obamacare Archives - Page 3 of 30 - Florida Politics

Puerto Rico governor asks Rick Scott for help addressing health care crisis

The governor of Puerto Rico has asked Gov. Rick Scott for his help in addressing the nation’s healthcare crisis.

In a letter to Scott dated March 17, Gov. Ricardo Rossello said his administration is working hard to stabilize the current fiscal fiscal and economic crisis and to “put the island back on a path of fiscal responsibility and economic growth.” However, he said the so-called Medicaid cliff that will come into effect before the end of 2017 threatens to derail Puerto Rico’s fiscal and economic efforts.

“This could lead to a full-blown collapse of our healthcare system,” he wrote. “Moreover, if this issue is not addressed by Congress in the very near future the fallout will be felt not only in Puerto Rico but also in the states, because the already high rate of migration of the U.S. citizens moving from Puerto Rico to the states will likely increase significantly, affecting Florida in particular.”

More than 440,000 residents of Puerto Rico have moved stateside between 2006 and 2015, driven mostly by better economic opportunities. The loss in population, he wrote to Scott, is “devastating because it decreases our tax base, erodes our consumer base, and diminishes our workforce, which all make our economic recovery more difficult.”

Rossello said he developed a fiscal plan approved by the Financial Oversight and Management Board, created under PROMESA, that reduces spending and spurs economic growth. But federal legislators need to address the Medicaid cliff and “ensure the success of these reforms.”

He asked for Scott’s help in “activating Florida’s congressional delegation as a voice of reason in Congress on this avoidable issue.”

“We are willing to do our part to provide greater accountability, increased spending controls, and prosecute any fraud, waste and abuse tied to federal healthcare dollars,” he wrote. “However, Congress must find a way to include Medicaid funding for Puerto Rico at current levels until ACA replacement comes into effect and must also help Puerto Rico obtain more equitable and fiscally sustainable federal healthcare funding going forward.”

Mike Pence: ‘Florida can’t afford Obamacare anymore’

Saturday saw United States Vice-President Mike Pence and Florida Governor Rick Scott talking about what Pence called “the Obamacare nightmare” with small business owners in Jacksonville.

Scott, who closed out the news week reprising a familiar call to allow the states to administer Medicaid via block grants, has worked closely with President Donald Trump and his administration on possible alternatives to the Affordable Care Act.

While the GOP line is “repeal and replace Obamacare,” finding bill language that offers comfort to moderate Republicans in the Senate and the Freedom Caucus in the House has proven challenging, making promotional media stops like this one for the vice-president a necessity as the Trump administration sets the stage for a House vote on health care next week.

Though support for the current bill may be shaky elsewhere in Florida, in Northeast Florida “repeal and replace” are the watchwords.

After a roundtable event with selected small-business leaders, the show for cameras and media commenced: the highlight, of course, was VP Pence, who Gov. Scott introduced as having stood with him in the health care battle since 2009.

Pence hyped the crowd for a couple of minutes, thanking the other speakers and extolling the virtues of Florida, pivotal on “the path to make America great again.”

“It was quite a campaign, wasn’t it? And it’s been quite an administration.”

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After discussing Trump’s “broad shoulders” and other crowd-pleasing ephemera, including his first job as a gas station attendant in his family’s store, Pence eventually pivoted to policy

“We know that when small business is strong, America is strong,” Pence said, describing the president’s “roll back of reams of red tape” and his work to “end illegal immigration – once and for all.”

“Businesses are already responding to President Trump’s ‘buy American, hire American’ vision,” Pence said, vowing tax cuts “across the board” and restraint of “unelected bureaucrats” and other talking points.

Pence pivoted from the crowdpopping lines to reference the Pulse attack last year, a function of “radical Islamic terrorism in this country.”

The wall will be built. And illegal immigrant criminals will be “off the streets of this country.” And “we will rebuild our military,” Pence said.

From there, Pence assured the crowd that “the Obamacare nightmare is about to end.”

