Republicans revamp Obamacare bill as Trump moves to promote overhaul


Reuters

UPDATE 3-Republicans revamp Obamacare bill as Trump moves to promote overhaul


(Adds details on House leadership amendments, paragraphs 3-6,
8-14, 18-23)
    By Yasmeen Abutaleb and Richard CowanWASHINGTON, March 20 (Reuters) - Congressional Republicans
recrafted their Obamacare replacement bill on Monday in hopes of
satisfying critics as U.S. President Donald Trump prepared to
promote his first major legislative initiative on Capitol Hill.
    In a sign of deepening concern among Republicans about the
bill's future, Trump will speak to the party's lawmakers in
Congress on Tuesday about the healthcare overhaul, two House
Republican aides said.
    The Republican leadership proposed a series of amendments
that marked major legislative changes, but it was not
immediately clear whether they would help win more Republican
support amid solid opposition from Democrats.
    A leading conservative voice in the House, Representative
Jim Jordan of Ohio, is still opposed to the legislation even
with the proposed changes, according to an aide.
    The administration and House leadership can only afford to
lose about 20 votes from Republican ranks. They need to shore up
support from moderate Republicans who fear the bill dismantling
President Barack Obama's signature Affordable Care Act will hurt
millions of Americans enrolled in the program.
    However, Trump and Republican leaders must also appeal to
hard-right conservatives who believe the original bill did not
go far enough in repealing the law, prompting some to dub it
"Obamacare Lite."
    According to Republican sources who asked not to be
identified, House leaders will propose an approximately $85
billion fund for tax credits to help people aged 50-64 get
health insurance.
    In an unusual move, the House proposed providing the Senate
flexibility to offer more help to that age group, which may need
a larger tax credit to help cover their healthcare costs - a
move aimed at winning over more moderate Republicans. It did not
specify how the Senate should do so.
    Conservatives have opposed refundable tax credits, calling
them another entitlement program.
    One amendment would dismantle most of Obamacare's taxes one
year earlier than initially proposed, in 2017 instead of 2018.
That includes both the individual mandate that requires everyone
to purchase health insurance or else pay a penalty, and the
requirement that employers of a certain size provide coverage.
    The new language also addresses Medicaid, the federally
backed healthcare program for the poor and disabled that is one
of the most contentious aspects of the bill.
    To appease conservatives, states would have the option of
implementing work requirements for able-bodied adults without
children or dependents. However, even the Heritage Foundation, a
powerful conservative group, has opposed such a provision.
    In addition, states could decide whether to take per capita
allotments for their Medicaid programs or block grants for
certain populations. Both would drastically reduce federal
Medicaid funding from current levels.
    Republican leaders hope to move the legislation to the House
floor for debate as early as Thursday.

    DAMAGED PROSPECTS
    At a rally in Louisville, Kentucky, on Monday night, Trump
said he wanted to add a provision to the bill that aims to lower
prescription drug costs through a "competitive bidding process."
    "We're trying to add it to this bill and if we can't, we'll
have it right after," he said. During the presidential campaign,
Trump called for allowing Medicare to negotiate with
pharmaceutical companies, something the law currently prohibits.
    The Congressional Budget Office (CBO) analysis of the
original House Republican bill a week ago severely damaged its
prospects. It said 14 million people would lose health coverage
under the measure over the next year and 24 million over the
next decade.
    The CBO is expected to update its analysis of the impact of
the legislation to take into account the latest changes being
proposed.
    Under the retooled legislation, the rollback of Obamacare's
Medicaid expansion, which provided states enhanced federal
funding for new enrollees, would be slowed.
    More than 30 states, including about a dozen with Republican
governors, chose to expand their Medicaid programs under
Obamacare. Several Republican governors and key senators and
House members have expressed concern over abruptly cutting
federal Medicaid funding and therefore taking insurance away
from millions of people.
    Republican leaders are now proposing that many of those who
gained coverage under the expansion could keep it. The federal
government would maintain the higher funding levels for those up
to 133 percent of the federal poverty level. Obamacare expanded
coverage to those making incomes up to 138 percent.
    Those beneficiaries could keep their coverage until they
"cycle off" the program, possibly because they would eventually
make enough money to purchase private insurance or obtain it
through an employer.
    Another amendment would allocate more money for healthcare
costs for the disabled and elderly on Medicaid. The unusual mix
of amendments to Medicaid reflects leadership's attempt to
assuage concerns from both staunch conservatives and moderates.
    Democrats oppose the Republicans' plan, which they say would
throw millions off health insurance and hurt the elderly, poor,
and working families while giving tax cuts to the wealthy.
    Democrats as well as hospitals and insurers have urged
Republicans to consider how their plan would affect access to
healthcare for the 20 million people insured by Obamacare.

    <^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
How U.S. healthcare stacks up under the ACA and AHCA    http://tmsnrt.rs/2n0ZMKf
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 (Reporting by David Morgan, Yasmeen Abutaleb, Susan Cornwell;
Additional reporting by Caroline Humer, Roberta Rampton and
Richard Cowan; Editing by Kevin Drawbaugh, Leslie Adler, Eric
Beech and Paul Tait)
 ((susan.cornwell@thomsonreuters.com))

Keywords: USA OBAMACARE/ (UPDATE 3, PIX, GRAPHICS)



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