Tag Archives: Obamacare

Senate Republicans reluctantly consider bipartisan healthcare talks

Healthcare activists with Planned Parenthood and the Center for American Progress protest in opposition to the Senate Republican healthcare bill on Capitol Hill in Washington, June 28, 2017. REUTERS/Joshua Roberts

By Amanda Becker and Susan Cornwell

WASHINGTON (Reuters) – As their seven-year effort to repeal and replace Obamacare derailed in the U.S. Senate, Republicans faced the prospect of doing the once unthinkable: working with Democrats to make fixes to former President Barack Obama’s 2010 healthcare law.

Bipartisan breakthroughs would likely come in the form of individual bills targeted at issues such as stabilizing insurance markets or lowering prescription drug costs. A wholesale overhaul of healthcare, senators say, is a bridge too far for the two parties, locked for years in an ideological battle on that issue and many others.

Democrats, clearly delighted with the turn of events, welcomed the Republicans’ failure to replace Obamacare as an opportunity to work together. Republicans conceded their other options may be exhausted.

“This is our moment, we have been waiting for this moment for months and months and in fact for years,” Democratic Senator Amy Klobuchar said at a Tuesday news conference.

Democrats are united in opposing repeal of the Affordable Care Act, popularly known as Obamacare, which boosted the number of Americans with health insurance through mandates on individuals and employers, and income-based subsidies.

The No. 2 Senate Republican, John Cornyn, told reporters it was “unfortunate” that he expected bipartisan talks to begin.

“Democrats are strongly committed to Obamacare and are unwilling to admit structural problems, which create the problems we are having in the individual market today,” Cornyn said. “But we’ll do the best we can with the hand we’ve been dealt.”

President Donald Trump invited all Republican senators to have lunch at the White House on Wednesday to discuss healthcare and other priorities, an administration official said, adding without elaboration: “There is movement on healthcare.”

Repealing and replacing Obama’s signature healthcare law was a top campaign promise for Trump and Republicans in Congress, who say it is a costly intrusion into the healthcare system.

Senate Majority Leader Mitch McConnell, working for the first time on major legislation with Republican control of both chambers of Congress and the White House, conceded on Monday night that there was not enough Republican consensus around his revised bill to replace Obamacare. He said he would instead hold a straight repeal vote sometime next week.

But at least three Republican senators have already said they oppose repealing Obamacare without an agreement on replacement legislation, likely dooming its prospects. McConnell can only lose two votes from his 52-seat majority in the 100-seat Senate to pass healthcare legislation.

Senate Republicans passed a straight repeal bill two years ago, but Obama vetoed it. The upcoming repeal vote will include a two-year delay, McConnell said.

That would “give us an opportunity to build something better on a bipartisan basis, that’s what I sense most of our members would like to vote on now, and we’ll be doing that in the near future,” McConnell told a news conference on Tuesday.

SHORING UP STATE MARKETS

An initial hurdle in coming weeks will be shoring up faltering state insurance markets by ensuring that insurers keep receiving subsidies that help lower the cost of insurance for low-income individuals.

The Trump administration will continue making the subsidy payments through August while a related Republican lawsuit is pending. The uncertainty beyond that has rattled insurers.

Republican senators have acknowledged the need to address the unstable markets but resisted Democratic calls to fund the subsidies without accompanying reforms, calling it a “bailout” for insurance companies.

Funding for the Children’s Health Insurance Program, a part of the Medicaid government health insurance program for the poor and disabled, known as CHIP, expires on Sept. 30 and will require reauthorization.

Bills to address the subsidy payments and CHIP would likely require 60 votes for passage, acting as a barometer of how inclined Republicans and Democrats are to work together, industry lobbyists and experts said.

Trump suggested on Tuesday that Republicans should allow the insurance markets to fail before working with Democrats. But Republican Senator Lamar Alexander, the head of the Senate Committee on Health, Labor and Pensions, said he would begin holding hearings on the issue in the next few weeks.

Senator Patty Murray, the top Democrat on the panel, said it would be “very smart” for lawmakers to work together to stabilize the markets by funding the subsidies.

“It would send a very strong message to the market, if Congress passes a bill. … I think that would do a lot to create some stabilization that is much needed,” Murray told Reuters.