Obamacare, said Pence, is a minefield of broken promises, and the VP has heard heartrending stories about the “hard choices” small businesses have made.

“It was a heartbreaking conversation,” Pence said.

Premiums: up 25 percent across the country.

A third of the country has one company available from which to choose.

And, said Pence, enrollment is down year over year.

“Florida’s actually a textbook example of what’s wrong with Obamacare,” Pence said, citing premiums up 19 percent year over year.

“Florida can’t afford Obamacare anymore,” Pence said to applause.

Referring to the business hosting the event, Pence noted that hundreds of thousands of dollars that could have been spent otherwise have been spent attempting to comply with this “failed” law.

“The core flaw of Obamacare was this notion that you could order every American to buy health insurance whether they need it or not,” Pence said.

The Trump alternative: “individual responsibility” and reform targeted to the state level, including expanded Health Savings Accounts and tax credits to facilitate buying private insurance.

Those with pre-existent conditions and kids under the age of 26, meanwhile, will be protected under the American Health Care Act, Pence said.

Pence spent some time talking about “engagement with Congress” to improve the bill, a seeming acknowledgement of issues.

As well, Pence vowed to allow “states like Florida” the ability to have a block grant to administer their plans, and a “work requirement” for coverage.

“President Trump supports the bill 100 percent, and we all do,” Pence said. “A new era for federal/state Medicaid partnership has begun.”

“State solutions,” Pence said, are the best way forward for Florida.

As well, Pence added that Americans will “have the freedom to buy health insurance across state lines,” via “dynamic marketplace.”

“It won’t be long until you see Flo and that little lizard on TV ads,” Pence quipped.

While “it’s going to be a battle in Washington,” Pence called for “every Republican in Florida” to support the administration’s moves to “repeal and replace Obamacare.”

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The VP had local and state support on hand.

U.S. Congressman John Rutherford, who flew down from D.C. with VP Pence, opined that “the American dream is being damaged by Obamacare … a policy that drives up costs and strangles small businesses.”

“We need a better way … we must repeal and replace Obamacare with a market-based health care policy that will reduce costs and increase consumer access to health care.”

CMS Administrator Seema Verna, introduced by Rutherford, likewise described the “burden of health care costs and overregulation” on “small businesses.”

“With the support of President Trump, we’re going to undo the damage done by Obamacare,” Verna said, also vowing to let states handle administering Medicare and have “freedom from Washington’s one-size-fits-all approach” – echoing Gov. Scott.

Jacksonville Mayor Lenny Curry, introduced by Verna, said “this is really simple. The President and Vice President told us they’re going to repeal and replace Obamacare and that’s what happens now.”

Gov. Scott, introduced by Curry, noted that “Obamacare was sold on a lie. A complete lie … choices have gone down, prices have gone up.”

“We’re going to change that,” Scott said. “Obamacare’s on a death spiral. Prices have just gone out of control.”

“We had to sue the Obama Administration for our low-income pool because we didn’t expand Medicaid,” Scott noted.

 

Ted Yoho introduces health care transition bill

Republican U.S. Rep. Ted Yoho has introduced a bill he says will give insurance companies flexibility while Congress tries to work out a replacement plan for ObamaCare.

Yoho’s Holding Health Insurers Harmless Act would roll back many of the regulations of health insurers in a strategy the Gainesville congressman said would free them to provide more plan options until the Affordable Care Act is replaced.

“It is important that all Americans have access to quality health insurance. Since ACA was signed into law, many insurers have either refused to participate in the exchanges established by the ACA, or have stopped participating in them altogether. In some states there is only one health insurance provider and option,” Yoho stated in a news release issued by his office. “This is unacceptable and not what was promised. “

Among the aspects in the bill, it would:

– Return federal requirements on health insurance plans back to pre-ACA days, removing mandates and penalties.

– Provide some certainty to private sector insurers that they can provide plans outside of the ACA’s requirements.

