Yahoo News’ Health Care Declassified series provides continuing coverage of the Republican efforts to repeal and replace Obamacare. We’ll combine our own reporting with the best insights from around the Internet to give you the latest on the future of health care in America.
WASHINGTON — President Trump is now “fully” behind a plan to repeal Obamacare and then delay its implementation for a year while senators come up with a replacement, according to an aide for Sen. Rand Paul, R-Ky.
“Senator Rand Paul suggested this very idea to the president,” Paul’s spokesman Sergio Gor told Yahoo News Friday. “He fully agrees that we must immediately repeal Obamacare and then work on replacing it right away.”
The president tweeted his support for the “repeal and delay” plan Friday morning, just days after Senate Majority Leader Mitch McConnell, R-Ky., was forced to postpone his health care bill amid deep divisions between conservatives and moderates in his caucus.
If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!
— Donald J. Trump (@realDonaldTrump) June 30, 2017
Sen. Ben Sasse, R-Neb., wrote a letter to Trump outlining this plan.
“On the current path, it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that attempts to prop up much of the crumbling Obamacare structures,” Sasse wrote in the letter. “We can and must do better than either of these — both because the American people deserve better, and because we promised better.”
Sasse called for senators to fully repeal Obamacare by the end of July, and then cancel August recess to work on a replacement they would have a year to pass before repeal kicked in.
Sounds great, Pres. @realDonaldTrump
— Ben Sasse (@BenSasse) June 30, 2017
At least one other conservative senator embraced the plan Friday. “Full repeal followed by an open process on replace is exactly what we called for back in DECEMBER!!!” Conn Carroll, an aide for Sen. Mike Lee, R-Utah, wrote in an email.
Shortly after the 2016 election, Republican lawmakers were coalescing around a similar plan to immediately pass a bill repealing Obamacare with a one- or two-year delay of its implementation to leave time to come up with a replacement. But Paul and at least three other GOP senators turned against the plan in January, with Paul saying he personally convinced the president to abandon it as well. Paul argued at the time that Republican senators must agree on a replacement to pass the same day they repealed the Affordable Care Act. Key moderate senators like Susan Collins, R-Maine, also rebuffed the plan, calling for simultaneous repeal and replace to ensure no one was left with a gap in coverage if senators could not agree on a plan.
Coming up with a replacement has been far more difficult than the caucus anticipated, however, with both moderate and conservative senators facing off in a stalemate over how much to cut Medicaid and other issues. A nonpartisan Congressional Budget Office analysis of the Senate bill estimated that in 10 years 22 million fewer Americans would be insured under it than under current law. Conservatives like Paul want to repeal all of Obamacare, while moderates like Collins want to give more Americans access to health care insurance by fixing the current system.
McConnell was forced to delay the vote he had vowed to push through before the Fourth of July, and then blew another self-imposed deadline when senators could not agree to a new deal by Friday, before they headed home for a weeklong recess.
Trump has been all over the map on health care, publicly embracing the House bill and then confirming in an interview that he told senators it was “mean.” If he follows through on an embrace of repeal and delay, it could be another presidential-sized headache for McConnell. The “mean” quip caused at least one GOP senator to warn his colleagues that the president would not “have your back” on the unpopular health care overhaul.
It’s unclear if McConnell would support a repeal and delay policy, even if his caucus can’t agree on a replacement. Gor said Paul’s office had not heard from McConnell’s on the plan, and Lee’s aide Carroll said he would be surprised if GOP leadership supported the plan. A spokesman for McConnell declined to comment.
GOP moderates would also likely raise the same objections they did last time around, arguing that if senators failed to reach a compromise, millions of Americans would be left uninsured by repeal. An aide for Collins told Yahoo News she would be unlikely to ever back the plan. And it’s unclear why senators believe they can reach a deal to replace Obamacare that the entire caucus can agree on within a year.
The Congressional Budget Office estimated 32 million more Americans would be uninsured after 10 years if Obamacare was repealed without a replacement, and premiums would skyrocket.
A Senate Democratic aide who did not wish to be named talking about the political implications of the bill said he believed repeal and delay would be “worse” for Republicans than a repeal and replace strategy. “The only thing worse than the original Republican bill would be pursuing repeal and delay,” he said. “Republicans would be doing nothing but doubling down on their already significant mistakes.”
