The report from the Congressional Budget Office also said federal deficits would fall by $119 billion between 2017 and 2026 under the bill, which was approved this month by the Republican-dominated House of Representatives. The CBO score raises the stakes for Republican senators now working on their own version of the legislation.
House Republicans came under sharp criticism for passing the bill before the CBO could make its assessment. The Trump administration already has relied on the House bill’s healthcare spending cuts in its proposed federal budget.
The bill is called the American Health Care Act and would fulfill a long-running Republican goal – repealing and replacing much of former President Barack Obama’s 2010 Affordable Care Act, commonly called Obamacare. President Donald Trump, who made replacing it a key campaign promise in 2016, and other Republicans say Obamacare is too costly and creates unwarranted government interference in healthcare decisions.
Congress is aiming to pass the bill under a process called reconciliation, which requires only a simple majority of votes in the Senate, where Republicans hold a 52-48 majority, instead of 60 votes. Under those rules, all elements of the bill must have a direct budgetary impact or else they must be stricken from the legislation.
A group of 13 Republican senators led by Senate Majority Leader Mitch McConnell are expected to draft their own version of the healthcare bill in the coming months. McConnell, however, told Reuters on Wednesday he does not yet know how Republicans will have the necessary votes.
The CBO said federal deficits would fall by $119 billion between 2017 and 2026 under the Republican bill.
The bill would eliminate most Obamacare taxes that help subsidize private health coverage for individuals, roll back the government’s Medicaid health plan for the poor and disabled and replace the law’s income-based tax credits for buying medical coverage with credits based on age.
The new CBO score predicts the AHCA would cover 1 million more Americans than a previous version of the bill, which the agency estimated would have left 24 million more people uninsured than Obamacare in 2026.
In the weeks leading up to the House vote on May 4, two controversial amendments were added to the bill that ultimately helped secure its passage, including one that was added the day before the vote.
One amendment would allow states to opt out of a popular Obamacare provision that prevents insurers from charging people with pre-existing conditions higher rates, as well as one that required insurers to cover 10 essential health benefits such as maternity care and prescription drugs.
Another amendment allocates an additional $8 billion over five years to help people with pre-existing conditions cover medical costs.
Trump promised to repeal Obamacare immediately upon taking office in January but replacing the program that provided health insurance to 20 million people poses political risks.
Hospitals could lose significant revenue because far fewer people will have insurance and insurers are worried about the affordability of the tax structure and proposed major changes in Medicaid financing.
The Republicans’ first attempt at undoing Obamacare resulted in a setback for the Trump agenda in March. Conservative and moderate Republican factions in the House were opposed to the initial legislation and the leadership decided not to put it up for a vote.
They found a consensus through the opt-out amendments on pre-existing conditions, which adds $8 billion for sufferers, and the essential health benefits and passed it on May 4.
Related video: Raul Labrador at the LCSC town hall (Provided by The Daily Dot)
Idaho Republican Rep. Raul Labrador sparked outrage from his audience and online after saying “nobody dies” for lack of health care access in a town hall Friday night at Lewis-Clark State College in Lewiston, Idaho.
“You are mandating people on Medicaid accept dying. You are making a mandate that will kill people,” the audience member said, before being drowned out by Labrador’s response.
“No one wants anybody to die,” Labrador said. “You know, that line is so indefensible. Nobody dies because they don’t have access to health care.”
The line immediately drew audible outrage from the crowd, as well as ire from social media users. Labrador was similarly booed for a comment he made last month that health care isn’t a “basic human right.”
Former Republican presidential candidate Mitt Romney was fiercely criticized for a similar comment he made in 2012.
“We don’t have people that become ill, who die in their apartment because they don’t have insurance,” the former Massachusetts governor told editors of the Columbus Dispatch.
It’s unclear how many people would lose health insurance under the current version of the GOP plan, which has yet to be scored by the Congressional Budget Office.
WASHINGTON — Congressional Republicans on Monday pointed fingers and assigned blame after their epic failure on health care and a weekend digesting the outcome.
