US Republican leaders grappled Wednesday with the possibility that their much-awaited Obamacare replacement bill goes down in flames, as rebels within the party demand sweeping changes before they get on board.
Seven years after Barack Obama’s landmark health care reforms became law — a period when Republicans repeatedly tried and failed to yank Obamacare out by its roots — the House and Senate will soon vote on a “repeal and replace” effort that hangs in the balance.
Staunch conservatives hate the new plan’s similarities to Obama’s law. Moderate Republicans are nervous that the new bill winding through the House of Representatives would cause many struggling families to suffer, a prospect highlighted by a damning congressional projection that 24 million people could lose insurance within a decade under the new bill.
And Senator Rand Paul, a key opponent in the upper chamber of Congress who wants the entire plan scrapped, went so far as to accuse House Speaker Paul Ryan of misleading President Donald Trump about the legislation, which the White House supports.
Ryan “is selling him a bill of goods that he didn’t explain to the president,” Paul told reporters at a rally on Capitol Hill where he and other Republicans voiced their opposition to the legislation.
Trump — and many congressional Republicans — campaigned relentlessly last year on a pledge to “repeal and replace” the Affordable Care Act.
But the solution introduced in the House, already facing united opposition from Democrats, has been eviscerated by some in Trump’s own party.
Paul urged activists to send a message to House conservative Republicans: “Tell them you want them to stand firm, you want to bring down the Paul Ryan plan.”
Enough opposition has swelled from Republicans in the Senate, where the party holds a narrow 52-48 majority, that the bill almost certainly will not pass without major changes.
“All of us are concerned about it,” Republican Senator John McCain told AFP.
McCain is one of several senators raising warning flags over the plan’s ending the expansion of Medicaid, the health care program for the poor and disabled.
The Congressional Budget Office on Monday projected that millions of Americans could lose their coverage if federal funding dries up for the expansion.
“My state is a Medicaid state, so obviously we have to address that,” McCain said.
“There are a lot of issues that concern me” about the bill, moderate Republican Senator Susan Collins added, including the Medicaid expansion rollback.
Ryan told Fox News on Monday that the legislation, which likely heads to a House vote next week, would ultimately include “refinements and improvements” before heading to the Senate.
But he appeared to reject the prospect of an overhaul of the bill.
“The major components are staying intact, because this is something we wrote with President Trump,” Ryan said.
Congressman Mark Meadows, who heads the fiery conservative House Freedom Caucus, said he has been in regular contact with the administration about the plan and stressed that Trump is open to changes.
“I think he is looking for amendments to be made to make it better,” Meadows told reporters at the rally, where he received a roar of approval from demonstrators.
“Ultimately it’s going to have to be amended in order to gain enough support to get passage on the House floor.”
The Republican plan replaces Obamacare’s government subsidies with tax credits to help individuals buy insurance, but critics say the credits are not enough to cover insurance costs for lower-income families.
Meadows said one of his bill priorities is to add a work requirement on Medicaid recipients.
Several Republicans, including some governors in states that expanded Medicaid, believe that such expansion to low-income adults without disabilities gives them an incentive not to work.
“There’s still plenty of time to work on this in the House and in the Senate,” he said.
“We need to get it right because the status quo cannot hold.”
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