By MJ Lee
January 16, 2017
Emboldened by
Donald Trump's surprise victory, Republican lawmakers vowed after Election
Night that they wouldn't waste a single day to pursue their most urgent
mission: Kill Obamacare.
The
President-elect, too, has been in a hurry, declaring that the Affordable Care
Act must be repealed and replaced more or less at the same time. "Probably
the same day, could be the same hour," Trump said at a news conference
last week.
But on Capitol
Hill, urgency doesn't always translate into speed.
In the first two
weeks of the new year, Republican leaders have confronted resistance from
rank-and-file lawmakers from across the ideological spectrum. Nervous about the
potential political fallout of moving too fast on Obamacare repeal, some
Republicans are now cautioning restraint -- a stark contrast from their
ferocious attacks against President Barack Obama's signature health care law
over the past several years.
Trump further
complicated matters over the weekend when he told The
Washington Post that he was nearly finished with his own plan to
replace Obamacare and warned that he won't let Congress get in his way.
"The Congress
can't get cold feet because the people will not let that happen," Trump
said.
Although he didn't
offer much in the way of details, the incoming president's comment that he
wants both "insurance for everybody" with "much lower
deductibles" sets the stage for a potential clash and drawn out
negotiations with Republican lawmakers who have been stressing universal access
over universal coverage.
"Repeal and replace
is a bloody complicated exercise," said Brian Fortune, president of the
Farragut Square Group, a health care consulting firm in Washington. "The
challenge for the Republicans is, of course, to rework something without
getting blamed for all the downstream effects -- quite difficult.
Senate Republicans
got the ball rolling on Day One of the new session of Congress, introducing a
budget resolution whose sole purpose was to repeal the health care law.
Following Senate and House approval of the resolution last week, Republicans
now get to work on crafting a second measure -- a budget reconciliation bill --
that contains the language to roll back big chunks of Obamacare.
But leading up to
last week's first procedural vote, Republicans in both chambers expressed deep
reservations.
The overarching
worry among Republicans is that the party will vote to dismantle major portions
of a law that covers some 20 million people before there is even a blueprint
for an alternative, and be held responsible for widespread disruptions in
health insurance.
Complicating matters is the reality that several main pillars
of the law enjoy broad support, such as the pre-existing conditions rule as
well as a provision that allows children under the age of 26 to stay on their
parents' health policy.
In the House, a mix
of conservative and moderate lawmakers was skittish
about supporting the budget resolution. They pressed House Speaker
Paul Ryan for reassurances that the process of replacing Obamacare would unfold
around the same time as the vote to repeal it.
GOP Rep. Charlie
Dent of Pennsylvania told CNN before the vote on Friday that things were moving
too quickly.
"I'm very
concerned on the policy side specifically, that the replacement occur either
simultaneously or as close to simultaneously as possible," Dent said.
"If we don't provide a credible replacement plan, my main concern is that
there would not be gaps in coverage for people who are currently subsidized.
Also concerned about how the insurance markets might react."
Dent -- along with
eight other House Republicans -- ultimately voted against the budget
resolution.
And in the Senate,
a group of five GOP senators introduced an amendment to the budget resolution
to extend the deadline by which to craft the reconciliation bill -- the measure
that would repeal Obamacare -- from January 27 to March 3.
While that deadline
is largely viewed as symbolic and unenforced, the senators were sending a clear
message: We need more time to figure out what's next.
"We just want
to make sure that we get it right," GOP Sen. Susan Collins of Maine, one
of the supporters of the amendment, told CNN. "One of the problems with
Obamacare is that it was rushed through without input from Republicans for the
most part, and we realize that insurance markets are complicated. And we don't
want people to fall through the cracks."
Asked whether the
amendment signaled that Republicans were increasingly less concerned about
overhauling Obamacare on the most expedient timeline, Republican Sen. Bill
Cassidy of Louisiana, another author of the amendment, pushed back.
"My gosh. If
you're going to say we're going to fly to the moon but we're going to do it in
March instead of next week, would you still feel it's pretty urgent?"
Cassidy said. "You'd say, oh my gosh, we've got to get to work!"
Under pressure,
Ryan has grown increasingly emphatic that there will not be long lag time
between a repeal vote and when Congress considers a replacement package or set
of measures.
At a CNN town
hall last week, Ryan went as far as to say that GOP leaders would
repeal and replace "at the same time." But other than to say that
there would be action within the first 100 days of the Trump administration, he
declined to commit to a specific timeline, noting that the whole process would
take "a little bit of time."
But even while
lawmakers in his party are growing wary of acting too quickly, Trump has been
ratcheting up the pressure on Republicans to help him deliver on his campaign
promise as fast as possible.
And if in fact
Trump does release an Obamacare replacement plan of his own, that could present
a series of new challenges for Ryan and Senate Majority Leader Mitch McConnell
who are under pressure to satisfy an array of ideological priorities from
rank-and-file members.
At his news
conference in New York City last week, Trump said that a plan to repeal and
replace the health care law would be submitted "as soon as" Tom
Price, his nominee for Health and Human Services secretary, is confirmed.
Price, a Georgia congressman, will testify before the Senate Health committee
on Wednesday, but the Senate Finance committee, which will vote on his
confirmation, has not yet set a hearing date.
It's unclear what
role Price will have in shaping the GOP's new healthcare system, and a Trump
transition official told CNN that the incoming administration is "taking
nothing for granted" before the congressman's confirmation.
"It's all
about the confirmation," the official said. "Nobody's looking past that
date."
No comments:
Post a Comment