– Repeal requirements that insurers to provide certain plans, nor does it prevent them from providing plans that still comply with the ACA.

American Action Network launches robocalls campaign to support American Health Care Act

Voters in three Florida congressional districts could be getting calls them to contact their representative about the American Health Care Act.

The American Action Network announced this week it was launching a robocall campaign in 30 congressional districts, including districts represented by Reps. Ted Yoho, Ron DeSantis, and Bill Posey.

The campaign comes on the heels of a TV ad buy launched last week, and is meant to encourage voters to call lawmakers to tell them to support repealing the Affordable Care Act, often called Obamacare, and replace it with the American Health Care Act, which is backed by President Donald Trump and Speaker Paul Ryan.

“Obamacare has been a nightmare for millions of Americans. We are calling activists across the country to urge them to call their member of Congress to ensure they do the right thing and stand with President Trump and Speaker Ryan in repealing this failed law,” said Corry Bliss, the group’s executive director. “The American Health Care Act will lower costs, increase competition, and reduce the deficit, while protecting those with pre-existing conditions. These conservative reforms will make health care truly affordable and patient-centered – that’s what all Americans deserve.”

The effort is part of an issue advocacy campaign worth about $10 million, according to the organization.

Matt Gaetz: Keep working to repeal and replace Obamacare

President Trump has endorsed a bill to repeal and replace Obamacare. His plan, called the American Health Care Act, is described as the first of three immediate steps occurring to end this nightmare. Remember, Obamacare was implemented over several bills, with tons of executive overreach. Administrative corrections and legislation clearing the 60-vote Senate threshold must follow.

For this bill, we need 51.

I’ll be frank — I’m not crazy about it. I wanted to like it, especially after hearing from Obamacare’s victims: prices skyrocketing, premiums rising, plans closing, coverage decreasing. I wanted to like it because the thought of government forcing people to buy anything — much less health insurance — disgusts me.

We know Obamacare is a wet blanket over our economy, smothering the job-creating ambition of small businesses. I wanted to love it; I just didn’t.

We should be going bolder. We should get the federal government out of health care completely, not just diminish its role.

Then I remembered Tom. I met him at Waffle House. His hash browns were smothered and covered; his question was direct: “How will you decide which way to vote on stuff?” he asked while wiping ketchup from his mustache.

I told him I’d vote for bills that got power out of Washington — and against ones that didn’t. He grumbled on the way out, “Don’t lie to me” — and took a bumper sticker.

There is no debate that the American Health Care Act means less power for Washington. Specifically, under Trump’s plan, the federal government cannot provide taxpayer dollars to Planned Parenthood; enroll illegal aliens in health care entitlements — only to check their status later; tax people for not buying government-mandated health insurance; stop associations or groups from forming their own risk pools; punish businesses for hiring more employees; or force you away from your doctor or plan.

It also reduces the deficit by $337 Billion over 10 years and constitutes $1 trillion in tax cuts by repealing 14 Obamacare taxes. These are big conservative wins.

With several key changes, this bill would be much bolder. It wouldn’t be perfect — but better.

First, there should be a work requirement.

Able-bodied, childless adults who can work and choose not to should not expect America to borrow money from China to pay for their health care. Everyone can contribute to society — if not through a job or skills enhancement, by volunteering. This will help curb costs and engage all Americans in productivity.

Second, Medicaid can’t keep expanding.

The bill currently takes the position that Medicaid can expand for two-and-a-half more years before it is ultimately contracted. Already, 1 in 4 Americans is on Medicaid. This is like hoping to lose weight by planning to diet in two-and-a-half years — and eating everything in sight until then.

Finally, states should be totally in charge of Medicaid.

The federal government has proved an incompetent operator of the Medicaid program. We need 50 laboratories of democracy, totally unconstrained, innovating for better health care and lower costs. Some states will get it right; others will copy.

It’s easy to vote “no” and just blame others for not bending to my will. It’s harder to persuade others that the conservative way is the Better Way.

