By ROBERT PEAR, JULIE HIRSCHFELD DAVIS and JENNIFER STEINHAUER
WASHINGTON – House Speaker Paul Ryan, facing a revolt among conservative and moderate Republicans, rushed to the White House on Friday afternoon to inform President Donald Trump that he did not have the votes to pass legislation to repeal the health care law and to decide whether to pull the bill from consideration.
The president and the speaker faced the humiliating prospect of a major defeat on legislation promised for seven years, since the landmark health legislation was signed into law. Trump had demanded a vote regardless, which has been scheduled for Friday afternoon. But House leaders were leaning against such a public loss.
The House opened debate Friday on what would have been one of the most consequential pieces of legislation in years, a bill that would have rolled back a major, established social welfare program, a feat that is almost unheard of.
The Republican legislation, called the American Health Care Act, would end the Affordable Care Act’s mandate that almost everyone have health care, replacing it with a system of age-based tax credits to purchase health insurance – a shift that would save the government hundreds of billions of dollars and would cut taxes, but could leave 24 million more Americans without coverage in a decade, the nonpartisan Congressional Budget Office said.
Republicans said President Barack Obama’s signature domestic achievement, the 2010 health care law, had been a failure, disrupting coverage for millions of people and fueling big increases in health insurance premiums and out-of-pocket medical costs. Insurers in many states, they said, were losing hundreds of millions of dollars under the health law and have dropped out of the public marketplaces.
“For seven years, Americans have been hurt by ‘Obamacare,’” said Rep. Kevin Brady, R-Texas, chairman of the Ways and Means Committee. “They have pleaded with Congress to get the government out of the examining room and give them health care they can afford. This failed Obamacare experiment is over. It’s time to act.”
Trump chimed in from Twitter, declaring, “After seven horrible years of ObamaCare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!”
He took a shot at the hard-line House Freedom Caucus, which has pressed for even more conservative policies, calling it ironic “that the Freedom Caucus, which is very pro-life and against Planned Parenthood,” would oppose a bill that strips federal funds from the women’s health provider – albeit for a single year.
But Republican divisions were still on public display. Rep. Rodney Frelinghuysen of New Jersey, chairman of the powerful House Appropriations Committee, announced Friday that he would oppose the Republican bill, joining other moderates from Northeastern states.
“Seven years after enactment of Obamacare, I wanted to support legislation that made positive changes to rescue health care in America,” he wrote. “Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents in New Jersey.”
Hard-line conservatives, the focus of Trump’s wooing, showed little sign of capitulation.
Democrats kept their focus on the law had that Republicans hoped to repeal, saying it provided coverage to at least 20 million people. In the last 48 hours, they said, the repeal bill became worse as Republicans cut deals to woo support from the most conservative members of their party.
Democrats were particularly critical of a last-minute decision by House Republican leaders to scrap federal standards for the benefits that must be provided in health insurance policies.
“I don’t have the ability to adequately express my outrage,” said Rep. Jim McGovern, D-Mass. “The Republican bill would return us to the day when insurers sold woefully inadequate policies with few protections.
This backroom deal will kill the requirement for insurance companies to offer essential health benefits such as emergency services, maternity care, mental health care, substance addiction treatment, pediatric services, prescription drugs and many other basic essential services.”
Republicans tried to address these concerns with an amendment filed late Thursday.
The amendment requires states to establish their own standards for “essential health benefits,” for the purpose of deciding which health plans can be used by people receiving federal tax credits to help pay premiums. The amendment also provides $15 billion in additional funds to states for “maternity coverage and newborn care” and for the “treatment of addiction and mental illness.”