The divisions, coming on top of House Republicans’ inability to deliver on a priority they all share — repealing and replacing “Obamacare” — raised serious questions about whether they will be able to achieve their other legislative goals for the year or even pass must-do spending legislation in time to avert a government shutdown at midnight April 28.
The hard-right House Freedom Caucus, which withheld a bloc of votes from the White House-backed health care legislation, came in for most of the criticism from fellow lawmakers.
“Clearly moving forward, we’re going to have to look at where a governing majority comes from. That’s going to require some answers from the Freedom Caucus,” said GOP Rep. Ryan Costello of Pennsylvania.
Like a number of other more moderate-leaning Republicans, Costello said he would have voted “no” on the bill in the end, partly because it kept moving to the right as House leaders and the White House made concessions to the Freedom Caucus without ever succeeding in locking in their support. President Donald Trump and House Speaker Paul Ryan decided to pull the bill from the House floor on Friday after it became clear it was bound to fail.
“They’re going to have to know when it’s time to get to the ‘yes,'” Costello said.
Freedom Caucus members bridled at the criticism, insisting they had done Trump and fellow Republicans a favor by blocking a piece of legislation that polled poorly and embraced the basic structures of Obamacare without significantly reducing premiums.
The Freedom Caucus spokeswoman, Alyssa Farah, said over Twitter that blaming the group ignored the opposition coming from moderate-leaning Republicans. And Rep. Jim Jordan of Ohio, a Freedom Caucus leader, accused GOP leaders of a rushed and secretive process in promoting their legislation, which would have eliminated the Obamacare mandate for people to carry insurance or face fines, and shrunk a Medicaid expansion, but relied on tax credits similar to those in President Barack Obama’s law to help consumers purchase insurance.
“They rolled it out after it was hidden away. When they rolled it out, they said it’s a binary choice, take it or leave it,” Jordan said on MSNBC. “Normally when you have hearings on a piece of legislation that impacts this much of our overall economy, you would bring in some witnesses and hear from some witnesses about what’s going to happen if this legislation actually becomes law. We had none of that.”
The divisions extended to whether Republicans should immediately try again to make good on seven years of promises to repeal and replace the health care law or cut their losses for now and move on to overhauling the tax code, a priority Trump seems more excited about. Senate Republicans, who had hoped to act next on the health legislation despite divisions of their own, voiced displeasure with the failure by their House counterparts.
“It’s disappointing. We’ve got to fulfill our promises,” said Sen. Thom Tillis, R-N.C. “Hopefully the temperatures have gone down just a little bit and we can get to an outcome. We don’t have the option of inaction. We own it and we’ve got to fix it.”
For Republicans who want to show voters they can govern after gaining control of the White House and both chambers of Congress, the outcome on health care suggests the opposite. The one bright spot for the GOP is Trump’s nomination of conservative appeals court Judge Neil Gorsuch to the Supreme Court, which will be considered on the Senate floor the week of April 3.
The disunity comes as Congress is fast approaching a deadline to pass government-wide spending legislation or face a shutdown. Given that lawmakers have a two-week recess in the middle of April, there is little time to negotiate an agreement. In the past such spending deadlines have been occasions for brinkmanship, including in 2013 when conservatives forced a 16-day partial government shutdown in a failed attempt to defund Obamacare.
The tentative game plan this time around to wrap up more than $1 trillion in unfinished spending bills is to draft a bipartisan omnibus measure that would fund the government through Sept. 30. Its outlines remain fuzzy and subject to change according to the whims of GOP leaders, but the working thesis is to craft legislation that could pass by a bipartisan vote without a filibuster by Senate Democrats.
Conservatives, however, may be disappointed that they wouldn’t score many wins in such legislation, even though Republicans control the entire government. They may insist on more money to build Trump’s border wall or even press to “defund” Planned Parenthood. And Democrats could abandon the effort if Republicans press too hard for the border wall or lard in too much extra money for the Pentagon, raising the specter of a shutdown showdown not far away. (AP)
House Republican leaders abruptly pulled a rewrite of the nation’s health-care system from consideration on Friday, a dramatic defeat for President Trump and House Speaker Paul D. Ryan (R-Wis.) that leaves a major campaign promise unfilled and casts doubt on the Republican Party’s ability to govern.