I serve on the Budget Committee. Earlier this week, my conservative colleagues and I offered Budgetary “Motions of Instruction” to address these issues. Thankfully, they passed, meaning the Rules Committee can accept our amendments to drain this swamp even lower.

I voted in favor of President Trump’s plan to keep the conversation going — to keep the legislative process focused on free-market, patient-centered health care. Giving up or accepting failure simply because the initial version of this bill underwhelms is not an option.

The American people won’t give us unlimited bites at the apple — it’s time to get health care reform right, or be stuck with the disaster that is Obamacare forever.

I owe Tom a strong fight to make President Trump’s bill far better. I also owe him whatever vote gives him more power, and Washington less.

Let’s keep working.

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Matt Gaetz is the U.S. Representative for Florida’s 1st Congressional District, stretching from Pensacola to Holmes County.

 

Joe Henderson: ‘Shy’ Rick Scott needs to pipe up on Medicaid expansion

Gov. Rick Scott hasn’t been shy about sharing his feelings on the Affordable Care Act. Like any good Republican, he hates it. He wants it to go away.

Now that Republicans have a legitimate proposal on the table to replace Obamacare, though, Scott has gone into stealth mode on the subject. In an Associated Press story, the governor did the Rick Scott Shuffle when asked for his reaction to the plan now being debated intensely in Washington.

Scott said he was glad there is “good conversation” happening on the subject. Not exactly a stop-the-presses comment.

He even met recently with House Speaker Paul Ryan, who is pushing a plan that the nonpartisan Congressional Budget Office said could leave up to 24 million Americans without health insurance.

Would the governor like to let us mere mortals in on what was discussed? People in Florida will be greatly affected by whatever finally becomes law, especially if it has a significant impact on Medicaid.

Florida depends heavily on federal money for Medicaid funding, and under the plan being discussed more than 4 million residents here would see their benefits reduced. That probably suits budget hawks in the state House just fine, but wouldn’t be good for many of the state’s elderly and low-income residents.

That’s where Scott needs to pipe up on this subject. In 2014, remember, he went to war (and lost) with the House over Medicaid expansion. Scott pushed for it; now-Speaker Richard Corcoran was intractably against.

Given his background as a hospital administrator before he went into politics, there are few people in the state better versed on health insurance than Scott. He could help frame the debate if he chose.

He certainly hasn’t been shy about making his opinions known recently on other subjects. He has been outspoken about his trying to save Enterprise Florida and Visit Florida. But now that the health care debate has intensified, we get crickets from the governor.

Curious.

Congress’ analyst: Millions to lose coverage under GOP bill

Fourteen million Americans would lose coverage next year under House Republican legislation remaking the nation’s health care system, and the number would balloon to 24 million by 2026, Congress’ budget analysts projected Monday. Their report deals a stiff blow to a GOP drive already under fire from both parties and large segments of the medical industry.

The Congressional Budget Office report undercuts a central argument President Donald Trump and Republicans have cited for swiftly rolling back the 2010 health care overhaul: that the insurance markets created under that statute are “a disaster” and about to implode. The congressional experts said that largely would not be the case, that the market for individual policies “would probably be stable in most areas under either current law or the (GOP) legislation.”

The report also flies in the face of Trump’s talk of “insurance for everybody,” which he stated in January. He has since embraced a less expansive goal — to “increase access” — advanced by House Speaker Paul Ryan and other Republicans.

Health secretary Tom Price told reporters at the White House the report was “simply wrong” and that he disagreed “strenuously,” saying it omitted the impact of additional GOP legislation and regulatory changes that the Trump administration plans for the future.

Still, the budget office’s estimates provide a detailed, credible appraisal of the Republican effort to unravel former President Barack Obama‘s 2010 overhaul. The office has a four-decade history of even-handedness and is currently headed by an appointee recommended by Price when he was a congressman. Trump has repeatedly attacked the agency’s credibility, citing its significant underestimate of the number of people who would buy insurance on state and federal exchanges under “Obamacare.”

