Published: Sat, March 18, 2017
Economy | By Melissa Porter

Ryan Clings to Core of GOP Obamacare Bill as Opposition Mounts

While the White House and GOP leaders are touting the change of heart among Republican Study Committee members, the House Freedom Caucus still remains opposed to the health care bill.

To his credit, one of Donald Trump's first acts as the new President was to repeal Obamacare, which helped to lift penalties off Americans.

The Republican Governor felt the expansion worked well and that it should still be allowed in the GOP bill as long as states will allow it.

House Speaker Paul Ryan has told senior Republicans that he won't change the main pillars of his plan to repeal and partially replace Obamacare, even as Republicans search for tweaks that can break their logjam over the legislation.

"We're working hand in glove with the White House", Ryan said.

By many accounts Trump has been closely involved in negotiations on the health bill, including calling Budget Committee members ahead of Thursday's vote, but he is seen as focused on delivering his "repeal and replace" promise and flexible on the fine print.

Nevertheless, House Speaker Paul Ryan tried to strike an optimistic tone as he addressed reporters Thursday for his weekly press briefing.

"The fact is he understands and he's a businessman and he understands the art of the deal and he's listening to the concerns here in the House and the Senate and he wants to try to get this thing moving forward", said Rep. Lou Barletta, a Republican from Pennsylvania and early Trump endorser. Only two Republican senators can defect from the bill without affecting its chances in the Senate.

State governments run Medicaid with reimbursements from the federal government.

In a report this week that prompted many GOP lawmakers to emerge as opponents, the nonpartisan Congressional Budget Office said the legislation would leave 24 million people uninsured in a decade, including 14 million next year, and boost out-of-pocket costs for many.

If funding is ultimately reduced, Kasich, Snyder, Sandoval and Hutchinson say Congress must also change the relationship between the states and federal government.

Ryan told reporters that GOP leaders could now make "some necessary improvements and refinements" to the legislation, reflecting an urgency to buttress support. Rep. Robert Aderholt, R-Ala., among those who met with Trump, said the president "told his people" to work on changes making the measure more generous for lower-earning and older Americans.

The official national figure of 12.2 million excludes 765,000 people signed up under a related Obama-era law used by NY and Minnesota.

The GOP replacement also is meeting resistance from some Republican governors. It eliminates the "Obamacare" mandate to buy health insurance, limits tax credits and unwinds a Medicaid expansion, but some conservatives say it doesn't go far enough.

"Anything that can get 218 votes and make the bill better, we're all about it", Rep. Moving up the end of Medicaid expansion from 2020 to 2018 is a "nonstarter", said Representative Charlie Dent of Pennsylvania, a co-chairman of a group of House moderates. Charles Grassley, R-Iowa, said the measure lacked the votes to pass in the Senate, where Republicans hold a precarious 52-48 majority.

Representative Phil Roe of Tennessee, an influential voice in the party on health care who co-chairs the GOP Doctors Conference, said several significant changes to the health care plan were likely, including an increase in tax credits for people ages 55-65, because costs "are pretty high" for them. Experts said the figures undercut Republican claims that the health law's insurance markets are teetering toward collapse.

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