(Additional reporting by Yasmeen Abutaleb; Editing by Mary Milliken and Peter Cooney)

Senate delays healthcare vote as McCain recovers from surgery

Sen. John McCain (R-AZ) speaks with reporters about the Senate health care bill on Capitol Hill

By David Morgan

WASHINGTON (Reuters) – The U.S. Senate will delay its consideration of healthcare legislation while Arizona Republican Senator John McCain recuperates from surgery, Senate Republican leader Mitch McConnell said on Saturday.

McCain’s absence cast doubt on whether the Senate would be able to pass the legislation to dismantle and replace Obamacare. McConnell needs 50 “yes” votes for passage in a chamber the Republicans control by a 52-48 margin.

“While John is recovering, the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act,” McConnell said in a statement.

The announcement came after McCain’s office said he would remain in Arizona next week following a procedure to remove a 2-inch (5-cm) blood clot from above his left eye.

Repealing and replacing President Barack Obama’s signature healthcare law was a top campaign promise for President Donald Trump and Republicans in Congress.

But two Republican senators have already declared their opposition to revised legislation unveiled on Thursday.

McCain has expressed concern about the healthcare bill but has not said how he would vote.

The 2008 Republican presidential nominee, McCain was resting comfortably at home in good condition after Friday’s operation, his office said.

“There are few people tougher than my friend John McCain, and I know he’ll be back with us soon,” McConnell said.

McCain’s surgeons removed the clot during a minimally invasive craniotomy through an incision in the 80-year-old lawmaker’s eyebrow. Tissue pathology reports would be available within the next several days.

“Thanks to @MayoClinic for its excellent care — I appreciate your support and look forward to getting back to work!” McCain, who chairs the Senate Armed Services Committee, said on social network Twitter late on Saturday.

 

(Reporting by David Morgan; Editing by Cynthia Osterman and Clarence Fernandez)

 

One more Republican defection would doom Senate healthcare bill

Senate Majority Leader Mitch McConnell speaks with reporters about the Senate health care bill on Capitol Hill in Washington, U.S., July 13, 2017. REUTERS/Aaron P. Bernstein

By Susan Cornwell and David Alexander

WASHINGTON (Reuters) – President Donald Trump turned up the heat on Friday on fellow Republicans in the U.S. Senate to pass a bill dismantling the Obamacare law, but with their retooled healthcare plan drawing fire within the party even one more defection would doom it.

Majority Leader Mitch McConnell has planned for a vote next week on revised legislation, unveiled on Thursday, and he has his work cut out for him in the coming days to get the 50 “yes” votes needed for passage. Republicans control the Senate by a 52-48 margin and cannot afford to lose more than two from within their ranks because of united Democratic opposition, but two Republican senators already have declared opposition.

“After all of these years of suffering thru Obamacare, Republican Senators must come through as they have promised,” Trump, who made gutting Obamacare one of his central campaign promises last year, wrote on Twitter from Paris, where he attended Bastille Day celebrations.

The top U.S. doctors’ group, the American Medical Association, on Friday called the new bill inadequate and said more bipartisan collaboration is needed in the months ahead to improve the delivery and financing of healthcare. Hospital and medical advocacy groups also have criticized the bill.

“The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage,” AMA President Dr. David Barbe said, referring to the government insurance program for the poor and disabled.

A major test for McConnell’s legislation expected early next week is an analysis by the nonpartisan Congressional Budget Office, which last month forecast that the prior version of the bill would have resulted in 22 million Americans losing insurance over the next decade.

A day after that CBO analysis was issued, McConnell postponed a planned vote on the legislation because of a revolt within his own party, including moderates and hard-line conservatives.

While the bill’s prospects may look precarious, the same could have been said of healthcare legislation that ultimately was passed by the House of Representatives. Republican House Speaker Paul Ryan called off a vote in March in the face of a rebellion involving the disparate factions of the party but managed to coax enough lawmakers to back it and engineered narrow approval on May 4.

PENCE SEEKS SUPPORT

Vice President Mike Pence sought to shore up support among the nation’s governors at a meeting in Rhode Island, but a key Republican governor, Ohio’s John Kasich, came out strongly against the revised bill, saying its Medicaid cuts were too deep and it does too little to stabilize the insurance market.

Kasich’s opposition could put pressure on Rob Portman, a Republican senator from Ohio, who has not yet taken a position on the bill.

If the current Senate legislation collapses, some lawmakers have raised the possibility of seeking bipartisan legislation to fix parts of Obamacare but leaving intact the structure of the Affordable Care Act, Democratic former President Barack Obama’s signature legislative achievement, commonly known as Obamacare.