In addition to leaving the Affordable Care Act in place, the news also raises questions about the GOP’s ability to advance other high-stakes agenda items, including tax reform and infrastructure spending. Ryan is still without a signature achievement as speaker — and the defeat undermines Trump’s image as a skilled dealmaker willing to strike compromises to push his agenda forward.
In an interview with The Washington Post, Trump deflected any responsibility for the setback and blamed Democrats instead.
“We couldn’t get one Democratic vote and we were a little bit shy, very little, but it was still a little bit shy so we pulled it,” he said.
“I don’t blame Paul,” Trump said, referring to Ryan.
In a news conference shortly after the decision, Ryan conceded that his party “came up short.”
Trump said he would not ask Republican leaders to reintroduce the legislation in the coming weeks. Instead, he said he would wait for the current law encounter problems, believing that Democrats will want to work with the White House to make changes.
“As you know, I’ve been saying for years that the best thing is to let Obamacare explode and then go make a deal with the Democrats and have one unified deal. And they will come to us, we won’t have to come to them,” he said.
“The beauty,” Trump continued, “is that they own Obamacare. So when it explodes they come to us and we make one beautiful deal for the people.”
Trump said he had no problem waiting for Democrats to seek cooperation with Republicans on health-care.
“I never said I was going to repeal and replace in the first 61 days,” he said.
In fact, Trump said repeatedly as a candidate and before his inauguration that he would work to repeal the ACA on his first day in office. And congressional Republicans have spent the last seven years campaigning to undo the law.
Democrats, completely sidelined as Republicans quarreled among themselves, quickly disputed Trump’s accusations.
“The blame falls with President Trump and with the Republicans,” Senate Minority Leader Charles E. Schumer (D-N.Y.) said in a statement.
“So much for the art of the deal,” he added.
At the Capitol, a deflated Ryan said he would confer with fellow Republicans in the coming days about how to proceed, but he warned that “we’re going to be living with Obamacare for the foreseeable future.”
“Moving from an opposition party to a governing party comes with growing pains. We’re feeling those growing pains today,” he told reporters at a news conference covered by at least 20 television cameras.
“This is a disappointing day for us. Doing big things is hard,” he added. “All of us, all of us — myself included — will need to time to reflect on how we got to this moment.”
The dramatic decision stunned legislators who have spent the last several years crafting proposals to repeal former president Barack Obama’s top domestic policy victory. Some were near tears exiting a meeting where Ryan announced his decision.
Rep. Greg Walden (R-Ore.), chairman of the House Energy and Commerce Committee who wrote much of the legislation under consideration on Friday, told reporters the proposal is “Dead. DOA.”
“We’re done with health care this year,” added Rep. Bill Flores (R-Tex.).
Asked what would happen to the ACA, Rep. Tom Rooney (R-Fla) said, “It’s the law of the land.”
Asked if Ryan had made the correct decision, Rep. Mark Amodei (R-Nev.), said “As long as they’re willing to go to work Monday.”
Before the decision, Rep. Bradley Byrne (R-Ala.) said that Friday would have been the “first big vote in the presidency of Donald Trump. I think it’s a statement, not just about him and the administration, but about the Republican Party and where we’re headed.”
“So much about political power is about perception. And if the perception is that you can’t get your first big initiative done, then that hurts the perceptions down the road about your ability to get other big things done,” Byrne said.
Ryan pulled the bill just a few hours after visiting the White House to warn Trump that despite days of intense negotiations and sales pitches to skeptical members, the legislation lacked the votes to pass.
Trump had personally lobbied 120 lawmakers, either in person or on the phone, White House press secretary Sean Spicer told reporters on Friday.
The president had “left everything on the field,” Spicer said.
No matter what happens, the White House did not think that defeat would slow other parts of Trump’s agenda including tax reform and immigration reform, Spicer added.
