Republicans senators conceded Thursday that a scathing analysis of the House GOP health care bill had complicated their effort to dismantle President Barack Obama’s health care law. ”It makes everything harder and more difficult,” Sen. Dean Heller, R-Nev., said of a Congressional Budget Office analysis projecting that the House bill would cause 23 million Americans to lose coverage by 2026 and create prohibitively expensive costs for many others. ”There’s blinking yellow lights throughout the whole thing,” Sen. Patrick Toomey, R-Pa., said of the report by lawmakers’ nonpartisan fiscal experts. Congress now begins a week-long recess, with GOP senators still hunting for a health-care overhaul plan that can win the support of no less than 50 of their 52 members. All Democrats seem likely to oppose the bill, and Vice President Mike Pence could break a 50-50 tie.
While the analysis of the House-passed plan simply gives senators a numerical starting point for their own work, it also made the Republican health care drive a fatter target for Democratic attacks. And it highlighted how some provisions in the House bill would produce damaging consequences for many people. ”The bottom line is very simple. Unless you’re a healthy millionaire, Trumpcare is a nightmare,” said Senate Minority Leader Chuck Schumer, D-N.Y. ”And I think that’s why our Republican colleagues are having such trouble putting together their own bill.” The House bill would relax many of the Obama statute’s consumer protections, kill its mandate that people buy coverage, trim federal subsidies for insurance purchasers and cut the Medicaid program for lower-income and disabled people.
Senate Republicans have been holding private meetings to narrow differences and produce their own health care package. They’ve said it will differ markedly from the House measure, including easing some Medicaid reductions and focusing tax credits for buying coverage more at poorer people. The No. 2 Senate GOP leader, John Cornyn of Texas, expressed optimism that senators were narrowing differences and said staff could ”start work” over the recess on writing some language of a Senate bill, but he conceded, ”There’s nothing final.” Senate Finance Committee Chairman Orrin Hatch, R-Utah, said, ”We’re still a ways away from having solutions here.”
That’s prompted increased talk of possibly breaking out a less ambitious bill aimed at keeping insurance markets stable over the next two years, Republicans say. That could involve providing money to insurance companies so they can contain customers’ costs, and perhaps retaining Obama’s individual mandate, which imposes tax penalties on people who go uninsured. The budget office concluded that on average, premiums for people buying their own insurance would eventually be lower than under Obama’s 2010 law under the House bill. That would fulfill a chief goal for many Republicans.
But the report said the lower prices would arise largely because many consumers would be buying skimpier coverage and others wouldn’t be able to afford it and would leave the market, particularly the very ill, lower earners and people in their 50s and early 60s. Many people in states that under the bill could permit slimmer benefits and higher premiums for customers with pre-existing conditions ”would face substantial increases in their out-of-pocket costs,” the report said. It said states could choose to let insurers charge extra for maternity coverage with costs that could exceed $1,000 monthly.
Several GOP senators said those problems need to be addressed. Sen. Bill Cassidy, R-La., said he wanted to require maternity coverage and beef up federal aid to help states curb premium increases for people with pre-existing conditions. He said he wanted the Senate bill to have ”a lot more money” than the House measure, which would provide $138 billion over a decade to help states buttress health care markets. And Sen. John Hoeven, R-N.D., said senators were ”kicking around” ideas for strengthening federally-backed high-risk pools that would help states contain out-of-pocket costs for the seriously ill. He said one idea involved charging insurers $1.50 per policy sold and diverting that money into such funds.
Congress’ top two Republicans chose to ignore the report’s troublesome findings in their public comments Thursday.
Senate Majority Leader Mitch McConnell, R-Ky., spoke for several minutes on the Senate floor without even mentioning the analysis. Instead, he discussed a Trump administration report showing that premiums have grown in recent years and accused Democrats of trying to ”blame someone other than themselves for the failures of Obamacare.” House Speaker Paul Ryan, R-Wis., cited the flexibility the House bill would give states to determine coverage requirements and said, ”That’s why I’m actually comforted by the CBO report which shows, yeah, we’ll lower premiums.”