“There are changes that need to be made to the law,” Dick Durbin, the No. 2 Senate Democrat, told MSNBC, citing “a bipartisan appetite to tackle this issue.”

Moderate Susan Collins and conservative Rand Paul already oppose the revised Senate bill. Other Republican senators have either expressed concern or remained noncommittal, including Portman, Mike Lee, Shelley Moore Capito, John McCain, Dean Heller, John Hoeven, Lisa Murkowski, Jeff Flake, Ben Sasse, Cory Gardner, Todd Young and Thom Tillis. Republican Senators Lindsey Graham and Bill Cassidy floated an alternative plan.

The new version was crafted to satisfy the Republican Party’s various elements, including moderates worried about Americans who would be left without medical coverage and hard-line conservatives who demand less government regulation of health insurance.

A provision championed by Republican Senator Ted Cruz and aimed at attracting conservatives would let insurers sell cheap, bare-bones insurance policies that would not have to cover broad benefits mandated under Obamacare.

But two major health insurance groups, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, called on McConnell to drop the Cruz proposal, saying it would undermine protections for pre-existing medical conditions, raise insurance premiums and destabilize the individual insurance market.

The bill retained certain Obamacare taxes on the wealthy that the earlier version would have eliminated, a step moderates could embrace. But it kept the core of the earlier bill, including ending the expansion of Medicaid that was instrumental in enabling Obamacare to expand coverage to 20 million people, and restructuring that social safety-net program.

John Thune, a member of the Senate Republican leadership, said in order to complete work on the bill by the end of next week, Senate leaders would have to try to formally begin debate on Tuesday or Wednesday, a move that requires a majority vote.

(Reporting by Susan Cornwell and David Alexander; Writing by Will Dunham; Editing by Bernadette Baum and Jonathan Oatis)

Senate may vote on revised healthcare bill next week

Senate Majority Leader Senator Mitch McConnell (R-KY) attends a new conference following party policy lunch meeting at the U.S. Capitol in Washington, U.S. July 11, 2017. REUTERS/Carlos Barria

By Yasmeen Abutaleb and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans said Tuesday they will seek to bring their healthcare overhaul to the Senate floor next week after a lengthy intraparty struggle, but it remained unclear whether they had the votes to pass the measure or even what form it would finally take.

With his reputation as a master strategist on the line, Senate Majority Leader Mitch McConnell laid out a timetable for Senate consideration of legislation to fulfill President Donald Trump’s campaign promise to dismantle the 2010 Affordable Care Act, also known as Obamacare.

In a departure from Republican orthodoxy on tax-cutting, the legislation likely will retain some of the taxes that were imposed on the wealthy under Obamacare, Senate sources said.

But it was unknown whether a revised version of the bill to be announced on Thursday morning can satisfy both moderates and hard-line conservatives in the Republican majority who voiced opposition to a draft unveiled last month on very different grounds.

With Trump urging the Senate to act before taking the August break, McConnell pushed back the Senate’s planned August recess by two weeks to allow senators more time to tackle the measure that would repeal key parts of Obamacare, as well as pursue other legislative priorities.

McConnell’s announcement drove a turn-around in stock prices in afternoon trading on Wall Street after an earlier sell-off, on hopes that a shortened recess could mean progress on the stalled Republican legislative agenda.

A dark mood lingered among some Republicans over the healthcare subject, with party leaders appearing to act because of the need to dispense with healthcare and turn to other issues, among them increasing the U.S. debt ceiling.

“I think we’ve narrowed down now to where we know where the decision points are, and we just have to make those decisions,” Senator John Thune, a junior member of the Republican leadership, told reporters. Leaders were still trying to “figure out how we get to 50” votes, he said.

Republicans, who hold 52 seats in the 100-seat Senate, would need 50 votes to pass the bill, with Vice President Mike Pence providing the tie-breaking vote.

“I am very pessimistic” about the prospects for Republican healthcare legislation, Chuck Grassley, a senior senator, told Fox News on Tuesday. Another Republican senator, Lindsey Graham, was working on his own healthcare proposal and will unveil it this week, a Graham aide said.

KEEPING OBAMACARE TAXES

McConnell said the plan was to vote on the healthcare bill next week, and said he hoped to have a fresh analysis of the bill from the nonpartisan Congressional Budget Office at the start of the week. He did not reveal any of the planned changes to the draft, on which he postponed action last month after it failed to gather enough support.

