Republicans reach a major impasse on their own health care bill

The party can’t decide if Trumpcare leans too far left or too far right.

President Donald Trump and House Speaker Paul Ryan of Wis. on Capitol Hill, Thursday, March 16, 2017, during a “Friends of Ireland” luncheon. CREDIT: AP/Evan Vucci
President Donald Trump and House Speaker Paul Ryan of Wis. on Capitol Hill, Thursday, March 16, 2017, during a “Friends of Ireland” luncheon. CREDIT: AP/Evan Vucci

A number of Republican appearances on Sunday morning television programs show just how scattered Republicans are in their support of the American Health Care Act. On Thursday, the bill will come up for a vote in the House.

Ryan is willing to make changes to the Republican plan in an effort to appeal to both moderate republicans and conservatives who oppose the plan, and in doing so, risks losing even more support for the bill. On Fox News Sunday, Ryan said lower-income older people should receive more assistance from tax credits than under the current bill.

He added that Republicans are seeking changes that allow for federal block grants to states for Medicaid. Ryan told Fox News Sunday’s Chris Wallace that he felt “very good” about the chances the bill would pass the House.

“I feel very good about it actually. I feel that it is exactly where we want to be. And the reason I feel so good about this is because the president has become a great closer. He is the one who has helped negotiate changes to this bill… All Republicans in the House, Senate, and the president made a promise that we would repeal and replace this faulty, collapsing law, and we’re going to make good on that promise.”

Sen. Rand Paul (R-KY) offered a very different perspective in his interview with This Week’s George Stephanopoulos. When Stephanopoulos asked Paul whether there are enough conservatives in the House who will vote for it, Paul said, “I don’t believe so.” Conservatives have called the health care bill “Obamacare-lite” said tax credits are too similar to those under Obamacare.

Paul explained:

“I talked to the House Freedom Caucus leadership over the weekend. They still believe that the conservatives in their caucus don’t want Obamacare-lite. I believe the real negotiation begins when you stop them. You have to stop them. Conservatives will only have a seat at the table if you have 21 votes or three or four in the Senate. At that point, it will become a real negotiation.”

After offering changes to the bill that would allow states the option of including optional work requirements for Medicaid recipients “who are able-bodied and without dependents,” and Medicaid block grants instead of per-capita grants, the conservative House Republican Study Committee endorsed the legislation. But on Friday, the even more conservative House Freedom Caucus tweeted that it still opposes the bill in its current form.


If the bill moves too far to the right, however, it may not have enough support to pass in the Senate. Eighteen Republicans senators said they have reservations about the bill. Sen. Susan Collins (R-ME) said the bill will leave rural Americans and seniors behind.

Health and Human Services Secretary Tom Price was apparently tasked with both defending the bill in its current form and making the case that it was above criticism because it will undergo changes during the legislative process. He told Stephanopoulos that Medicaid work requirements were “restorative to people’s self worth” and that Medicaid recipients should “contribute to society.”

He told Jake Tapper Americans shouldn’t worry about the Congressional Budget Office’s assessment of how many people would lose insurance under the plan (24 more million people than under Obamacare) because the bill will undergo changes.


“This bill that’s moving through Congress right now is simply the first step… Every American will have access to the kind of coverage that they want,” Price told Tapper.

When Tapper pressed Price on the fact that every American having access to coverage is different the president’s guarantee that every American would have insurance, Price said, “What the Congressional Budget Office looked at was simply the first piece of legislation. It’s not the plan in its entirety.”

So far, President Donald Trump’s role in the process has been to push for changes that would appease conservatives who consider the health care law to be much like Obamacare. On March 8, Trump met with groups that opposed the AHCA, such as the Heritage Foundation, Club for Growth, Tea Party Patriots, and Americans for Prosperity. The groups were “heartened” that the administration would consider rolling back Medicaid in 2018, a year earlier than the AHCA would allow, Politico reported.

On Friday, the president said he was “100 percent” behind the health care bill, although the White House insists it doesn’t want it to be called “Trumpcare.” In an interview on Fox News, Kellyanne Conway, senior White House adviser, said, “I didn’t hear President Trump say to any of us, ‘Hey, I want my name on that… This is serious stuff. It’s not about branding according to someone’s name.”

Meanwhile, as the bill comes under attack, House Speaker Ryan continues to emphasize the president’s involvement in writing the bill.