On the plus side for Republicans, the budget office said the GOP measure would reduce federal deficits by $337 billion over the coming decade. That’s largely because it would cut the federal-state Medicaid program for low-income Americans and eliminate subsidies that Obama’s law provides to millions of people who buy coverage.

It also said that while the legislation would push premiums upward before 2020 by an average of 15 to 20 percent compared to current law, premiums would move lower after that. By 2026, average premiums for individuals would be 10 percent lower than under Obama’s statute, it said.

The GOP bill would obliterate the tax penalties Obama’s law imposes on people who don’t buy coverage, and it would eliminate the federal subsidies reflecting peoples’ income and premium costs for millions.

It instead would provide tax credits based largely on recipients’ ages, let insurers charge more for older people and boost premiums for those who let coverage lapse. It would phase out Obama’s expansion of Medicaid to 11 million additional low earners, cap federal spending for the entire program, repeal taxes the statute imposes and halt federal payments to Planned Parenthood for a year.

Administration officials took strong issue with the budget office’s projections of lost coverage.

“We believe that our plan will cover more individuals and at a lower cost and give them the choices that they want,” Price said.

And House Speaker Ryan said in a statement the GOP legislation “is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford.” In fact, on the Fox News Channel, he said the CBO report “exceeded my expectations.”

Not in a good way, Democrats said. Senate Minority Leader Chuck Schumer of New York said the projections show “just how empty the president’s promises, that everyone will be covered and costs will go down, have been..”

“I hope they would pull the bill. It’s really the only decent thing to do,” said House Minority Leader Nancy Pelosi of California.

The American Medical Association, which has opposed the Republican bill because it would reduce coverage, said the report shows the legislation would cause “unacceptable” consequences. “

Two House committees approved the legislation last week, and Ryan wants to bring it to the full House next week. Though many Republicans back the bill, conservatives say it doesn’t go far enough in repealing Obama’s law while moderates whose states used the statute to expand Medicaid don’t want people losing coverage.

GOP leaders hope the Senate will consider the measure before breaking for an early April recess. Opposition from both ends of the Republican spectrum in that chamber suggests senators might demand significant changes.

The budget office attributed projected increases in uninsured Americans to the GOP bill’s elimination of tax penalties for people who don’t buy insurance, to reduced federal subsidies for many people who buy policies and to the reductions in Medicaid.

By 2026, the office estimated, a total of 52 million people would lack insurance, including 28 million expected to lack coverage under Obama’s statute.

Even though Republican tax credits would be less generous than those under Obama’s law, the combination of those credits and other changes to lower premiums would attract enough healthy people to stabilize markets under the new plan, the report said.

The budget office sees federal spending on Medicaid declining by $880 billion over the coming decade — about 25 percent lower than current projections. That would push about 14 million low-income people off the federal-state program.

Though average premiums are ultimately expected to fall, that would vary for people of different ages because compared to Obama’s law Republicans would let older people be charged more.

The report estimates that individuals’ out-of-pocket costs under the GOP bill “would tend to be higher than those anticipated under current law.” That runs counter to another claim from the president, that his health care plan would offer “much lower deductibles.”

CBO had predicted that 23 million people would be enrolled under Obama’s law, but the number proved to be about 12 million — largely because CBO overestimated the extent to which the individual mandate would prompt them to buy coverage.

Republished with permission of The Associated Press.

Florida Dems in Congress blast GOP health care plan after budget report

As expected, the scoring of the Republican health care plan in Congress affirmed many of Democrats’ biggest warnings.

And, as expected, many of Florida’s delegation wasted no time Monday attacking the “American Health Care Act” as “wrong,” “inhumane,” “alarming,” and “ruthless and cruel.”