But Senate sources said it is likely that two Obamacare taxes on the wealthy will be kept in place – a 3.8 percent net investment tax and a 0.9 percent payroll tax that helps finance Medicare – which would appeal to moderates who have balked at the prospect of cutting taxes for the wealthy while reducing benefits for the poor.

“Obviously that’s the direction I think that a lot of our members want to move, is to keep some of those (taxes) in place and be able to use those revenues to put it into other places in the bill,” Thune said, while stressing that no decisions were final.

Republicans could also retain Obamacare’s limit on corporate tax deductions for executive pay in the health insurance industry, one Senate source said.

It was unclear whether the bill would include a proposal by conservative Republican Ted Cruz that would allow insurers to offer basic low-cost healthcare plans that do not comply with Obamacare regulations.

Cruz argues it would help to lower premiums, but critics say it would allow insurers to offer skimpier plans that may not cover essential health benefits while also charging more for more comprehensive, Obamacare-compliant plans.

The Senate Republican healthcare bill unveiled last month would phase out the Obamacare expansion of Medicaid health insurance for the poor and disabled, sharply cut federal Medicaid spending beginning in 2025, repeal many of Obamacare’s taxes, end a penalty on individuals who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

Democrats are united in opposition to the bill and at least 10 Republicans have said they oppose the existing draft. The House of Representatives passed its own version in May.

Moderate Republicans are uneasy about the millions of people forecast to lose their medical insurance under the draft legislation, and hard-line conservatives say it leaves too much of Obamacare intact.

Democrats call the Republican legislation a giveaway to the rich that would hurt the most vulnerable Americans.

(Additional reporting by David Morgan and Amanda Becker; Writing by Susan Cornwell and Tom Brown; Editing by Mary Milliken and Leslie Adler)

Trump presses congressional Republicans to pass healthcare plan

By Susan Heavey and Susan Cornwell

WASHINGTON (Reuters) – President Donald Trump on Monday prodded the Republican-led U.S. Congress to pass major healthcare legislation but huge obstacles remained in the Senate as key lawmakers in his party voiced pessimism about the chances of rolling back the Obamacare law.

The House of Representatives approved its healthcare bill in May but the Senate’s version appeared to be in growing trouble as lawmakers returned to Washington from a week-long recess.

“I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!” Trump wrote on Twitter, referring to the seven-year Republican quest to dismantle Democratic former President Barack Obama’s signature legislative achievement.

Trump appeared to be referring to the August recess that lawmakers typically take.

Senate Republican leaders have faced a revolt within their ranks, with moderate senators uneasy about the millions of Americans forecast to lose their medical insurance under the legislation and hard-line conservatives saying the bill leaves too much of Obamacare intact.

Republican Senator Pat Toomey said a new version of the legislation is expected to be released on Monday, telling the CNBC program “Squawk Box” that “there’s a shot” of getting to the 50 votes his party needs to win passage in the 100-seat Senate, with Vice President Mike Pence casting a tie-breaking vote.

Repealing and replacing the Affordable Care Act, dubbed Obamacare, was a central campaign pledge for Trump.

Obamacare expanded health insurance coverage to some 20 million people, with much of the increase due to an expansion of the Medicaid government health insurance program for the poor and disabled.

Republicans criticize the law as a costly government intrusion into the healthcare system while Democrats call the Republican legislation a giveaway to the rich that will hurt millions of the most vulnerable Americans.

“The Senate now is literally within weeks of being able to deliver on that promise to the American people,” Pence said in an interview with conservative radio host Laura Ingraham, adding there is “not yet agreement” in the Senate “but we are close.”

Some Republican lawmakers were more pessimistic, with Senator John McCain saying on Sunday the legislation is “probably going to be dead.”

Opponents of the legislation are expected to hold protests in Washington, organizing sit-ins at congressional offices, holding marches and stage vigils outside Republican senators’ homes. During last week’s recess, liberal groups organized town hall meetings and protests and ran advertisements criticizing the bill.

Senate Majority Leader Mitch McConnell faces the tricky task of crafting a bill that can attract Republican moderates and hard-line conservatives in a chamber his party controls with a slim 52-48 majority.

The Senate legislation would phase out the Medicaid expansion, drastically cut federal Medicaid spending beginning in 2025, repeal most of Obamacare’s taxes, end a penalty on Americans who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

The nonpartisan Congressional Budget Office, which assesses the impact of legislation, has estimated 22 million people would lose health insurance over the next decade under the Senate bill.