Vice President Pence, White House Chief of Staff Reince Priebus and Health and Human Services Secretary Tom Price also made a last-ditch attempt to win over members of the hard-line House Freedom Caucus, huddling with them at midday at the Capitol Hill Club, a GOP social hall next door to the headquarters of the Republican National Committee. All three exited the meeting quickly without taking questions.
Signs of trouble across the Republican spectrum were evident early Friday.
In one stunning defection, House Appropriations Committee Chairman Rodney Frelinghuysen (R-N.J.) announced at midday that the health care bill is “currently unacceptable” and that changes made late Thursday to placate conservatives “raise serious coverage and cost issues.”
Other members, including Rep. David Joyce (R-Ohio) — who had met with Trump on Wednesday night — said he would vote against the bill. So did Rep. Barbara Comstock (R-Va.), a longtime Ryan ally who represents a competitive Northern Virginia congressional district.
Rep. Paul Gosar (R-Ariz.), a Freedom Caucus member, was one of six Republicans who voted against a procedural resolution bringing the bill to the floor on Friday morning.
“You know what? I came here to do health care right,” said Gosar, a dentist. “This is one chance we that can get one-sixth of our GDP done right. It starts with here.”
At the heart of the argument made by GOP leaders to skeptical members: keeping the Affordable Care Act is a worse outcome than passing a potentially flawed replacement. That worked with only some Republicans.
Rep. Joe Barton, a Freedom Caucus member who said he would have voted for the bill, rejected the idea that his caucus was to blame.
“I thought we were constructive,” he said. “Because of the sensitivity of the issue, some of the normal compromise mechanism didn’t quite get us there. That doesn’t mean they won’t get us there some time in this Congress.”
At the White House on Friday morning, Trump had projected confidence as he answered shouted questions following an announcement of a presidential permit for the Keystone XL pipeline, a revived project that the president said would create jobs.
Asked by a reporter what he would do if the bill fails, Trump — seated at his Oval Office desk — shrugged and said: “We’ll see what happens.”
On Twitter, Trump said that “After seven horrible years of ObamaCare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!”
When formal debate on the bill began on Friday morning, top leaders used a procedural vote to gauge last-minute support. House Majority Whip Steve Scalise (R-La.) was seen conferring with Rep. Christopher Smith (R-N.J.), a key holdout. House Ways and Means Committee Chairman Kevin Brady (R-Tex.) sat in the row behind them cajoling Rep. Patrick Meehan (R-Pa.), another moderate who has yet to announce what he plans to do.
Rep. Mark Meadows (R-N.C.), who chairs the Freedom Caucus, did not respond to requests for comment on Friday about his plans.
Rep. Ken Buck (R-Colo), a caucus member who said before the election that minor losses in the House Republican ranks would increase conservative clout, said he remained undecided.
“I’m examining life experiences,” he said. Asked to explain what he meant, he said he was joking.
Rep. Peter King (R-N.Y.), a moderate who had expressed qualms as recently as Tuesday, when he was singled out by Trump inside a private meeting of House Republicans, said he had all but decided to vote for the bill.
“I’m not one they should worry about,” he said.
Rep. Louie Gohmert (R-Tex.), one of Trump’s most ardent congressional supporters, said he remained opposed to the legislation because it made more political sense to keep current law than to start rewriting it.
“A no vote means we save Donald Trump from a Democratic majority in 2019,” Gohmert said. “If this passes, then Obamacare stays.”
Republican leaders had introduced several tweaks intended to appeal to skeptics on either ideological flank. The amendment looks to appease moderates by adding $15 billion to a flexible fund for states to pay for maternity, mental health and substance abuse programs under Medicaid. That money adds to an existing $85 billion pot of money created by leaders earlier in the week.
The amendment attempted to appease conservatives by allowing states to determine the minimum standards for health insurance plans. It would allow insurers to drop basic coverage, like maternity care and preventative screenings, in order to cut premium rates.
Several members from both groups said the new additions were helpful but did not go far enough to win their votes. Moderate Rep. Leonard Lance (R-N.J.) told reporters Friday that he worries the bill still does not give states enough flexibility.
“I think there’s trouble with a significant number,” he said. (The Washington Post)