- The Washington Times - Monday, December 5, 2016

Republicans are trying to rope the country’s governors into their Obamacare repeal effort, soliciting feedback from the state executives Monday as they plot their strategy for early next year.

While they’ve said dismantling the Affordable Care Act is their top priority in the new year, congressional Republicans are still sketching out what comes next, and the governors, who have grappled with the effects of Obamacare and the uninsured up close, could provide a lifeline for the GOP.

House Majority Leader Kevin McCarthy, chairman of two key committees, asked the governors to suggest ways to lower costs and expand choices for consumers without resorting to the heavy-handed mandates President Obama used.

“Working as a team, with your help and creative ideas, we can achieve our mutual goal of putting patients first,” they wrote in a letter asking state officials to weigh in by Jan. 6.

With health care looming next year, Republicans are trying to clear the decks on Capitol Hill this week.

That means passing a stopgap spending bill to keep the government funded into the new year, giving President-elect Donald Trump a say in those decisions. Congressional leaders were debating whether the “continuing resolution” on government funding will last through March, as initially planned, or extend deeper into the spring to give GOP leaders more breathing room.

Mr. McCarthy said they hope to unveil the bill Tuesday.

House and Senate negotiators also finalized a water resources bill Monday that includes $170 million for Flint, Michigan, and other communities reeling from lead-tainted water — a top priority for Democrats.

A massive medical-innovation bill cleared a major test vote in the Senate on Monday, 85-13, despite vocal opposition from progressives such as Sen. Elizabeth Warren, Massachusetts Democrat, and Sen. Bernard Sanders, Vermont independent.

The $6.3 billion bill dubbed “21st Century Cures” fast-tracks regulatory approval of groundbreaking drugs, ushers in bipartisan mental health reforms and provides $1 billion to tackle America’s prescription painkiller and heroin epidemic. It injects nearly $5 billion into the National Institutes of Health, including $1.8 billion for the cancer “moonshot” project led by Vice President Joseph R. Biden, who presided over Monday’s vote.

Opponents say the bill fast-tracks drug companies’ products while doing nothing for Americans struggling with high prescription costs.

But the White House supports the legislation, which passed the House 392-26 last week, and it is poised for final approval in the Senate later this week.

Beyond the holidays, GOP leaders say they will kick off the new Congress in January by writing a budget that sets in motion fast-track rules that allow Republicans to gut Obamacare on a majority-line vote in the Senate, avoiding a Democratic filibuster and clearing the way for Mr. Trump’s signature at the White House.

Settling on a replacement, however, will be much harder. It will take 60 votes in the Senate, and the GOP can only count on, at most, its own 52 members.

Republicans say they’re casting a wide net to build consensus and avoid a repeat of 2010, when Mr. Obama relied on Democratic majorities to muscle his health reforms through Congress without a single GOP vote.

Democrats said the GOP was simply reaching for a lifeline that probably won’t come after Obamacare extended federal assistance to low- and moderate-income residents seeking private insurance and helped 31 states expand their Medicaid programs for the poor.

“Given that repealing the ACA will blow a massive hole in state budgets across the country and is the exact opposite of fiscal conservatism, it’s no surprise that Republicans have no idea how to handle this issue and are looking everywhere they can for help,” said Matt House, spokesman for incoming Senate Minority Leader Charles E. Schumer, New York Democrat.

Mr. McCarthy and the House chairmen, in their letter to governors, asked if they’d be interested in setting up high-risk pools to cover sicker customers priced out of the market.

And it hints at expedited approval of GOP-preferred changes to Medicaid and separate waivers that allow states, starting in 2017, to supplant Obamacare with their own reforms, so long as they match or outperform Mr. Obama’s design.

“I think it’s just an attempt to lobby the states, saying, ‘We’re going to give you a lot more flexibility and control than the Obama administration did — to show you how sincere and eager we are to do that. We’re going to send you a lot of questions and ask you for your thoughts,’” said Timothy Jost, a law professor at Washington and Lee University in Virginia who closely tracks the debate.

Mississippi Insurance Commissioner Mike Chaney said the new Congress and administration should start by extending “transitional” plans that do not comply with Obamacare and cannot be renewed past the end of 2017.

Under political pressure, Mr. Obama in late 2013 told states they could allow consumers to keep plans that don’t comply with his coverage requirements for a few more years, after he had promised Americans they could keep coverage they liked under his law.

Mr. Chaney said roughly 250,000 people in his state rely on the transitional plans, which tend to be cheaper than Obamacare-compliant plans and their associated doctor networks.

“It affects a lot of people here,” Mr. Chaney said.

Mr. Chaney, a Republican, appeared to agree with many of the House GOP’s aims — allowing sick customers to still get covered, while using market forces to entice people into plans — but said they should tread cautiously with the 20 million-plus who rely on the current program.

“[If] you’re not careful, you’re going to have a problem,” he said.

Republicans insist they will not pull the rug out from Americans who hold Obamacare coverage and would be affected by repeal, though they haven’t said how their bridge to a new system will work.

“Those are all challenges that we’re working through right now. Nothing to report yet,” Mr. McCarthy said.

• Tom Howell Jr. can be reached at thowell@washingtontimes.com.

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