Shares of U.S. hospital companies and health insurers, which have been particularly sensitive to developments involving the healthcare legislation, were mixed in midday trading on Monday.

Among hospital stocks, Tenet Healthcare Corp edged up 0.3 percent while HCA Healthcare Inc fell 0.5 percent.

Insurer Anthem Inc inched up 0.1 percent while Centene Corp, an insurer focused on Medicaid, was flat.

The broader S&P 500 healthcare sector was off 0.1 percent, underperforming a 0.2 percent gain for the overall S&P .SPX.

(For a graphic on who’s covered under Medicaid, click http://bit.ly/2u3O2Mu)

 

(Additional reporting by Doina Chiacu; Writing by Will Dunham; Editing by Tom Brown)

 

Republican leaders work to buoy Senate healthcare bill

FILE PHOTO: U.S. Vice President Mike Pence attends a healthcare listening session at the White House in Washington, DC, U.S. June 5, 2017. REUTERS/Joshua Roberts

By Susan Cornwell and Richard Cowan

WASHINGTON (Reuters) – Republican leaders are in a frenzied push to shore up support for a healthcare bill in the U.S. Senate after a non-partisan congressional office said on Monday it would cause 22 million Americans to lose insurance over the next decade.

Vice President Mike Pence is expected to travel to Capitol Hill on Tuesday to join Senate Republicans for a policy lunch before hosting a key conservative senator for dinner.

Senate Majority Leader Mitch McConnell will continue meeting on-the-fence senators facing questions from their governors and state Medicaid offices about the bill’s cuts to the government insurance program for the poor and disabled, lawmakers said.

The Congressional Budget Office (CBO) analysis on Monday prompted Senator Susan Collins, a key moderate vote, to say she could not support moving forward on the bill as it was written.

At least four conservative Republicans – Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee – said their opposition remained unchanged after the CBO analysis.

Further, Collins, Paul and Johnson, along with Senator Dean Heller, have all said they will oppose a procedural motion that would allow McConnell to move forward and bring the bill up for a vote. Heller, a moderate Republican up for re-election next year in Nevada, is already facing political fallout after a group started by former campaign aides to President Donald Trump and Pence promised to run ads against him.

The overlapping concerns and competing interests of the lawmakers highlights the balancing act facing McConnell as he tries to unify his party and deliver a legislative win to the president.

Trump – and most Republicans in Congress – were elected on campaign pledges to repeal and replace Obamacare, Democratic President Barack Obama’s signature 2010 law that extended insurance coverage to some 20 million Americans. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate.

McConnell’s goal was to vote on the bill before the July 4 recess that starts at the end of this week. He can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate to pass healthcare, with Pence casting the tie-breaking vote.

Moderate senators are concerned about millions of people losing insurance. Conservative senators have said the Senate bill does not do enough to repeal Obamacare.

The CBO is only able to assess the impact of legislation within a 10-year window, but it said insurance losses were expected to grow beyond 22 million due to deep cuts to Medicaid that are not scheduled to go into effect until 2025. The CBO estimated it would decrease the budget deficit by $321 billion between 2017 and 2026.

If the Senate passes a bill, it will either have to be approved by the House, which passed its own version last month, or the two chambers would have to reconcile their differences in a conference committee. Otherwise, the House could pass a new version and bounce it back to the Senate.

(Writing by Amanda Becker; Additional reporting by Yasmeen Abulateb, Amanda Becker and Eric Walsh; Editing by Paul Tait)

U.S. Senate Republicans to issue revised health bill to win support

Speaker of the House Paul Ryan (R-WI) speaks after Senate Republicans unveiled their version of legislation that would replace Obamacare on Capitol Hill in Washington, U.S.

By Yasmeen Abutaleb and Richard Cowan

WASHINGTON (Reuters) – U.S. Senate Republicans plan to issue a revised version of their healthcare bill on Monday, according to a Republican Senate aide, as the chamber’s leaders scrambled to get legislation passed ahead of a July 4 holiday recess starting on Friday.

The aide, who is familiar with the plan, did not provide details of changes in the works. Politico reported that a likely change to the bill would be to add a provision to encourage people, mainly those who are young and healthy, to enroll in insurance plans.

President Donald Trump and his fellow Republicans in Congress have been pushing to repeal and replace Obamacare, Democratic former President Barack Obama’s signature domestic legislation. The House of Representatives passed its version of a healthcare bill last month.

