Is TrumpCare in your future??? If so, open your wallet...

House approves GOP bill to repeal and replace Obamacare

By Carolyn Lochhead

House Republicans won a significant but politically perilous victory in their seven-year campaign against Obamacare on Thursday, voting to replace the Affordable Care Act with a law that would remove the requirement that all adults carry health insurance, let states strip coverage requirements and open the door for insurers to charge higher premiums for people with past or current health problems.

No Democrats voted for the bill, which was approved by a 217 to 213. The legislation now goes to the Senate.

Republican leaders said their bill, the TrumpCare American Health Care Act, would lower insurance costs for younger and healthy people, provide customers with more options and supply funding to help people with health problems, or pre-existing conditions, pay what could be sharply higher premiums.

The Democratic leader in the House slammed the he Republican health care bill that appears on its way toward final passage. Rep. Nancy Pelosi called it a "stupid bill." (May 4)
Media: Associated Press

“We know we can have fair health care that helps those who need it without trapping everyone in a government-run system dreamed up by Washington central planners,” said House Majority Leader Kevin McCarthy, R-Bakersfield.

House Speaker Paul Ryan, R-Wis., said the vote heralded “a new era of reform based on liberty and self-determination.”

Democrats cited independent analyses indicating that millions of people who gained coverage under Obamacare would lose it under the GOP measure.

“Most Americans don't know their member of Congress, but they will now,” said House Democratic leader Nancy Pelosi of San Francisco, a chief architect of the Affordable Care Act. She told Republicans, “You have every provision of this bill tattooed on your forehead. You will glow in the dark.”

Democrats hope both to kill the measure in the Senate and use the House’s repeal-and-replace vote to bludgeon Republicans in the 2018 midterm elections. Nearly every major health care group from the American Medical Association to the American Lung Association opposed the bill, as did AARP, which lobbies for senior citizen issues.

California Democrats said the bill would prove devastating in their home state, especially lower-income areas where many of the working poor could be stripped of Medicaid coverage. The bill could cost the state $160 billion in federal revenue.

President Trump and House leaders applied intense pressure on wavering Republicans, including several members of California’s GOP delegation, arguing that the party had to fulfill its promise to repeal Obamacare or face the wrath of its own voters. Several members of the delegation who had said until this week that they were undecided on the bill voted “yes” Thursday.

One of them, Rep. Dana Rohrabacher, R-Costa Mesa (Orange County), quoted former President Ronald Reagan in declaring the Affordable Care Act untenable, saying, “The status quo is Latin for the mess we’re in.”

Obamacare has been a GOP target and campaign talking point ever since it became then-President Barack Obama’s main domestic priority in his first term. Trump said during the campaign that he wanted to sign a repeal bill on his first day in office, voiced frustration with both Republicans and Democrats when an earlier version of the bill stalled in March, and lobbied heavily for the latest measure.

As public attention focused on how Republicans would replace Obamacare, public support for the law grew. Throughout Obama’s presidency, it was opposed by more Americans than backed it, according to the RealClear Politics’ average of opinion polls. Now, however, it is backed by 49.6 percent to 42.1 percent.

The Republican proposal was retooled after March to appease far-right GOP members of the Freedom Caucus. They won the provision allowing states to opt out of the ban on charging more for people with pre-existing conditions. They would also let states end requirements that insurers offer “essential benefits” in any policy they sell, such as coverage for prescription drugs, maternity care and emergency room services.

Key to winning the support of more moderate Republicans for the new measure was an amendment co-sponsored by three California Republicans — Reps. Steve Knight of Lancaster (Los Angeles County), David Valadao of Hanford (Kings County) and Jeff Denham of Turlock (Stanislaus County) — adding $8 billion over five years to help people with pre-existing conditions pay for health insurance. The amendment is largely irrelevant to California, which embraced the Affordable Care Act and is unlikely to opt out of its insurance standards.

Democrats and other critics of the measure derided the $8 billion in federal funding as far too little to cover the number of people who would be at risk of skyrocketing premiums in states that do opt out of the Obamacare requirements.

Republicans held the vote without an analysis by the Congressional Budget Office, the nonpartisan arm of Congress that assesses the effects of legislation on the public. Rep. Chris Collins, R-N.Y., said Republicans did not need a new analysis because there were only minor changes to the original repeal-and-replace legislation that Republicans withdrew just before a vote in March.

The budget office said that legislation would cause 24 million people to lose or drop their insurance by 2026, and that premiums in the individual market could spike as much as 20 percent in the first two years before leveling off.

Many of those who lose insurance qualified for coverage under the Affordable Care Act’s expansion of Medicaid. The Republican bill guts funding for that expansion.

In addition, the measure would repeal the Affordable Care Act’s requirement that all adults who can afford it carry health insurance or pay a tax penalty. That was one of the main sources of funding for covering people who had been unable to obtain coverage before Obamacare’s passage.

It would also repeal taxes on high-income people, prescription drugs, medical devices and indoor tanning that had paid for expanded coverage.

To replace at least some of that money, the GOP bill would let insurers impose a 30 percent surcharge on people who go more than 63 days without coverage, then seek a new policy.