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Susan Walsh, AP Photo

Future of revamped health care bill remains dubious in House

By Alan Fram and Julie Pace, Associated Press  |  Posted Apr 21st, 2017 @ 3:04pm


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WASHINGTON (AP) — President Donald Trump on Friday downplayed the significance of pushing Republican health care legislation through the House next week, a retreat from more bullish White House pronouncements a day earlier, which had gotten a skeptical reception at the Capitol.

In brief comments to reporters Friday, Trump said the attempt to rekindle the GOP drive to repeal President Barack Obama's health care law is "coming along well." But he said there was "no particular rush" to do it next week, when Congress returns from its spring recess.

"It doesn't matter if it's next week. Next week doesn't matter," Trump said at the White House.

Those comments represent a ratcheting back from Thursday, when Trump said at a news conference that there was "a good chance" of passing health legislation soon, adding, "I'd like to say next week."

Amplifying those comments, a senior White House official was also expressing confidence Thursday that a breakthrough on the mired Republican health care bill could emerge in the House next week. That official was not authorized to discuss the internal process publicly and insisted on anonymity.

The White House is eager to pass the health bill quickly, partly because Trump will likely hit his 100th day in office — April 29 — without having signed a major piece of legislation.

But that goal is running straight into the time-consuming, push-and-pull reality of Congress, not to mention enduring divisions between the conservative and moderate wings of Trump's party.

Many GOP lawmakers and aides have expressed doubt that the House would vote next week on health legislation, just a month after an earlier version died for lack of support within the party. They cited the higher priority of passing a spending bill to avert a government shutdown. Also, there's uncertainty over a developing deal to revive the Republican health bill. In any case, it would take time to sell such an agreement to lawmakers.

Republicans are also expressing doubts that a health care compromise that's been discussed between party conservatives and moderates would win enough support to put the bill over the top. The party has long promised to repeal Obama's 2010 health care law, and the House bill would replace it with less generous subsidies and eased insurance requirements.

An outline of a deal has been crafted by Rep. Mark Meadows, R-N.C., who heads the hard line House Freedom Caucus, and Rep. Tom MacArthur, R-N.J., a leader of the centrist Tuesday Group. Vice President Mike Pence also played a role in shaping that plan, Republicans say.

The plan would deliver a win to moderates by amending the GOP health care bill to restore Obama's requirement that insurers cover specified services like maternity care. But in a bid for conservative support, states would be allowed to obtain federal waivers to abandon that obligation.

In addition, states could obtain waivers to an Obama prohibition against insurers charging sick customers higher premiums — a change critics argue would make insurance unaffordable for many. To get those waivers, states would need to have high-risk pools — government-backed insurance for the most seriously ill people, a mechanism that has often failed for lack of sufficient financing.

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Associated Press writer Jonathan Lemire contributed to this report.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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It measure taking shape would deliver a win to moderates by amending the GOP bill to restore Obama's requirement that insurers cover specified services like maternity care. But in a bid for conservative support, states would be allowed to obtain federal waivers to abandon that obligation.

In addition, states could obtain waivers to an Obama prohibition against insurers charging sick customers higher premiums than consumers who are healthy — a change critics argue would make insurance unaffordable for many. To get those waivers, states would need to have high-risk pools — government-backed insurance for the most seriously ill people, a mechanism that has often failed for lack of sufficient financing.

"It looks to me like we're headed in the right direction," Rep. Dave Brat, R-Va., a Freedom Caucus member, said Thursday. He said that assuming the outline is translated into legislative text he backs and is added to the health care bill, he would now support the legislation and believes most of the Freedom Caucus' three dozen members would also back it.

The Tuesday Group has roughly 50 members. They don't necessarily vote as a bloc, and it is unclear how many colleagues MacArthur would bring with him to such an agreement.

The White House is anxious to pass legislation quickly, partly because Trump will likely hit his 100th day in office without having signed a major piece of legislation.

In an interview Thursday with The Associated Press, budget chief Mick Mulvaney said he was surprised at "the toxicity levels" that have divided the GOP over health care and hoped lawmakers' two-week break would prove "healing."

But House GOP leaders face the same problem that's plagued them for seven years of trying to concoct a plan for repealing Obama's 2010 law: The party's conservatives and moderates are at odds over how to do it. With Democrats solidly opposed, Republicans can lose no more than 21 House votes to prevail, and Ryan short-circuited a planned vote last month because more than that would have defected.

That was a major embarrassment to Ryan and Trump, and House leaders are loath to bring a revised health care bill to the House floor unless they are convinced it would pass.

Ryan sent a mixed message about the bill's prospects in remarks Wednesday to reporters in London.

"It's difficult to do. We're very close," he said, adding, "It's just going to take us a little time."

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Associated Press writers Julie Bykowicz, Catherine Lucey, Andrew Taylor and Erica Werner contributed to this report.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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