Cruz reportedly proposes establishing dual markets
Sen. Ted Cruz, R-Texas, has proposed a provision that could help pass the health care bill stalled in the Senate, according to Vox. The provision would allow insurers who offer insurance plans compliant with Obamacare regulations — including protections for those with preexisting conditions — to also sell noncompliant plans that might be cheaper in the same state.
“It’s not fair to a working-class person who’s struggling to put food on the table, for the federal government to double their premiums trying to work an indirect subsidy for others who are ill,” Cruz told Vox. “Far better to have it through direct tax revenue.”
Under Cruz’s plan, Americans would have the option to purchase lower cost, less protective plans or more expensive, robust plans complete with Obamacare provisions that are subsidized by the federal government. The potential problem with the plan, however, is that only the sickest Americans will purchase the Obamacare compliant plans, therefore substantially inflating their cost.
“If they’re healthy, they could buy inexpensive noncompliant plans. But if they have pre-existing conditions, they’d be stuck in plans with escalating premiums,” Larry Levitt, senior vice president at the Kaiser Family Foundation, told Vox.
Currently Senate Republicans are ideologically divided between conservatives who want to repeal all of Obamacare and moderates who want to keep some of its provisions, according to Sen. Rand Paul, R-Ky. Cruz is among the group of conservatives who said they would not vote for the current version of the legislation. By allowing insurers to sell both regulated and unregulated plans, Cruz’s proposal could potentially satisfy both sides.
Cruz’s office did not immediately respond to Yahoo News’ request for comment. — Taylor Rogers
Health care bill could slash funding from public schools
Schools could lose funding for students with disabilities and low-income children if the Senate health care bill passes, the Washington Post reported.
In the new Senate bill, a “per capita cap” system would require the federal government to give a fixed amount of funding rather than match whatever the states spend on Medicaid.
The Senate version of the bill would cut about $772 billion from federal spending over the next decade, according to the nonpartisan Congressional Budget Office.
Like doctors and hospitals, schools can register as Medicaid providers. Schools must also fight cuts in state education budgets, and superintendents say that it’s likely certain programs would have to be cut or downsized if the health care bill passes.
Even though schools receive less than 1 percent of federal Medicaid funds, according to the Post, the federal dollars make up the third-largest federal fund to public schools. States could choose to bar schools from receiving Medicaid funding to avoid spreading resources too thin by forcing schools to compete against hospitals and doctors.
A spokeswoman for the Senate Finance Committee said that the bill “reflects Republican priorities to bend the cost curve on federal entitlement programs and encourage states that tend to spend beyond their means to actually stay within their budget.” — Julia Munslow
Veterans hit hard by potential Medicaid cuts
In addition to rural communities and the elderly, veterans are among the groups that would be hit hard by Medicaid cuts in the Better Care Reconciliation Act. The cuts put nearly 2 million veterans who are covered by Medicaid at risk of losing their coverage.
“A lot of people are under the assumption that everyone who’s ever served in the military is covered by the [U.S. Department of Veterans Affairs] and that the VA is a 360 health service [provider],” Kelly Gregory, an Air Force Veteran with stage IV breast cancer, told Yahoo News. “Neither of those things are true.”
“Medicaid absolutely saved my life,” she said.
Read the full story, by Caitlin Dickson, here. — Taylor Rogers
Democratic senator says ‘Morning Joe’ attacks are tactics to distract from health care bill
Sen. Chris Coons, D-Del., said Friday that Trump’s attacks on “Morning Joe” host Mika Brzezinski were intended to distract people from negative coverage of the Senate health care bill.
“Frankly, this is just part of his ongoing tactic of distracting,” Coons said on CNN’s “New Day.” “We’ve got a situation in Capitol Hill where the Senate Republican version of Trumpcare is floundering.”
Coons pointed fingers at the GOP senators, blaming their inability to pass the long-promised health care bill as the reason behind Trump’s attack.
“They had promised that they’d take a vote this week — they delayed that,” Coons said. “They promised they’d have a revised version of it by Friday — they don’t.”
Instead of discussing the impact of the health care bill, the media has focused on the president’s tweets, Coons said. — Julia Munslow
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