Lacking Enough Votes, Paul Ryan Pulls Obamacare Replacement Bill

House Speaker Paul Ryan abruptly withdrew the GOP’s bill to repeal and replace Obamacare Friday afternoon after it became clear Republicans didn’t have the votes to pass the plan.

The news came just minutes before the lower chamber was expected to vote on the bill, called the American Health Care Act, and after Ryan, R-Wis., huddled with President Donald Trump at the White House. The bill also faced Republican opposition in the Senate.

Trump and Ryan spent the better part of the past two weeks trying to court conservative lawmakers and centrist Republicans, who had doubts about the proposal and planned to vote against it.

But ultimately, their charm offensive proved to do little to sway the Republican conference.

Now, Republicans will head back to the drawing board as they work to fulfill their yearslong promise to repeal Obamacare.

The House initially was scheduled to vote on the bill Thursday—exactly seven years after President Barack Obama signed into law the Affordable Care Act, popularly known as Obamacare.

But Republican leaders postponed the vote Thursday afternoon after they failed—even with repeated efforts by Trump—to rally enough support for the plan.

Ryan quickly scheduled the vote for Friday after White House budget director Mick Mulvaney delivered a message from Trump to Republicans: Vote on the bill now, and if it fails, Obamacare remains.

“He has other things he wants to do,” Mulvaney said of Trump in an interview with CNBC. “‘Impatient’ is not the right word. ‘Busy’ would be the right way to describe this president.”

Ryan and other House GOP leaders unveiled the long-awaited plan to repeal and replace Obamacare two weeks ago.

Though Republicans long had promised to unwind the health care law, which passed without a single Republican vote, the leadership’s bill received little support from conservatives, centrist Republicans, and outside groups.

Members of the conservative House Freedom Caucus took issue with several of the bill’s key provisions, including its phasing out of expanded eligibility for Medicaid and introducing age-based, refundable tax credits.

The House’s right flank gradually whittled its list of demands down to just one: repeal of Obamacare’s insurance regulations, including its mandate of “essential” benefits—provisions they said drove up the price of insurance premiums.

Those essential health benefits are 10 services that insurance plans had to cover without co-payments.

GOP leaders ultimately gave conservatives part of what they wanted.

Along with a series of technical changes, they altered the bill Thursday to allow states to define which health benefits were required to be included in plans.

But it was not enough to win enough conservatives’ votes and left some centrist Republicans edgy.

While conservative lawmakers weren’t shy in speaking out against the legislation, the hours before Friday’s expected vote also saw more defections by centrist Republicans.

Earlier this week, Tuesday Group leader Rep. Charlie Dent, R-Pa., said he planned to oppose the bill, along with Rep. Jaime Herrera Beutler, R-Wash., and several New Jersey Republicans.

On Friday, though, House Appropriations Chairman Rodney Frelinghuysen, R-N.J., and Rep. Barbara Comstock, R-Va., allies of the speaker, said they wouldn’t support the bill.

The White House made many attempts to woo conservatives and convince them to vote in favor of the plan.

Trump held several meetings with the Freedom Caucus, and administration officials spoke on the phone frequently with Rep. Mark Meadows, R-N.C., the group’s chairman.

Just hours before the scheduled vote Friday, Vice President Mike Pence met with conservative members in a last-ditch attempt to sway them.

Republican leaders were left in a tough spot after conservatives and the list of centrist Republicans opposing the bill began to grow.

With 237 House seats held by Republicans , leadership could afford to lose only 22 “no” votes. All Democrats were expected to vote against it.

The post Lacking Enough Votes, Paul Ryan Pulls Obamacare Replacement Bill appeared first on The Daily Signal.

Why I’m Voting Against the GOP Health Bill

From the moment I decided to run for Congress, I have repeatedly promised the residents of the East Valley that I would fight for a clean repeal of the Affordable Care Act, or “Obamacare.”

Since this law took effect in 2010, Americans have faced rising premiums, fewer choices, and decreasing quality of care.

My home state of Arizona has been hit hardest of all with premiums more than doubling. In fact, nearly all Arizonans have only one insurance option on the Obamacare marketplace, and even that option may soon disappear.

