everybody,\u201d Republicans were choosing their words with utmost caution: Their goal in replacing the health law was to guarantee \u201cuniversal access,\u201d they said, not necessarily universal coverage.<\/span><\/p>\n

\u201cWe will give everyone access to affordable health care coverage,\u201d Mr. Ryan said in early December when asked if Republicans had a plan to cover everyone.<\/span><\/p>\n

But that discipline has broken down as lawmakers hear from constituents terrified of losing insurance and as Mr. Trump weighs in.<\/span><\/p>\n

\u201cNo one who has coverage because of Obamacare today will lose that coverage,\u201d Representative Cathy McMorris Rodgers of Washington, the chairwoman of the House Republican Conference, said on Jan. 10.<\/span><\/p>\n

A spokeswoman for Ms. McMorris Rodgers later tried to clarify what she had said. The congresswoman \u201cdidn\u2019t deliver her remarks exactly as prepared,\u201d the spokeswoman said. In the prepared remarks, Ms. McMorris Rodgers included an important qualification: \u201cNo one who has coverage because of Obamacare today will lose that coverage the day it\u2019s repealed\u201d \u2014 in the transition to a new market-oriented health care system.<\/span><\/p>\n

But Senator John Cornyn of Texas, the No. 2 Senate Republican, has made a sweeping commitment just like the one by Ms. McMorris Rodgers. After meeting with governors on Jan. 19, Mr. Cornyn was asked about concerns that people who benefited from the expansion of Medicaid might lose that coverage with a repeal.<\/span><\/p>\n

\u201cWe\u2019re all concerned, but it ain\u2019t going to happen,\u201d Mr. Cornyn said. He amplified the point, adding: \u201cNobody\u2019s going to lose coverage. Obviously, people covered today will continue to be covered. And the hope is we\u2019ll expand access. Right now 30 million people are not covered under Obamacare.\u201d<\/span><\/p>\n

A spokesman for Mr. Cornyn said he \u201cmeant no one will lose access to coverage.\u201d<\/span><\/p>\n

Chris Jacobs, a health policy analyst who used to work for Republicans in Congress, said Republicans and Mr. Trump were at risk of overpromising, just as Mr. Obama did.<\/span><\/p>\n

\u201cConservatives should not remain fixated on the number of people with health insurance when designing an Obamacare alternative,\u201d Mr. Jacobs said. \u201cWe will never win the battle with liberals if you measure success in terms of how many people have health insurance cards. We don\u2019t want to spend as much as liberals, and we don\u2019t believe in coercing people to buy insurance.\u201d<\/span><\/p>\n

Democrats remember how Republicans hounded Mr. Obama for breaking his promise that \u201cif you like your health care plan, you can keep your health care plan.\u201d Democrats say they will hold congressional Republicans and the Trump administration accountable in the same way.<\/span><\/p>\n

Increasing the number of people with insurance was a lodestar for the Obama administration. It spent tens of millions of dollars advertising the benefits of the law. It extended deadlines to give people more time to sign up. It allowed many people to sign up outside the regular annual enrollment period and played down the significance of big premium increases, saying consumers could get subsidies to defray the costs.<\/span><\/p>\n

Republicans say they can get the same results for less money and without a statutory mandate that most Americans have insurance. But without that requirement, budget analysts say, it will be difficult for Republicans to achieve coverage gains as large as those achieved under the Affordable Care Act.<\/span><\/p>\n

\u201cIt\u2019s easier for the Congressional Budget Office to estimate significant coverage effects if there is a federal requirement\u201d for people to have insurance, said Douglas W. Elmendorf, who was the budget office director from 2009 to 2015. \u201cIt would be very hard to maintain the levels of insurance coverage we have now without the penalties and subsidies.\u201d<\/span><\/p>\n

Source:-\u00a0https:\/\/www.nytimes.com\/2017\/01\/27\/us\/politics\/affordable-care-act-republican-retreat.html?_r=0<\/span><\/p>\n

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