White House pushes uncertain bid to revive health care bill

Peter Welch

Following the failed attempt to repeal the Affordable Care Act - otherwise known as Obamacare -President Trump indicated that he plans to turn his attention next to tax reform.

Even if the GOP measure eventually passes the House, it's likely to run into big logistical and political problems in the Senate, where moderates have concerns with it and special budget reconciliation rules limit what it can contain. A White House spokesman said only that "no decisions have been made at this time". "As soon as we solve that, we can have a vote", the official said. I'm confident we're going to get there mainly because the president literally not only wants to repeal and replace Obamacare, but the other part of that is he wants to drive down premiums for all Americans.

"Are you shocked?", he said in reference to health care and passing a continuing resolution to fund the government next week.

Already, voters from around the country have hammered Republican lawmakers at town halls over the GOP's health care plan.

"The moment you call it 'repeal and replace, ' you make it impossible for a Democrat to support the bill", he said.

The colleagues he has spoken with appear "cautiously optimistic", Cole added.

On Thursday, they released details of their new plan that, if passed, would gut protections for Americans with pre-existing health conditions.

I think it is best to understand the periodic reemergence of the American Health Care Act as similar to the periodic searches for evidence that President Barack Obama really did "tapp" Trump's phones. "We're still waiting to figure out what President Trump is going to embrace", says Traub, who's now at the consulting firm Deloitte.

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Jon Traub, a former Republican staff director at the tax-writing House Ways and Means Committee, says the outlines of a Trump tax bill are still unclear.

Press Secretary Sean Spicer was stumped at a recent White House press conference, because he was unable to name a single legislative accomplishment for the Trump administration within its first 100 days.

But there are significant obstacles.

And there are serious philosophical divides between the House's more moderate and conservative members. The spending the Freedom Caucus hates is what keeps coverage levels high. Does the GOP's health care bill get rid of pre-existing conditions?

While the changes could win over some conservatives in the Freedom Caucus, aides expressed doubts it will win over a number of centrists, who are critical to getting a bill through the House in the face of unanimous opposition from Democrats.

According to a summary of the proposal, states would get a limited waiver option where they could apply for exemption from certain federal standards, including essential health benefits and community rating. Under the so-called MacArthur Amendment, states could never allow insurers to price plans based on gender or to turn away people because of pre-existing conditions. Conservatives argue funding for high-risk pools could fill the gap, but opponents say high-risk pools were underfunded and did not work before ObamaCare.

The plan also doesn't address the concerns of moderates who are anxious about cuts to Medicaid and tax benefits that are too small to help people purchase individual coverage.

The House Freedom Caucus, the most conservative GOP members in the chamber, had objected to the Affordable Care Act's requirement that all insurers provide specific benefits, like hospitalization coverage, obstetric care or annual checkups. Politico has a summary of changes to the bill. Much of the coverage loss stemmed from the reductions to Medicaid. With Democrats solidly opposed, Republicans can lose no more than 21 House votes to prevail, and Ryan short-circuited a planned vote last month because more than that would have defected. Remember, it took Obamacare 17 months. The new poll was conducted April 12-18 among 1,062 respondents in the United States and has a margin of error of plus or minus 3 percentage points.

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