No word yet from any of Florida’s 17 Republican members of Congress on how they feel about the Congressional Budget Office legislative analysis of the bill Republicans introduced last week. Its aim is to replace “Obamacare,” the Affordable Care Act President Barack Obama and Democrats pushed through in 2010.

Democrats loaded up Monday at several of the CBO findings of the bill being dubbed both “RyanCare” for House Speaker Paul Ryan and “TrumpCare,” for President Donald Trump. The CBO reported that 14 million people would drop from being insured in the first year, and that a total of 24 million now covered would be without health insurance in a decade. The CBO also projected rapidly increasing premiums for the first couple of years, that it would cut $880 million from Medicaid, and increase costs for seniors on Medicare. And it reported that cuts to Planned Parenthood would mainly affect low-income women.

Almost all 12 Florida Democrats decried all those findings, through news releases, social media posts and statements on their websites. Among the responses:

“It is wrong to take away health insurance for 24 million people, as well as increase the cost to seniors,” wrote U.S. Sen. Bill Nelson.

“This legislation is terrible for those in their golden years, our seniors. And most distressing is how this bill treats the poor and the disabled of our society,” wrote U.S. Rep. Charlie Crist of St. Petersburg, representing Florida’s 13th Congressional District. “The Gospel of Matthew teaches us that we will be judged by how we treat the ‘least of these.’ But this bill treats the least among us in the most inhumane way possible.”

“Biggest non-shocker of the week #Trumpcare knocks 24M people off insurance,” tweeted U.S. Rep. Darren Soto of Orlando, representing Florida’s 9th Congressional District.

“This report from the nonpartisan CBO confirms what we already knew to be true, millions of Americans will lose health insurance, hardworking families will be forced to pay higher premiums, and Medicaid recipients will suffer greatly,” declared U.S. Rep. Val Demings of Orlando, representing Florida’s 10th Congressional District. “As Republicans recklessly work to push through this plan, the people who need it the most, working families, seniors, and children stand to lose the most. The GOP plan is not better than the Affordable Care Act and Republicans know it.”

“This bill does not make good on claims by @SpeakerRyan,” tweeted U.S. Rep. Ted Deutch, representing Florida’s 22nd Congressional District. “It will block millions from coverage in exchange for cutting taxes for the wealthy.”

“Despite numerous promises by Trump that no one would lose health insurance, Republican scheme does just that!” tweeted U.S. Rep. Kathy Castor of Tampa, in Florida’s 14th Congressional District. “Irresponsible @SpeakerRyan!”

“Yanking insurance coverage from 14 million people and leaving them uninsured next year would be ruthless and cruel,” wrote U.S. Rep. Debbie Wasserman Schultz, representing Florida’s 23rd Congressional District.

“House Republican leaders are rushing this process with closed-door meetings and midnight committee sessions,” wrote U.S. Rep. Stephanie Murphy of Winter Park, representing Florida’s 7th Congressional District. “We need to slow down, bring both parties together, and get health care reform right so there aren’t any unintended consequences that hurt families, seniors, and small businesses.”

Rick Scott says ACA replacement is a work in progress

Gov. Rick Scott said Thursday that he thinks Florida would be treated unfairly under the current version of congressional Republicans’ Obamacare repeal bill.

Scott did not tell reporters he opposed the bill after meeting with House Speaker Paul Ryan in Washington, D.C., though he did say the repeal bill needs to be fair for states like Florida, which did not expand Medicaid. He also said the bill needs to give autonomy to run their own Medicaid programs.

States like Florida which didn’t expand can’t get treated unfairly,” he said. He also called the current plan “a work in progress.”

The newly unveiled proposal would allow states that expanded Medicaid to keep their extra federal funds for the next few years until the program phases out in 2020. The bill would also tie Medicaid funding to the number of enrollees in each state.

States that did not expand Medicaid would get an extra $10 billion over the next five years under the bill and would also have spending cuts for safety net hospitals lifted in 2018, 2 years ahead of Medicaid expansion states.