The Senate bill unveiled last week was immediately criticized by both conservatives and moderates in the party. With Republicans holding only a 52-seat majority in the 100-seat Senate, the bill was unlikely to win passage in its initial form.

At least four conservative Republicans have expressed opposition to the draft legislation, saying it does not go far enough in repealing Obamacare.

A spokesman for Senate Majority Leader Mitch McConnell would not comment on whether a vote on a bill would be held in the full Senate on Thursday, as originally anticipated.

The nonpartisan Congressional Budget Office later Monday might release its assessment of the bill’s cost and impact on future budget deficits. It was not clear whether the report will also estimate how many people might lose healthcare coverage under the legislation or whether that estimate would come later.

Meanwhile, some moderate Republicans have either withheld judgment or expressed doubts about replacing Obamacare with legislation that is similar to the House version.

They are concerned that the party’s approach to healthcare would cause too many people, and especially those with low incomes, to lose insurance. Trump touted passage of the House bill as a victory but later called it “mean.”

Republicans have targeted Obamacare since it was passed in 2010, viewing it as costly government intrusion and saying individual insurance markets are collapsing. The legislation expanded health coverage to some 20 million Americans, through provisions such as mandating that individuals obtain health insurance and expanding Medicaid, the government program for the poor.

TRUMP’S INVOLVEMENT

As he did during the House negotiations, Trump has personally pushed for a Senate bill, calling fellow Republicans to mobilize support.

In the efforts by Senate Republicans to push through a bill, the party has split over a provision in the draft bill ending federal funding of Planned Parenthood, the women’s healthcare provider, for one year.

Moderates are wary of this, while conservatives have called for an end to federal funding of Planned Parenthood because it provides abortions, even though they are not performed with taxpayer dollars.

Health insurance companies are concerned about the bill’s plan to cut Medicaid and any impact on state governments as well as the prospect of losing Obamacare’s mandate on individuals to buy insurance without creating alternative incentives for people to stay in their plans.

If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate.

The House is also controlled by Republicans but faced a similar balancing act between moderates and conservatives to pass its version.

A Republican leadership aide in the House said if the Senate manages to pass a healthcare bill this week, no decision has been made on when the House might schedule a vote on it or whether House Republicans might seek any changes to the Senate measure.

(Writing by Richard Cowan and Frances Kerry; Editing by Jeffrey Benkoe)

Senate Republicans unveil Obamacare replacement bill, but fate uncertain

U.S. Capitol is seen after the House approved a bill to repeal major parts of Obamacare and replace it with a Republican healthcare plan in Washington, U.S., May 4, 2017. REUTERS/Yuri Gripas

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – U.S. Senate Republicans on Thursday unveiled legislation that would replace Obamacare with a plan that scales back aid to the poor and kills a tax on the wealthy, but the bill’s fate was quickly thrown into question as several senators voiced skepticism.

Four conservative lawmakers said they could not support it in its current form, leaving Republicans short of the votes they need for passage. Democrats are united in opposition.

The 142-page proposal, worked out in secret by a group led Senate Majority Leader Mitch McConnell, aims to deliver on a central campaign promise of President Donald Trump by rolling back former President Barack Obama’s signature healthcare law, which has provided coverage to millions of Americans since it was passed in 2010.

Republicans view the law, formally known as the Affordable Care Act, as a costly government intrusion into the private marketplace.

Trump welcomed the bill but indicated that changes may be in store.

“I am very supportive of the Senate #Healthcarebill. Look forward to making it really special!” he wrote on Twitter.

Trump urged the House of Representatives to pass a similar bill in May, only to criticize it in private as “mean” once it passed. He said on Wednesday he wanted a health plan “with heart.”

Democrats immediately attacked the legislation as a callous giveaway to the rich that would leave millions without coverage.

“The president said the House bill was mean,” said Senate Democratic leader Chuck Schumer. “The Senate bill may be even meaner.”

Obama weighed in on Facebook. “If there’s a chance you might get sick, get old, or start a family – this bill will do you harm,” he wrote.

The Senate’s most conservative members said the plan did not do enough to scale back the U.S. government’s role.

“This current bill does not repeal Obamacare. It does not keep our promises to the American people,” said Senator Rand Paul, who along with fellow Republican Senators Ted Cruz, Mike Lee and Ron Johnson said they could not support it in its current form.

Shares of hospital companies and health insurers rose on the bill’s release, with the overall S&P 500 healthcare sector closing up 1.1 percent at an all-time high.

