Health Care

GOP Turns Gloomy Over Obamacare Repeal

Politico: “A feeling of pessimism is settling over Senate Republicans as they head into a week-long Memorial Day recess with deeply uncertain prospects for their push to repeal Obamacare. Senators reported that they’ve made little progress on the party’s most intractable problems this week, such as how to scale back Obamacare’s Medicaid expansion and overall Medicaid spending.”

“Republicans have started writing the very basics of their repeal legislation, even though they’ve made few decisions about what it will say. Staffers will work on the bill over the break to try to increase the pace of negotiations, as well as haggle with the Senate parliamentarian over whether the chamber can even consider the bill because of procedural reasons. But in the meantime, frustrations are rising and confidence is diminishing.”

Not Much Good News for Republicans In CBO Report

David Nather: “You have to try pretty hard to find good news for the Republicans in the Congressional Budget Office report on the final House health care bill. Individual insurance premiums would go down in the long term — with some pretty important exceptions — and the House might not have to vote again. And that’s about it.”

New York Times: “The CBO… warned that a last-minute amendment made to win conservative votes would result in deeply dysfunctional markets for about a sixth of the population. In those places, insurance would fail to cover important medical services, and people with pre-existing illnesses could be shut out of coverage, the budget office said.”

For members: We Don’t Need a CBO Score to See Political Suicide

GOP Health Bill Would Leave 23 Million Uninsured

The CBO finds that the health-care bill that passed the House would leave 23 million more Americans uninsured by 2026, the Washington Post reports.

“The new estimate, which reflects a series of last-minute revisions Republicans made in order to win over several conservative lawmakers and a handful of moderates, calculates that the American Health Care Act will reduce the federal deficit by $119 billion between 2017 and 2026.”

Bloomberg: “The CBO said in its projection that more people will get insurance but that the coverage under those plans would be less generous. In some cases, people would use tax credits under the law to buy plans that don’t cover major medical risks.”

David Nather: “But CBO is warning Congress that the latest changes — letting states opt out of two of the ACA’s main insurance regulations — could ruin the insurance markets in those states even if they make insurance cheaper for healthy people.”

For members: It Was Never a Health Care Bill

McConnell Still Doesn’t See Path for Obamacare Repeal

Senate Majority Leader Mitch McConnell (R-KY) told Reuters that he “has yet to hit upon a formula for repealing Obamacare and replacing it with a new healthcare program.”

Said McConnell: “I don’t know how we get to 50 votes at the moment. But that’s the goal.”

He declined to provide any timetable for producing even a draft bill to show to rank-and-file Republican senators and gauge their support.

One Thing That Won’t Change with New CBO Score

Caitlin Owens: “There’s a lot of uncertainty about how the Congressional Budget Office will estimate the costs of the GOP health care bill the House passed earlier this month. But one thing that’s almost certain: It won’t change its estimate that 14 million people will lose their Medicaid coverage.”

“That’s because the House didn’t change the bill’s Medicaid provisions since CBO analyzed an earlier version of the bill. It makes significant cuts to the program, which will knock millions of people off their coverage. It then pairs these cuts with tax credits for those on the individual market, which fall well short of what very low-income people need to afford insurance, experts say.”

Fate of GOP Health Care Bill Depends on CBO Score

“House Republicans are waiting anxiously for a new financial estimate Wednesday on their Obamacare repeal proposal that could force them into an embarrassing do-over on the bill they barely passed early this month,” Bloomberg reports.

“For the health plan to comply with requirements for using a streamlined Senate process called reconciliation, the CBO will have to conclude that it reduces the deficit by at least $2 billion over 10 years. If not, the House will have to redo the bill to meet that standard and vote on it again. And that won’t be easy after the weeks of negotiations and revisions that led to the American Health Care Act’s May 4 passage by a narrow 217-213 House majority.”

David Nather: What to watch from the CBO score.

Corker Blasts Process for GOP Health Care Bill

Sen. Bob Corker (R-TN) “unexpectedly torched his party’s process for crafting an Obamacare repeal bill behind closed doors,” the HuffPost reports.

Said Corker: “It’s a very awkward process, at best. There are no experts. There’s no actuarials… Typically, in a hearing, you’d have people coming in and you’d also have the media opining about if a hearing took place, and X came in and made comments.”

“Corker’s frustrations come as Republicans continue to struggle with how, exactly, to repeal and replace the Affordable Care Act. The House barely passed its bill, which is going nowhere, earlier this month. Senate leaders delegated the task of drawing up a bill in that chamber to a group of 13 Republicans who have been quietly meeting. Corker said he went to one of their meetings to offer input because he’s worried they’re going to unveil a final bill that hasn’t been shaped by public hearings or media analyses.”

Obamacare Repeal Is Now Up to McConnell

Politico: “Mitch McConnell has sidestepped the Russia controversy that’s dogged Donald Trump all year and eluded the wrath rained down on Paul Ryan over the GOP’s Obamacare repeal effort. But the health care reform battle is now squarely in McConnell’s court: He will decide the contents of the Senate’s plan, most likely behind closed doors. And he is on the hook for getting something through a sharply divided Senate Republican Conference in the midst of an increasingly imperiled presidency.”

“So far, McConnell has led a series of closed-door meetings with senators, where they’ve mainly aired their grievances with the House bill without making substantive progress, according to attendees. In the coming days, McConnell will have to move to break the impasse.”

Trump Will Propose Massive Cuts to Medicaid

“President Trump’s first major budget proposal on Tuesday will include massive cuts to Medicaid and call for changes to anti-poverty programs that would give states new power to limit a range of benefits… despite growing unease in Congress about cutting the safety net,” the Washington Post reports.

“For Medicaid, the state-federal program that provides health care to low-income Americans, Trump’s budget plan would follow through on a bill passed by House Republicans to cut more than $800 billion over 10 years. The Congressional Budget Office has estimated that this could cut off Medicaid benefits for about 10 million people over the next decade.”

“The White House also will call for giving states more flexibility to impose work requirements for people in different kinds of anti-poverty programs, people familiar with the budget plan said, potentially leading to a flood of changes in states led by conservative governors.”

Trump Wants to End Obamacare Subsidies

President Trump “has told advisers he wants to end payments of key Obamacare subsidies, a move that could send the health law’s insurance markets into a tailspin,” Politico reports.

“Many advisers oppose the move because they worry it will backfire politically if people lose their insurance or see huge premium spikes and blame the White House, the sources said. Trump has said that the bold move could force Congressional Democrats to the table to negotiate an Obamacare replacement.”

House May Need to Vote Again on Health Care Bill

“House Republicans barely managed to pass their Obamacare repeal bill earlier this month, and they now face the possibility of having to vote again on their controversial health measure,” Bloomberg reports.

“House Speaker Paul Ryan hasn’t yet sent the bill to the Senate because there’s a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority.”