House GOP releases bill replacing Barack Obama health care overhaul

House Republicans on Monday released their long-awaited plan for unraveling former President Barack Obama‘s health care law, a package that would scale back the government’s role in health care and likely leave more Americans uninsured.

House committees planned to begin voting on the 123-page legislation Wednesday, launching what could be the year’s defining battle in Congress and capping a seven-year Republican effort to repeal the 2010 law. Though GOP leaders expect their measure to win the backing of the Trump administration, divisions remain and GOP success is by no means ensured.

The plan would repeal the statute’s unpopular fines on people who don’t carry health insurance. It would replace income-based subsidies the law provides to help millions of Americans pay premiums with age-based tax credits that may be less generous to people with low incomes. Those payments would phase out for higher-earning people.

The bill would continue Obama’s expansion of Medicaid to additional low-earning Americans until 2020. After that, states adding Medicaid recipients would no longer receive the additional federal funds the statute has provided.

More significantly, Republicans would overhaul the federal-state Medicaid program, changing its open-ended federal financing to a limit based on enrollment and costs in each state.

In perhaps their riskiest political gamble, the plan is expected to cover fewer than the 20 million people insured under Obama’s overhaul, including many residents of states carried by President Donald Trump in November’s election.

Republicans said they don’t have official estimates on those figures yet. But aides from both parties and nonpartisan analysts have said they expect coverage numbers to be lower.

House Speaker Paul Ryan, R-Wis., said the bill would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance.” He added, “This unified Republican government will deliver relief and peace of mind to the millions of Americans suffering under Obamacare.”

But besides solid opposition from Democrats, there were signals galore that Republican leaders faced problems within their own party, including from conservatives complaining that the measure isn’t aggressive enough in repealing parts of Obama’s law.

“It still looks like Obamacare-lite to me,” said Sen. Rand Paul, R-Ky., among three Senate conservatives who have criticized the emerging GOP bill. “It’s going to have to be better.”

The Republican tax credits — ranging from $2,000 to $14,000 for families — would be refundable, meaning even people with no tax liability would receive the payments. Conservatives have objected that that feature creates a new entitlement program the government cannot afford.

Senate Finance Committee Chairman Orrin Hatch, R-Utah, wouldn’t rule out changes in the measure by his chamber, where significant numbers of moderate Republicans have expressed concerns that the measure could leave too many voters without coverage.

“The House has the right to come up with what it wants to and present it to the Senate by passing it. And we have a right to look it over and see if we like it or don’t,” Hatch told reporters.

Underscoring those worries, four GOP senators released a letter to Senate Majority Leader Mitch McConnell, R-Ky., shortly before the bill was unveiled.

They complained that an earlier, similar draft of the measure “does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.” Signing the letter were Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska.

Thirty-one states and the District of Columbia opted to expand Medicaid coverage under the law and accept beefed-up federal spending for the program. Around half those states have GOP governors, who are largely reluctant to see that spending curtailed.

In another feature that could alienate moderate Republicans, the measure would block for one year federal payments to Planned Parenthood, the women’s health organization long opposed by many in the party because it provides abortions. It also forbids people receiving tax credits to help pay premiums to buy coverage under a plan that provides abortions.

Republicans said they’d not yet received official cost estimates on the overall bill from the nonpartisan Congressional Budget Office. That office’s projections on the bill’s price tag and the number of people the measure would cover could be key in winning over recalcitrant Republicans, or making them even harder to win over.

A series of tax increases on higher-earning people, the insurance industry and others used to finance the Obama overhaul’s coverage expansion would be repealed as of 2018.

In a last-minute change to satisfy conservative lawmakers, business and unions, Republicans dropped a plan pushed by Ryan to impose a first-ever tax on the most generous employer-provided health plans.

Popular consumer protections in the Obama law would be retained, such as insurance safeguards for people with pre-existing medical problems, and parents’ ability to keep young adult children on their insurance until age 26.

Republished with permission of The Associated Press.

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