Every week, I hear first-hand from constituents about this law’s devastating effects. One family from Gilbert I spoke with said their monthly premiums are now higher than their mortgage and their annual deductible has increased to an astounding $7,000.

That is simply unaffordable for the average family. Americans like these are desperately looking to Congress for relief.

Unfortunately, the new health bill that was introduced—the American Health Care Act—merely amends the existing framework of Obamacare. Rather than representing a true reform package, this bill does not fully address funding for our high-risk population, nor does it lead to the lower premiums Americans are expecting for economic relief.

>>>Broad Conservative Criticism Mounts Against GOP Health Bill

The bill also provides massive federal subsidies to make permanent an entitlement program that our grandchildren will pay for in the future. Many of the residents of the East Valley have already taken to calling it “Obamacare Lite”—and they are absolutely right.

The American Health Care Act has repeatedly been sold as merely the first step of a three-stage repeal and replace process that would look something like this:

  • Step One: Congress passes a partial repeal bill.
  • Step Two: The Trump administration uses executive orders to overturn the onerous regulations established by Obamacare.
  • Step Three: Congress passes further health care policy legislation to address issues not covered in the first bill.

This roadmap is fatally flawed.

The success of the partial repeal of Obamacare critically depends on the completion of the last two steps. But, unfortunately, the second step would instantly be met with intense litigation, and any executive action can be overturned by a future president.

Worse still, any health care reform bills passed as part of the third step would require 60 votes in the Senate—a near impossibility in the current political climate.

The tragedy is that all of our efforts should have been placed in step one from the very beginning. The current strategy leaves the most egregious parts of Obamacare in place, and I simply cannot vote in favor of the American Health Care Act.

>>>New Analysis: Obamacare Regulations Drove Up Premium Costs by Up to 68%

Over the past few weeks, I have worked in good faith with my colleagues to propose changes to the bill in line with the expectations of my district. Instead of halfway measures, I have consistently proposed a clean repeal of Obamacare that eliminates all of its regulations, mandates, subsidies, and taxes.

Additionally, I have advocated for patient-centered, free market health care reform that would allow individuals to shop for and purchase health insurance across state lines, block-grant Medicaid funds to states, encourage the development of high-risk sharing pools, and increase cost transparency for all consumers.

These measures would truly drive down costs and get the federal government out of the health insurance business, where it doesn’t belong in the first place. Americans expected Congress to provide real solutions to our nation’s health care challenges. They simply have no patience for half-hearted measures. We can—and we must—do better than the American Health Care Act.

I am committed to completely repealing Obamacare, and will not support anything less.

The post Why I’m Voting Against the GOP Health Bill appeared first on The Daily Signal.

Broad Conservative Criticism Mounts Against GOP Health Bill

As lawmakers furiously debate the American Health Care Act, a growing number of health policy experts and other conservatives are sounding their concerns with the policies and passage process for the House GOP health bill.

Key among those concerns is that the bill leaves too much of Obamacare in place, primarily the regulations and mandates that imposed new rules on health insurance markets.

Overall, Americans are paying 44.5 percent to 68 percent more in health premiums just from Title I insurance regulations, according to new Heritage Foundation analysis.

“President [Donald] Trump pledged during the presidential campaign to deliver legislation that ‘fully repeals Obamacare,’” wrote Michael Cannon with the Cato Institute.

“But Republican leaders are doing something else: pushing a bill that leaves much of Obamacare in place.”

Cannon points out that the House GOP bill retains Obamacare’s health insurance regulations. “Obamacare’s regulations are the driving force behind its skyrocketing premiums and low-quality coverage. Yet the Republican bill would preserve them with only slight modifications.”

Other leading conservative scholars also have weighed in:

Avik Roy, Forbes opinion editor with the Foundation for Research on Equal Opportunity, argued the House Freedom Caucus, which is made up of conservative House members, was right to care about the insurance regulations.

“The good news is that the House Freedom Caucus is right to care about this problem. Obamacare’s regulations do increase premiums in ways that make health insurance unaffordable for millions. The [American Health Care Act’s] treatment of Obamacare regulations absolutely can be improved,” Roy noted.