“The initial proposal I think is more generous and more positive to the industry than expected,” said Jeff Jonas, a portfolio manager with Gabelli Funds.

SHARPER CUTS TO MEDICAID

Over months of often bitter debate, Republicans have struggled to craft legislation that lowers costs and reduces government involvement, while minimizing the inevitable disruptions that would come with a revamp of a sector that accounts for one-sixth of the world’s largest economy.

The nonpartisan Congressional Budget Office found that the House bill would kick 23 million Americans off their health plans, and the legislation is unpopular with the public. Fewer than one in 3 Americans supports it, according to Reuters/Ipsos polling.

The Senate measure maintains much of the structure of the House bill, but differs in several key ways.

The Senate bill would phase out Obamacare’s expansion of the Medicaid program for the poor more gradually than the House version, waiting until after the next presidential election in 2020, but would enact deeper cuts starting in 2025. It would also allow states to add work requirements for some of the 70 million Americans who depend on the program.

The legislation also provides more generous tax subsidies than the House bill to help low-income people buy private insurance.

Those subsidies would be based on income, rather than the age-based subsidies contained in the House bill – a “major improvement,” according to Republican Senator Susan Collins, a key moderate who has expressed concern over the bill’s impact on the poor.

The Senate legislation provides less money, however, for the opioid epidemic, allocating $2 billion in 2018, compared with $45 billion over 10 years in the House version.

Both versions would repeal the 3.8 percent net investment income tax on high earners, a key target for Republicans.

They also would repeal a penalty imposed on large employers that do not provide insurance to their workers, and remove the fine that Obamacare imposes on those who choose to go uninsured.

Policy experts said that would keep more young, healthy people out of the market and likely create a sicker patient pool.

The Senate bill would provide money to stabilize the individual insurance market, allotting $15 billion a year in 2018 and 2019 and $10 billion a year in 2020 and 2021.

It proposes defunding Planned Parenthood for a year, but abortion-related restrictions are less stringent than the House version because of uncertainty over whether they would comply with Senate rules. They could be included in another Senate bill.

McConnell said Democrats chose not to help frame the bill, which Republicans say would fix a collapsing health marketplace.

“Republicans believe we have a responsibility to act, and we are,” he said.

Democrats say they offered to help fix Obamacare but were rebuffed.

The bill’s real-world impact is not yet known, but the CBO is expected to provide an estimate early next week.

As lawmakers spoke about the legislation on the Senate floor, a protest erupted outside McConnell’s personal office, with many people in wheelchairs blocking a hallway, holding signs and chanting: “No cuts to Medicaid.” U.S. Capitol Police said 43 protesters were arrested and charged with obstruction.

Aside from the quartet of conservatives, none of the other 48 Republican senators appeared to reject the bill out of hand. But several said they would check with home-state constituents before taking a position.

“I expect there’s going to be a number of changes between now and the final vote,” said Senator John Barrasso of Wyoming.

(Additional reporting by Yasmeen Abutaleb, Caroline Humer and Lewis Krauskopf; Writing by Andy Sullivan and Steve Holland; Editing by Jonathan Oatis and Peter Cooney)

Obamacare replacement bill to take center stage in Senate

U.S. Capitol is seen after the House approved a bill to repeal major parts of Obamacare and replace it with a Republican healthcare plan in Washington, U.S., May 4, 2017. REUTERS/Yuri Gripas

By Richard Cowan and Susan Cornwell

WASHINGTON (Reuters) – A seven-year push by U.S. Republicans to dismantle Obamacare and kill the taxes it imposed on the wealthy will reach a critical phase on Thursday when Senate Republican leaders unveil a draft bill they aim to put to a vote, possibly as early as next week.

Senate Majority Leader Mitch McConnell and his lieutenants have worked in secret for weeks on the bill, which is expected to curb Obamacare’s expanded Medicaid help for the poor and reshape subsidies to low-income people for private insurance.

Those subsidies are expected to be linked to recipients’ income in the Senate bill, a “major improvement” from a measure approved last month by the U.S. House of Representatives that tied them solely to age, Republican Senator Susan Collins of Maine said.

Some of the Senate bill’s provisions could be political land mines, with individual senators’ reactions to it crucial to determining whether or not the Affordable Care Act, popularly known as Obamacare, survives a Republican attack that has been under way since its passage in 2010.

