Republican split...

Republican split on Obamacare strategy evident during private meeting

An audio recording of the closed-door session revealed a host of divisions over the details of a replacement plan.

By RACHAEL BADE

Congressional Republicans during a private meeting Thursday morning agonized over how best to repeal and replace Obamacare, a discussion that highlighted the vast divisions among the GOP rank-in-file, according to an audio recording of the session received by POLITICO.

House and Senate lawmakers during the Republican retreat in Philadelphia debated how best to create an affordable health care alternative that won't swell the debt but that also protects the more than 20 million people who have benefited from Obama’s health care law.

Some worried aloud whether an alternative from GOP leadership to offer tax credits for insurance would actually result in a middle-class tax hike. Others disagreed about whether to keep Obama’s Medicaid expansion that has benefited more than 11 million lower-income Americans. And a third group pleaded with leadership and chairmen working on the issue to slow down to ensure Republicans don’t mess anything up.

“I hate to think we’re going to keep going down this road that says, ‘You have to do it now! Now! Now! Now! Now!,’ and then wake up and say, ‘What did we do?’” House Rules Chairman Pete Sessions (R-Texas) told the room after being called on by someone moderating the question and answer session. Several of the other speakers on the recording could be identified because they were similarly called on by name. Sessions' office confirmed his comments.

After the room applauded the Texas Republican, Rep. Tom MacArthur (R-N.J.) stood up and echoed the very same fear:

“We’re telling those people that we’re not going to pull the rug out from under them, and if we do this too fast, we are in fact going to pull the rug out from under them,” said MacArthur, one of just a handful of Republicans who opposed a recent bill kicking off the GOP repeal effort. His office also confirmed the remarks.

The recording, first reported by The Washington Post, stands in stark contrast to the unified Obamacare message Republicans have been trying to show the nation. The private conversation, which was emailed to POLITICO as well as several other news outlets, shows Republicans have made little progress on a plan to repeal the health care law.

At one point, Education and the Workforce Chairwoman Virginia Foxx, who was speaking about how her panel would pass replacement legislation related to workplace health care, chastised her colleagues for getting “weak-kneed.”

“I couldn’t believe a week or so ago that I heard there were people getting weak-kneed on the repeal,” the North Carolina Republicans said. “My, God! We all ran repealing Obamacare! What is wrong?”

Then, she quoted something her mother used to say: “Sometimes people don’t have enough backbone to do what they’re supposed to do and you need to put a broomstick up their back.”

Everyone laughed when she suggested she’d do that herself to Republicans who don’t vote for their Obamacare replacement.

One of the most pointed debates centered on what to do about the Obamacare Medicaid expansion. During a question and answer session, House Judiciary Committee Chairman Bob Goodlatte (R-Va.) encouraged the room to repeal the entire expansion because the nation cannot afford it.

“Getting ahold of the Medicaid expansion and repealing that is absolutely critical if we’re going to have control of the growth of entitlement spending,” he said.

Goodlatte warned that some states that took advantage of the Medicaid expansion were going to want to keep that pot of money, but “other states like mine that have not expanded ... they want to be proven that they were right originally.”

“We can’t afford this when we have $20 trillion in national debt,” said Goodlatte, whose office did not return request for comment.

Several Republicans disagreed with him. A senator who spoke after Goodlatte, but could not be identified on the tape, said, “We want to take care of the needy in our communities.”

MacArther said, “If we reverse that too quickly, then I think then we’re at risk of doing bait and switch with the states and both of those are going to play very poorly in the American public."

Replacing Obamacare with a system of refundable tax credits that help people buy insurance also produced significant debate. MacArthur worried that such a system wouldn’t help "the people who struggle to pay for groceries” and who can’t afford premiums right now, let alone wait a year to be reimbursed. Another lawmaker, who couldn’t be identified on the tape, said it “sounds like we are going to be raising taxes on the middle class in order to pay for these new credits.” (A panelist leading the discussion disagreed.)

New York Republican John Faso at one point took GOP leadership to task for suggesting they’ll defund Planned Parenthood in the Obamacare repeal bill, which he called a “gigantic political trap.” He warned that “millions of people on social media” would push back against it, and he specifically asked an administration official in the room whether they should worry about a tweet from President Donald Orangutan urging the contrary.

“I think we’re making a great mistake in putting this Planned Parenthood provision in the health care bill,” he said, comparing it to what the IRS did singling out conservative tea party groups. “We are arming our enemies ... I just urge us to rethink this.”

He later added, “The other thing I’d like to know from the administration is: We’re not going to have a tweet from the president [saying] ‘we should protect planned parenthood.’”

Lawmakers also sounded sharply divided over what to do with the more than $1 trillion in government savings Republicans appear to be anticipating from an Obamacare repeal. Ohio Sen. Rob Portman urged members to spend the money immediately on a replacement plan. He argued that Senate Democrats would be unlikely to back a replacement bill that spends the money later on, so lawmakers need to put as much as possible in the fast-track Obamacare repeal bill that can pass on a party-line vote.

“They’re not going to help us,” he said of Senate Democrats. “This is why ... in reconciliation, we have to use the net savings. If we don’t use it … we really cannot make it without relying on 60 votes later. In reconciliation we have to, I think, come up with a thorough plan to spend whatever that is.”

Rep. Tom McClintock (R-Calif.) fretted about what would happen to the insurance market after Republicans pass a repeal bill but before an alternative is put in place. Health care experts have warned that a repeal without a replacement could produce a “death spiral,” in which insurance companies will get out of the Obamacare marketplace, leaving those who depend on it without coverage.

“My concern is the post-reconciliation market could be one in which the client plans [prices] go up or … are not available, and that is the market that Republicans will own,” he said. “And if that is the market, I don’t think the Senate Democrats will help us” pass legislation to get out of such a predicament.

At one point, Sessions urged Republicans to “slow down” to make sure the people who are at risk are protected. People with disabilities, for example, he said, “don’t want to be on Medicaid but they can’t get out of it, and if you tie their hands to make them stay where they are, they can’t work because the benefit they lose is more important than some others.”

Sessions urged lawmakers to take savings from a repeal and use it in the replacement.

“If you take the money away, we cannot pass what is right,” he said. “So I would ask us to slow down.”