- The Washington Times - Wednesday, April 26, 2017

New polling says the GOP’s latest ideas on health care are unpopular and that a majority of Americans will hold President Trump and his congressional allies responsible for Obamacare’s problems moving forward, underscoring the tall task before Republicans sticking to a repeal-and-replace strategy.

Hoping to hand Mr. Trump a much-needed win, House Republicans are floating a proposal that lets states opt out of parts of the Affordable Care Act that require insurers to cover “essential” benefits and to charge healthy and sick customers the same amount.

Yet majorities say those protections should be maintained nationwide, according to a Washington Post-ABC News poll, the first to examine the contours of the emerging compromise plan.

Americans also are cool to the GOP’s repeal-and-replace strategy generally, with 61 percent preferring to “keep and try to improve” it, compared to 37 percent who back the Republican push.

More than 40 percent of people want Mr. Trump to work with Democrats to overhaul health care, compared to about a quarter who think he should team with conservative Republicans.

To that point, a separate poll from WSJ/NBC News out Tuesday shows a 16-point drop in confidence in the GOP when it comes to health care, with 50 percent saying they now have little to no confidence in the Republicans’ ability to improve things.

Republicans on Tuesday said they had no plans to abandon their repeal-and-replace strategy, even if it’s taking longer than they’d hoped, saying the 2010 Affordable Care Act failed to deliver and has resulted in higher premiums and fewer choices on the individual market.

“The House and the Senate continue to work on not just repealing, but repealing and replacing the Obama health care law with health care that works for all Americans,” said Sen. John Barrasso, Wyoming Republican. “So it should be no surprise that it takes some time to do that. But what’s critically important is that we get it right.”

Rep. Mark Meadows, North Carolina Republican and chairman of the archconservative House Freedom Caucus, tweeted that “Obamacare repeal and replace will happen — it’s just a matter of when.”

The White House wanted to pass a repeal bill by Saturday, the 100th day of Mr. Trump’s presidency, but House GOP leaders say they’re focused on a stopgap spending bill needed to keep the government open beyond this week.

A senior Democratic aide said negotiators on their side still want the GOP to authorize vital “cost-sharing” reimbursements for insurers in the spending bill, yet Mr. Trump has threatened to withhold them, saying it will force his political rivals to negotiate on a health overhaul.

The payments are still being made for now, but Mr. Trump can stop them by withdrawing the previous administration’s appeal of a court ruling that said the payments must be blessed by Congress to be lawful.

“ObamaCare is in serious trouble. The Dems need big money to keep it going — otherwise it dies far sooner than anyone would have thought,” Mr. Trump tweeted Sunday.

Three in five people say Mr. Trump shouldn’t use negotiating tactics that could disrupt the insurance markets, although it’s an opinion mainly driven mainly by Democrats and independents. Two thirds of Republicans are OK with the White House playing hardball in this way, according to the Kaiser Family Foundation.

Yet 60 percent of Americans, including a majority of Republicans, say because Mr. Trump and congressional Republicans control the government, they will be responsible for any problems with Obamacare moving forward.

House Minority Whip Steny Hoyer said 7 million low-income people rely on the payments, so it is Mr. Trump’s duty to reimburse insurers as prescribed by then-President Barack Obama’s signature law.

“In my view, it’s not part of some quid pro quo from them to us. It is the law,” he said. “It ought to be done.”

The Kaiser foundation also crunched the numbers and found that government costs would rise by $2.3 billion if the cost-sharing payments are eliminated. Insurers would hike their premiums to be made whole, forcing taxpayers to keep pace by shelling out more in Obamacare subsidies.

The House GOP is hoping to head off hard decisions on the legal case by replacing Obamacare’s framework with one that repeals its unpopular mandates and replaces its generous premium and cost-sharing subsidies with age-based tax credits, while reining in and capping federal funds for Medicaid, the government insurance program for the poor.

Right now the talks center on a proposal negotiated by Rep. Tom MacArthur, New Jersey Republican who chairs the centrist Tuesday Group, and members of the archconservative House Freedom Caucus.

The plan would shift to the states the burden of deciding what services insurers must cover, and would let insurers charge healthy customers less, so long as states set up risk pools to subsidize sicker people priced out of the market.

No state could waive the part of the Affordable Care Act requiring insurers to cover people with preexisting medical conditions, however, preserving the most popular part of the 2010 health law.

It’s unclear whether the proposal can win over enough holdouts to pass. Multiple centrist holdouts said the changes did little to change their minds.

“I see nothing that makes me want to support it,” Rep. Leonard Lance, New Jersey Republican, told CNN.

Two other centrists, Rep. Tom LoBiondo of New Jersey Republican and Rep. Dan Donovan of New York, have said the changes haven’t flipped them into the “yes” column, though others are keeping their powder dry, noting they haven’t even seen legislative text.

The Washington Post-ABC News poll found that three in five U.S. adults want insurers to cover maternity care, prescription drugs and Obamacare’s other “essential” benefits in all states.

It also found that seven in 10 U.S. adults want to bar insurers from denying sick customers or charging them more nationwide, while only a quarter thinks states should decide.

The MacArthur plan says no state could waive the part of Obamacare requiring insurers to cover people with preexisting medical conditions, though analysts say that’s a meaningless protection if sick consumers face skyrocketing costs.

The emerging idea would set up high risk pools to subsidize customers priced out the market. Analysts warn that risk pools have been inadequately funded in the past, however, and appear to be shortchanged in the GOP’s latest plans.

• Sally Persons contributed to this report.

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