President Trump on Tuesday will personally urge House Republicans to rally behind legislation to repeal and replace Obamacare, as GOP leaders dig in for a three-day push that could make or break the White House’s agenda moving forward.
Mr. Trump, who frequently boasts about his negotiating skills, will head to the Capitol to lobby conservatives who say the plan doesn’t go far enough, and centrists who’ve demanded more help for older Americans whose premiums would rise under the GOP plan.
House Republicans late Monday said they would set aside at least $75 billion to help people who buy insurance on their own but aren’t quite old enough for Medicare, the popular program for seniors, as party leaders scrounge up the 216 GOP votes needed to pass the bill during a floor vote scheduled for Thursday.
Their amended bill doesn’t actually beef up the tax credits for Americans aged 50 to 64 — it simply leaves room for the Senate to do it — though it formalizes agreed-upon changes to Medicaid designed to reel in a vital bloc of conservatives.
Mr. Trump said he’s willing to work with Mr. Paul on necessary changes to get the health bill done and then move on tax reform.
The House Freedom Caucus, a group of 30-plus Republicans that frequently spars with leadership, remains the most visible impediment to the bill in the lower chamber. Its chairman, Rep. Mark Meadows of North Carolina, said the group didn’t plan on taking an official position on the bill late Monday, leaving the door open to arm-twisting from Mr. Trump and GOP leadership, though members say the votes simply aren’t there.
“They haven’t changed the bill’s general framework. They don’t have the votes to pass it. They have seriously miscalculated,” Rep. Justin Amash, Michigan Republican, said on Twitter.
House Speaker Paul D. Ryan and his chief aides have a lot riding on Mr. Trump’s role as the ultimate “closer,” from fulfilling their seven-year pledge to kill Obamacare to maintaining enough momentum to overhaul the tax code before the summer recess.
“These next few days could define us for years to come. We ran for Congress to do big things and save our country from leftist progressivism,” House Majority Whip Steve Scalise said late Sunday in a letter to his whip team. “We ran for Congress to seize the opportunity and achieve the promise that the American people have bestowed upon us.”
Republicans can’t lose more than 21 GOP votes, because every Democrat is expected to reject the bill that repeals most of Obamacare’s taxes and its individual mandate, replaces the ACA’s generous subsidies with refundable, age-based tax credits and reins in and caps spending on Medicaid by 2020.
A “manager’s amendment” submitted late Monday would repeal many of Obamacare’s taxes sooner — this year instead of 2018 — while barring any more states from expanding their Medicaid populations and receiving generous federal matching funds outlined by the 2010 law.
The implementation of the so-called “Cadillac tax” on particularly generous employer plans is moved back from 2025 to 2026.
Democrats said they’ve invited their own cheerleader to the Capitol, former Vice President Joseph R. Biden, to rally in defense of Obamacare Wednesday, saying the GOP bill would fully unwind its extension of coverage to more than 20 million Americans.
The House Rules Committee will meet early Wednesday to vet final changes to the GOP replacement and set the terms of debate for floor votes Thursday — the seventh anniversary of Obamacare’s passage. Republicans in the Senate are already mulling its own changes, however, so the House would likely have to revisit the plan down the road.
As written, the Congressional Budget Office estimated the plan would save more than $300 billion but result in an eye-popping 24 million fewer people being insured a decade from now.
Criticism of the plan continued to pour in Monday, as doctors’ groups and America’s Catholic bishops said there were laudable parts of the legislation but that it fell woefully short in maintaining coverage for needy Americans.
Republican leaders have pleaded with conservatives and outside lobbies to give them more time. They say the bill, which leverages budget rules to avoid a Democratic filibuster later on, is simply the first part of a three-pronged strategy to bring health costs down. Phase two involves regulatory action by the Trump administration, while phase three would require Democratic support for future GOP legislation.
Mr. Trump reeled in members of the Republican Study Committee by agreeing Friday to amendments that would make changes to Medicaid, the insurance program for the poor.
The changes would allow states to impose work requirements on able-bodied people in the program and let governors accept a block grant of federal funding for the program instead of a per-capita allotment.
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