>>>New Analysis: Obamacare Regulations Drove Up Premium Costs by Up to 68%

National Affairs Editor Yuval Levin, with the Ethics and Public Policy Center, also pointed out that the American Health Care Act does not reverse Obamacare’s “core federalization of insurance coverage.”

He argued the hurried process to pass the bill will likely undermine its success. “This could have started better, and it needs to end smarter,” he wrote.

“If Republicans rush a plan through Congress with major flaws, it will likely backfire on them, and perhaps lead to another round of legislation that is far less to their liking,” added Jim Capretta with the American Enterprise Institute.

“The bill’s lack of full repeal, the premium increases scheduled to take effect over the next two years, and the spending ‘cliff’ hitting in 2020 leave the bill with little natural political constituency to support it,” said Chris Jacobs with the Texas Public Policy Foundation.

Some have lodged excuses that insurance regulations would not pass the reconciliation process in the Senate. Ramesh Ponnuru, American Enterprise Institute visiting scholar and senior editor at National Review, hit back at those excuses, saying, “Republicans can change or eliminate more of Obamacare’s regulations with a simple majority vote.”

He continued, “They don’t have to wait for a second and third stage of policy change to make needed reforms. They can write a bill that would do more to lower premiums, get a better [Congressional Budget Office] score on coverage, and do more to repeal Obamacare than their current one.”

Even journalists opposed to Obamacare have little enthusiasm for the American Health Care Act.

“You’re not exactly seeing enthusiastic cheers from the journalists who opposed Affordable Care Act, of which I am one,” writes Bloomberg View columnist Megan McArdle. “See? This is me, emphatically not cheering. If such is possible, I am actively failing to cheer.”

The culminating message from many is that the House must pause and rewrite the health bill so that it pulls out more of Obamacare’s infrastructure.

As the Washington Examiner editorial board urged members of Congress, “Republicans ought to take their time and write a better bill that, unlike the [American Health Care Act], actually repeals Obamacare and institutes real reform of the broken health care system.”

The post Broad Conservative Criticism Mounts Against GOP Health Bill appeared first on The Daily Signal.

Conservative Leaders Announce Opposition to GOP Health Care Bill

A group of conservative leaders released a memo Thursday denouncing the House GOP health care bill.

The Conservative Action Project memo states, “The current House bill does not achieve the health care vision articulated by President Trump.”

Signers of the memo demanded the House legislation meet certain requirements.

“The House of Representatives bill must include full repeal of the Obamacare insurance regulations, must permit interstate purchasing of health insurance and must expand health savings accounts,” the memo said.

The memo continued to say that the House health care legislation should not depend on what happens in the Senate.

“The House should not pre-emptively capitulate on these principles by making unwarranted assumptions about how the Senate will proceed,” the memo said.

According to the Conservative Action Project’s website, the organization “is designed to facilitate conservative leaders working together on behalf of common goals. Participants include the CEOs of more than 100 organizations representing all major elements of the conservative movement—economic, social, and national security.”

The Conservative Action Project memo was signed by 45 conservative leaders, including Adam Brandon, president of FreedomWorks, and Judson Phillips, founder of Tea Party Nation.

Some members of The Heritage Foundation also signed the memo, including Edwin Meese III and Becky Norton Dunlop, who both worked in the White House under President Ronald Reagan.

The memo is another blow for the GOP health care legislation that is already short of the 215 votes it needs to pass.

This announcement comes the same day that House Republican leaders postponed the afternoon vote for the health care bill, lacking adequate support to pass the bill, according to NBC News.

Members of the House Freedom Caucus have been some of the harshest conservative critics of the health care bill, called the American Health Care Act.

However, Freedom Caucus Chairman Rep. Mark Meadows, R.-N.C., told reporters after a meeting at the White House Thursday that while no deal was in place, they would be willing to keep negotiating.

“I would hope that we would continue to negotiate in good faith and hopefully get there. We’re certainly trying to get to yes,” Meadows said.

The post Conservative Leaders Announce Opposition to GOP Health Care Bill appeared first on The Daily Signal.

