- The Washington Times - Sunday, March 12, 2017

The House GOP plan to replace Obamacare survived its first week on Capitol Hill, but everyone from the AARP to the American Lung Association is lining up against the plan, suggesting the tough road Republicans have ahead of them.

The AARP says the bill increases the “age tax” on older Americans by allowing insurers to charge even more for older customers than Obamacare already did. Doctors’ groups, meanwhile, say the poor and sick won’t be able to afford to buy plans with the level of assistance the GOP proposal would offer.

Hospitals say their bottom lines will suffer, and say the GOP bill could also risk progress that’s been made in fighting the opioid epidemic that’s touched every part of the country.

Others, such as the American Psychiatric Association, aren’t sure what to think, saying they’ll wait until the Congressional Budget Office reports on how the legislation will affect the number of people insured.

White House officials Sunday preemptively downplayed the analysis of their plan, which should be out this week, saying the independent office may not be capable of handling such a large, complex piece of legislation.

“If the CBO was right about Obamacare to begin with, there’d be 8 million more people on Obamacare today than there actually are,” said Mick Mulvaney, director of the White House Office of Management and Budget. “I love the folks at the CBO; they work really hard, they do. But sometimes we ask them to do stuff they’re not capable of doing, and estimating the impact of a bill of this size probably isn’t the best use of their time.”

Obamacare’s insurance exchanges failed to attract enough customers, particularly the young and the healthy, resulting in rising premiums and dwindling plan choices, and opening the door to a Republican do-over on health care reform.

Yet Obamacare’s taxpayer-funded subsidies, Medicaid expansion and provisions for young adults extended coverage to more than 20 million people, swelling the federal footprint in health care and making it difficult for Mr. Trump and Republicans to reel it back in without blowback from powerful interest groups who lobbied for the changes in 2010 and fear widespread disruption.

“There’s a pretty big medical industrial complex in America, and when you touch it, I’ve discovered, it touches back,” said Rep. Greg Walden, Oregon Republican and chairman of the Energy and Commerce Committee.

Mr. Walden, who held a panel on part of the GOP plan last week, said the hospitals’ opposition was “sort of disappointing” because the plan repeals cuts that Obamacare made to certain hospital payments.

House Speaker Paul D. Ryan said too many of the complaining groups are trying to compare the GOP plan to an unsustainable Obamacare program.

“A lot of people who you just mentioned, I think they would like to see us continue to make Americans buy what we say they should buy. We don’t agree with that,” he told “Face the Nation” in an interview that aired Sunday on CBS.

GOP leaders point to a list of 17 groups who’ve praised the proposal — from taxpayer advocates, insurers and medical device makers, who are thrilled with its tax cuts, to insurers who appreciate efforts to smoothly transition to the new system by 2020.

But many conservative groups are furious, saying the House GOP plan is a “betrayal” that creates a costly new entitlement by ditching Obamacare’s exchanges and replacing them with tax credits to help Americans buy coverage on the private market.

Though the tax credits grow with age, topping out at $4,000 for older consumers, AARP has launched a campaign against the GOP plan, saying it will harm the older Americans they represent.

It released a goofy web video last week featuring a rugged outdoorsman and his friend, Charlie — a squirrel that isn’t nuts about the GOP plan — whose narrative is that insurers will be able to charge older consumers up to five times what they charge younger ones, instead of Obamacare’s 3-1 ratio.

“I was like, ‘What the heck is age rating?’” the ax-wielding man says. “But then Charlie explained that it’s Washington politician-speak for overcharging older Americans for their health insurance while lining the insurance companies’ pockets.”

A rival group, the conservative Association of Mature American Citizens, applauded the GOP’s efforts, however, saying premiums are through the roof, and federal coverage regulations forced too many people off coverage they liked.

“Our members strongly support the full repeal of Obamacare,” said Dan Weber, executive director of the group boasting 1.3 million members.

Yet many conservative lawmakers say they cannot support the House GOP plan without significant changes.

The Republican Study Committee, an influential bloc of 170 House conservatives, says it wants to amend the GOP plan so that it freezes Obamacare’s federal funding rates for states that expanded their programs in 2018, rather than waiting until 2020.

House leaders have balked at moving up the date, however, saying there needs to be a transition, and that tweaks could scare off Republicans from states that benefited from the expansion.

“I think the current date is better. I don’t like the idea of making it shorter,” said Rep. Thomas MacArthur, New Jersey Republican and co-chair of the centrist Tuesday Group.

Those concerns are echoed by the American Hospital Association and other health providers, who fear they’ll get stuck with the bill for providing uncompensated care to the newly uninsured.

The main insurers’ lobby, America’s Health Insurance Plans, also said any changes to Medicaid should “ensure that the program is sustainable long-term,” since managed-care plans that contract with the government cover about 50 million people in the program.

AHIP also said it wishes the GOP’s tax credits would factor in both age and income on the individual market, though it said the GOP was on the right track with efforts to entice people into continuous coverage so they don’t wait until they’re sick to sign up.

Ben Wolfgang contributed to this report.

Copyright © 2018 The Washington Times, LLC. Click here for reprint permission.

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