The Washington Post reported on Wednesday that the bill would seek to repeal most of the taxes that pay for Obamacare, give states more latitude to opt out of its regulations and eliminate federal funding for Planned Parenthood, a healthcare provider that offers abortion services.

Former Democratic President Barack Obama’s signature domestic policy achievement has been a target of Republican wrath for years. But even with control of both chambers of Congress and the White House since January, the party has struggled to make good on its bold campaign promises to repeal and replace Obamacare.

The law is credited with expanding health insurance to millions of Americans. Republicans say it costs too much and involves the federal government too much in healthcare. President Donald Trump made Obamacare repeal a centerpiece of his 2016 campaign and celebrated the House-passed bill.

Democrats accuse Republicans of sabotaging Obamacare, and say the Republican bill will make healthcare unaffordable for poorer Americans while cutting taxes for the wealthy.

TOUGH SELL

But McConnell may have a tough job convincing enough Republican senators that the Senate bill improves on the House version. A Reuters/Ipsos poll found nearly 60 percent of adults believed the House bill would make insurance costlier for low-income Americans and people with pre-existing conditions. Only 13 percent said it would improve healthcare quality.

The non-partisan Congressional Budget Office estimated the House bill would kick 23 million people off their healthcare plans. Healthcare is a top priority for voters and many Republicans fear a legislative misstep could hurt them.

Collins said she would weigh the CBO’s upcoming assessment of the Senate bill’s impact on costs and coverage.

Conservative Republican Senator Rand Paul, who wants a full repeal of Obamacare, said he feared that with the legislation being developed, “we’re actually going to be replacing Obamacare with Obamacare,” referring to the continuing role of government.

If legislation is to prevail in the Senate, McConnell can lose the support of only two of his 52 Republicans, assuming all 48 Democrats and independents oppose the bill, as expected.

(Reporting by Richard Cowan and Susan Cornwell; Editing by Kevin Drawbaugh and Peter Cooney)

Democrats protest Senate Republican healthcare secrecy

FILE PHOTO - U.S. President Donald Trump (C) turns to House Speaker Paul Ryan (3rdL) as he gathers with Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, to repeal major parts of Obamacare and replace it with the Republican healthcare plan, in Washington, U.S., May 4, 2017. REUTERS/Carlos Barria

By Susan Cornwell

WASHINGTON (Reuters) – U.S. Democrats took to the Senate floor on Monday to throw a spotlight on behind-the-scenes efforts by the Republican majority to repeal former President Barack Obama’s healthcare law, known as Obamacare.

In a series of floor motions, inquiries and lengthy speeches, Democrats criticized the closed-door meetings that Republicans have been holding to craft a replacement for Obamacare, formally known as the Affordable Care Act. They called for open committee hearings and more time to consider the bill before a Senate vote, which Republicans say could come in the next two weeks, although a draft bill has yet to emerge publicly.

Lacking the votes to derail or change the Republican process, the maneuvers by the Democratic minority seemed more aimed at highlighting Republican efforts on a controversial issue. Polls have said that a majority of Americans disapprove of the Obamacare replacement that has passed the House of Representatives and that Senate Republicans are now considering.

Senate Democratic Leader Chuck Schumer said that the closed-door Republican meetings on healthcare amounted to “the most glaring departure from normal legislative procedure that I have ever seen.”

“Republicans are writing their healthcare bill under the cover of darkness because they are ashamed of it,” Schumer charged. The resulting legislation would likely throw millions out of health insurance, he said, while granting “a big fat tax break for the wealthiest among us.”

Senators are not obligated to hold meetings in the open, but Democrats pointed out that there were lengthy committee meetings and many days of floor debate on Obamacare before it passed in 2010.

Several Democrats moved for the healthcare legislation to be referred to Senate committees for hearings, but Senate Majority Leader Mitch McConnell refused.

McConnell said all Republican senators have been involved to some degree in healthcare meetings and that Democrats would have a chance to amend the legislation they produce, once it is brought to the Senate floor.

“We’re going to have a meeting on the Senate floor, all hundred of us, with an unlimited amendment process,” McConnell said. “So there will be no failure of opportunity.”

Senate Republican leaders would like a vote on healthcare legislation in July, before the July 4 recess if possible. But Republicans have struggled to coalesce around a bill, with moderates and conservatives pushing in different directions.

Senate Republicans also face pressure from the right. In the House, conservatives have written to McConnell to express concern about reports that say the Senate may water down the House bill.

(Reporting by Susan Cornwell; Editing by Jonathan Oatis and Leslie Adler)