Conservative Leaders Announce Opposition to GOP Health Care Bill

A group of conservative leaders released a memo Thursday denouncing the House GOP health care bill.

The Conservative Action Project memo states, “The current House bill does not achieve the health care vision articulated by President Trump.”

Signers of the memo demanded the House legislation meet certain requirements.

“The House of Representatives bill must include full repeal of the Obamacare insurance regulations, must permit interstate purchasing of health insurance and must expand health savings accounts,” the memo said.

The memo continued to say that the House health care legislation should not depend on what happens in the Senate.

“The House should not pre-emptively capitulate on these principles by making unwarranted assumptions about how the Senate will proceed,” the memo said.

According to the Conservative Action Project’s website, the organization “is designed to facilitate conservative leaders working together on behalf of common goals. Participants include the CEOs of more than 100 organizations representing all major elements of the conservative movement—economic, social, and national security.”

The Conservative Action Project memo was signed by 45 conservative leaders, including Adam Brandon, president of FreedomWorks, and Judson Phillips, founder of Tea Party Nation.

Some members of The Heritage Foundation also signed the memo, including Edwin Meese III and Becky Norton Dunlop, who both worked in the White House under President Ronald Reagan.

The memo is another blow for the GOP health care legislation that is already short of the 215 votes it needs to pass.

This announcement comes the same day that House Republican leaders postponed the afternoon vote for the health care bill, lacking adequate support to pass the bill, according to NBC News.

Members of the House Freedom Caucus have been some of the harshest conservative critics of the health care bill, called the American Health Care Act.

However, Freedom Caucus Chairman Rep. Mark Meadows, R.-N.C., told reporters after a meeting at the White House Thursday that while no deal was in place, they would be willing to keep negotiating.

“I would hope that we would continue to negotiate in good faith and hopefully get there. We’re certainly trying to get to yes,” Meadows said.

The post Conservative Leaders Announce Opposition to GOP Health Care Bill appeared first on The Daily Signal.

Freedom Caucus Looks to Continue Negotiations After Vote on Obamacare Plan Delayed

Following the postponement of the vote on the House GOP’s Obamacare replacement plan, members of the conservative House Freedom Caucus are calling for additional negotiations with the White House and centrist Republicans.

Members of the conservative group gathered for more than two hours following a White House meeting with President Donald Trump earlier Thursday to discuss their strategy going forward.

After the conservative lawmakers broke for the afternoon, Freedom Caucus Chairman Mark Meadows, R-N.C., told reporters that many of the group’s members still were opposed to the bill, called the American Health Care Act.

“We have not gotten enough of our members to get to yes at this point under what we’re currently considering,” Meadows said.

But the North Carolina Republican stressed that he and his fellow conservatives were working with the White House in an attempt to negotiate changes to the bill that would get them to “yes.”

“If we can make sure that there is an adequate safety net, that pre-existing conditions are taken care of, where truly premiums start to go down for moms and dads, that’s what it’s all about,” Meadows continued.

Rep. Andy Harris, R-Md., a Freedom Caucus member, told reporters Trump extended an offer to the group Thursday to include a repeal of Obamacare’s essential health benefits requirements, 10 services plans are required to cover, in the bill.

But Harris said members wanted more of the regulations repealed and voted to reject Trump’s deal during their meeting.

Still, the Maryland Republican said he was optimistic negotiations would continue.

“These are substantive issues,” Harris told reporters. “Substantive issues take awhile to get right. The Democrats took 14 months to get this policy right.”

Meadows, meanwhile, put the number of Republicans opposing the bill between 30 and 40. A growing number of centrist Republicans have announced their opposition to the GOP’s health care plan.

Following the Freedom Caucus meeting, Meadows said he was planning to reach out to members of the Tuesday Group, a group of centrist Republicans, to “have some discussions on how we can come together and have a consensus, realizing there’s different motivations for different members of our conference.”

The looming vote on the House GOP’s health care bill was initially supposed to take place just two weeks after Republican leaders rolled out the plan.

Three House committees marked up the legislation, and the House Rules Committee met for 10 hours Wednesday to debate the bill.

