- The Washington Times - Wednesday, January 11, 2017

Senate Republicans on Thursday imposed a deadline on their plans to dismantle President Obama’s health care law, saying Americans are demanding relief from rising prices and dwindling choices even if the path toward a replacement is politically perilous.

A budget resolution instructing GOP-led committees to draft repeal legislation by Jan. 27 was approved, 51-48, in the wee hours after Republicans who hold a narrow Senate majority fended off attempts to derail the effort.

“The Senate just took an important step toward repealing and replacing Obamacare by passing the resolution that provides the legislative tools necessary to actually repeal this failed law while we move ahead with smarter health care policies,” Majority Leader Mitch McConnnell, Kentucky Republican, said.

Democrats forced Republicans to take a series of politically painful votes in the process, putting them on record as opposing measures that protect rural hospitals, let patients seek cheap drugs from Canada and preserve money-saving provisions for seniors in Medicare.

Yet GOP leaders stomached the “vote-a-rama” to get to the pivotal roll call on the underlying resolution, which won the support of every Republican except Sen. Rand Paul of Kentucky, who joined Democrats in voting “no” because the budget didn’t balance. Sen. Dianne Feinstein, California Democrats, missed the vote.

House leaders hope to pass the resolution by Friday, paving the way for Congress to send President-elect Donald Trump a repeal bill as soon as February.

Obamacare is the No. 1 target for Republicans, who grabbed all of Washington’s levers of power in November’s elections. While the rate of uninsured Americans is the lowest ever, Obamacare exchange premiums are skyrocketing, and many customers have only one option.

Republican leaders say they have no choice but to turn their clout into a rescue mission alongside Mr. Trump, even though some of their members have expressed reservations about starting the process without a replacement.

“This is not a rushed or hurried response. It’s merely the first step in a deliberative process that Republicans in both chambers of Congress have been working on for years,” said Senate Majority Whip John Cornyn, Texas Republican. “The only difference is now, we’ll have a president in office who understands that people are hurting, asking for change and in need of promises that are actually delivered.”

Republicans are using an arcane process known as budget reconciliation to repeal and replace as much of the 2010 law as they can on majority votes, as long as they stay within parliamentary lines.

Policy analysts say insurers will be unable to plan for 2018 and beyond if Congress fumbles the transition, and some Republicans wanted to slow down the process to avoid stumbling blocks.

Sen. Bob Corker, Tennessee Republican, withdrew a budget amendment late Wednesday that would have given committees an extra five weeks to draft repeal language — March 3 instead of Jan. 27 — saying its sponsors will “place their faith” in leaders to get the policy right once Mr. Trump’s team is in place.

Yet Democrats, sensing a political advantage, twisted the knife in defense of Obamacare.

“Once they set this [repeal] process in motion, it’s hard to stop,” Sen. Christopher Murphy, Connecticut Democrat, said late Wednesday. “We’re going to figure out what parts of the Affordable Care Act they’re going to preserve and what parts they’re going to throw out. We’re going to use votes tonight to try and divine what this secret replacement plan is.”

Obamacare’s supporters forced Republicans to beat back a proposal that would torpedo legislation barring someone from getting health care coverage because of their occupation.

The amendment from Sen. Angus S. King Jr., Maine independent, was defeated on a 48-50 vote, and Sen. Bill Nelson, Florida Democrat, tried but failed on a 47-51 vote to protect Obamacare’s phase-out of the Medicare drug program’s “doughnut hole,” a temporary limit on what plans will cover for seniors.

Though nonbinding, the budget votes could be used as political cudgel against Republican lawmakers down the road.

Democrats and Mr. Obama say Obamacare could be fixed by adding a government-run plan, or “public option,” to improve competition in the exchanges, or boosting the taxpayer-funded subsidies to entice more people to sign up.

“We’re not for replacing it,” said House Minority Whip Steny H. Hoyer, Maryland Democrat. “What we’re for is improving it and making sure that it works better.”

Yet Republican leaders say they will use every means to replace as much of the law as they can once Mr. Trump’s pick to lead the Health and Human Services Department is confirmed.

Rep. Tom Cole, Oklahoma Republican, said the HHS nominee, Rep. Tom Price of Georgia, will be an “indispensable traffic cop” in weaving together executive and legislative action that pursues repeal.

“There’s hundreds of times in the original law where the phrase is used, ‘the secretary shall’ or the ‘secretary may,’ so the amount of executive authority here is unusually high,” Mr. Cole said outside the House chamber.

Republicans want to put a repeal bill on Mr. Trump’s desk by the end of February, House Majority leader Kevin McCarthy told radio host Hugh Hewitt on Wednesday.

Among other things, the repeal bill will scrap Obamacare’s tax penalty on people who don’t acquire insurance and its 2.3 percent levy on medical device sales, he confirmed.

A 2015 repeal bill that served as a template for this year’s effort scrapped taxpayer-funded subsidies that help people buy private plans on Obamacare’s exchanges and the expansion of Medicaid to people earning up to 138 percent of the poverty level.

So far, 31 states and the District of Columbia have opted to expand their programs.

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

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