Meadows told reporters that after reading over changes to the bill put forth by the White House and Republican leadership, members of the Freedom Caucus still had questions as to what the bill did and didn’t do, including whether the plan would deny veterans access to tax credits.

“If we’re not sure of those answers, we need to read the bill and understand the bill fully before we take a vote on it,” he said.

The post Freedom Caucus Looks to Continue Negotiations After Vote on Obamacare Plan Delayed appeared first on The Daily Signal.

Freedom Caucus Looks to Continue Negotiations After Vote on Obamacare Plan Delayed

Following the postponement of the vote on the House GOP’s Obamacare replacement plan, members of the conservative House Freedom Caucus are calling for additional negotiations with the White House and centrist Republicans.

Members of the conservative group gathered for more than two hours following a White House meeting with President Donald Trump earlier Thursday to discuss their strategy going forward.

After the conservative lawmakers broke for the afternoon, Freedom Caucus Chairman Mark Meadows, R-N.C., told reporters that many of the group’s members still were opposed to the bill, called the American Health Care Act.

“We have not gotten enough of our members to get to yes at this point under what we’re currently considering,” Meadows said.

But the North Carolina Republican stressed that he and his fellow conservatives were working with the White House in an attempt to negotiate changes to the bill that would get them to “yes.”

“If we can make sure that there is an adequate safety net, that pre-existing conditions are taken care of, where truly premiums start to go down for moms and dads, that’s what it’s all about,” Meadows continued.

Rep. Andy Harris, R-Md., a Freedom Caucus member, told reporters Trump extended an offer to the group Thursday to include a repeal of Obamacare’s essential health benefits requirements, 10 services plans are required to cover, in the bill.

But Harris said members wanted more of the regulations repealed and voted to reject Trump’s deal during their meeting.

Still, the Maryland Republican said he was optimistic negotiations would continue.

“These are substantive issues,” Harris told reporters. “Substantive issues take awhile to get right. The Democrats took 14 months to get this policy right.”

Meadows, meanwhile, put the number of Republicans opposing the bill between 30 and 40. A growing number of centrist Republicans have announced their opposition to the GOP’s health care plan.

Following the Freedom Caucus meeting, Meadows said he was planning to reach out to members of the Tuesday Group, a group of centrist Republicans, to “have some discussions on how we can come together and have a consensus, realizing there’s different motivations for different members of our conference.”

The looming vote on the House GOP’s health care bill was initially supposed to take place just two weeks after Republican leaders rolled out the plan.

Three House committees marked up the legislation, and the House Rules Committee met for 10 hours Wednesday to debate the bill.

Meadows told reporters that after reading over changes to the bill put forth by the White House and Republican leadership, members of the Freedom Caucus still had questions as to what the bill did and didn’t do, including whether the plan would deny veterans access to tax credits.

“If we’re not sure of those answers, we need to read the bill and understand the bill fully before we take a vote on it,” he said.

The post Freedom Caucus Looks to Continue Negotiations After Vote on Obamacare Plan Delayed appeared first on The Daily Signal.

New Analysis: Premium Hikes Largely Caused by Obamacare Regulations

Until recently, the House was scheduled to vote on the American Health Care Act, the GOP leadership’s proposal to repeal and replace parts of Obamacare. That vote has been postponed.

Obamacare caused premiums to rise for various reasons, chief among them being the vast new regulations the law imposed on insurance markets.

While the American Health Care Act does repeal some Obamacare regulations, it does not go far enough. The following chart provides estimates of the average impact that various Obamacare regulations have had on premiums.

acagraph4

Most of these averages vary state by state, depending on demographic differences.

Take the example of Oregon. While reinsurance may have driven up rates nationally, in Oregon they initially reduced premium rates by eight percent, followed by a decreasing impact from then on, lowering rates by two percent.

Changes in morbidity (or the sickness of the population) due to newly uninsured by itself caused four percent increases in premiums nationally, but in Ohio it raised premiums by 35-40 percent.

Age is also a factor in premium prices, and Obamacare disrupted the natural order by dictating the age banding, which disproportionately harmed young people. (Age banding here refers to how much the most expensive plans can be in comparison to the cheapest.)

Before Obamacare, the national rate of age banding was 1-5. In other words, the most expensive plan was 5 times more costly than the cheapest plan, with expense increasing with age.

Obamacare mandated that the rate be set at 1-3, so that the most expensive plan could be no more than three times as expensive. While elderly people’s premiums might have seen fewer increases—which is both due to banding and the fact that Obamacare is close to a death spiral—young people have suffered.

Overall, young people can expect to have rate increases between 58.9 percent and 91.8 percent using national averages. However, not every state had a 1-5 age band.

In places like Ohio, the effects are far worse—they had a 1-6 age band. Even accounting for the differences in their population from the national average, young people in Ohio can still expect to pay an average of 7.7 percent more on top of other increases.

In addition to this “youth tax,” mandates like the “essential health benefits” and actuarial requirements further punish all Americans with benefits that they don’t need, at prices they can’t afford. While in places like Maryland, these mandates might only contribute eight to ten percent to premium increases, nationally they raise premiums by an average of 16.5 percent, up to 32 percent.

Overall, accounting for gender, age, and the relative proportions of all those groups, Americans are paying 44.5-68 percent more in premiums owing just to Title I regulations. That number is even higher when factoring all the other adverse effects of Obamacare.

Obamacare’s Title I regulations bid up the price of premiums drastically for many Americans. While the current House bill begins to repeal Obamacare, it does not go far enough, as many of the most damaging regulations are left in place.

Alleviating this pain should be strongly considered at every step of the process.

The post New Analysis: Premium Hikes Largely Caused by Obamacare Regulations appeared first on The Daily Signal.

House Freedom Caucus Chairman After White House Health Care Meeting: ‘No Deal’

House Freedom Caucus Chairman Mark Meadows, R-N.C., told reporters after a White House meeting that no deal had been reached on the House GOP’s health care bill.

Meadows and members of the conservative House Freedom Caucus met with Trump and his key advisers Wednesday in the hours before the House was expected to vote on the bill to repeal and replace Obamacare.

Following the meeting, Meadows said there was “no deal” in place at that time, according to the Associated Press.

Conservatives want Obamacare’s insurance regulations repealed in the plan, and say they believe undoing them will lower the cost of insurance premiums.

Trump met with the conservatives in hopes of convincing them to support the bill. But ultimately, it doesn’t appear the members were swayed at the meeting.

Rep. Raul Labrador, R-Idaho, told reporters he still wasn’t supporting the bill, despite meeting with Trump.

House leaders haven’t announced whether they’ll postpone tonight’s expected vote.

Despite the meeting’s outcome, White House press secretary Sean Spicer said “nothing leads me to believe” the vote was going to be canceled.

The post House Freedom Caucus Chairman After White House Health Care Meeting: ‘No Deal’ appeared first on The Daily Signal.

House Freedom Caucus Chairman After White House Health Care Meeting: ‘No Deal’

House Freedom Caucus Chairman Mark Meadows, R-N.C., told reporters after a White House meeting that no deal had been reached on the House GOP’s health care bill.

Meadows and members of the conservative House Freedom Caucus met with Trump and his key advisers Wednesday in the hours before the House was expected to vote on the bill to repeal and replace Obamacare.

Following the meeting, Meadows said there was “no deal” in place at that time, according to the Associated Press.

Conservatives want Obamacare’s insurance regulations repealed in the plan, and say they believe undoing them will lower the cost of insurance premiums.

Trump met with the conservatives in hopes of convincing them to support the bill. But ultimately, it doesn’t appear the members were swayed at the meeting.

Rep. Raul Labrador, R-Idaho, told reporters he still wasn’t supporting the bill, despite meeting with Trump.

House leaders haven’t announced whether they’ll postpone tonight’s expected vote.

Despite the meeting’s outcome, White House press secretary Sean Spicer said “nothing leads me to believe” the vote was going to be canceled.

The post House Freedom Caucus Chairman After White House Health Care Meeting: ‘No Deal’ appeared first on The Daily Signal.