Democrats mounted ferocious resistance Wednesday to the Republican health care plan, erecting roadblocks in committees and attempting to shut down the House floor, saying the party’s lawmakers are plowing ahead without knowing what the Obamacare replacement will cost or how many people will lose insurance coverage.
The efforts to gum up the works were a hindrance, but the bigger threat to the bill remains defections within the Republican Party, where moderates say the repeal goes too far and conservatives say the repeal doesn’t go far enough.
House Speaker Paul D. Ryan, Wisconsin Republican, said lawmakers have a choice: Either stick with a failing Obamacare law or back the replacement. “This is what good conservative health care reform looks like. It is bold, and it is long-overdue, and it is us fulfilling our promises,” he said.
When the process began, Republicans were sticking together, turning back repeated Democratic amendments in the Ways and Means Committee aimed at preserving Obamacare’s levels of coverage.
The House Energy and Commerce Committee was also debating the bill, but Democrats were slowing progress. Committee Democrats insisted that the bill be read word for word and then said they had 100 amendments to offer, forcing the session into a second day.
The tax committee finished its work in the wee hours, allowing its chairman to declare victory, but the commerce panel worked through the night, voting down a series of Democratic amendments that would prevent a GOP overhaul of Medicaid insurance for the poor or changes that would let insurers charge older customers far more than younger people.
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Republicans also defeated a proposal to retain federal funding for Planned Parenthood, the nation’s largest abortion provider, along party lines.
Democrats on both panels had said they wanted to delay votes until next week, after the Congressional Budget Office releases its projected costs of the legislation and effects on coverage.
“They’re afraid of the facts,” said House Minority Leader Nancy Pelosi, California Democrat, defending the delays.
Democrats held a series of procedural votes to keep lawmakers on the floor Wednesday and away from the committee rooms. Delay tactics took their toll by sundown, when neither committee had taken a substantive vote to reshape the legislation, though the logjam started to ease overnight.
The sessions meandered into strange alleys at times, including a light-hearted spat in Ways and Means over the relative health risks of patronizing tanning salons, which were taxed under Obamacare, versus eating ice cream. One GOP lawmaker said Democrats should tax the sun, though Democrats said that’d be rather difficult.
Republicans said they would have a CBO score in hand before the package hits the House floor, yet a battery of influential groups said they must oppose the plan until they have that information.
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The American Hospital Association said it cannot support the bill in its current form, citing the lack of scoring and fears that it would slash coverage. The American Medical Association said the legislation is “critically flawed” and will “make coverage more expensive — if not out of reach — for poor and sick Americans.”
AARP, an influential lobby for seniors, balked at insurers’ ability to charge people ages 50-64 up to five times more than younger people, instead of Obamacare’s 3-1 ratio. It said tax credits included in the Republican plan will not be enough to keep up with increases, particularly for seniors with low incomes.
“This is a work in progress. We’ve got a lot of distance to travel,” said Rep. Charles W. Dent, Pennsylvania Republican. The centrist wants to make sure the replacement is sufficient for constituents receiving benefits under Obamacare.
White House spokesman Sean Spicer said President Trump is making a “full-court press” to move the bill through Congress so Republicans can claim victory and move on to other parts of his agenda.
Mr. Trump was dining Wednesday evening with Sen. Ted Cruz, a Texas Republican who has been skeptical of the bill, and was meeting with conservative pressure groups to try to rally support.
“I think you will see a lot of travel and a lot of activity by the president and all of the administration,” Mr. Spicer said.
Mr. Trump has expressed support for the House Republican plan and used his favorite bully pulpit — Twitter — to call out a leading Republican opponent of the plan. He said he believes Sen. Rand Paul of Kentucky, a rival in last year’s Republican presidential primary, will eventually come on board.
Yet additional senators want the House to slow down or even start over, saying the package can’t pass the upper chamber in its current form.
Sen. Tom Cotton, Arkansas Republican, chastised the House on Twitter for putting out its bill Monday night and hurtling forward without a CBO score.
“What matters in long run is better, more affordable health care for Americans, NOT House leaders’ arbitrary legislative calendar,” he tweeted early Thursday.
The stakes are high. Rep. John Shimkus, Illinois Republican, said congressional Democrats suffered massive losses at the polls in 2010, 2014 and 2016 because of their support for Obamacare, and he said Republicans are making a similar gamble with their own bill.
“We’re going to stake our votes, and our majority, that it works,” he said. “We all know that we’re on the hook.”
Democrats said the Republican bill would throw millions of people off their insurance and cut guaranteed benefits from others’ plans.
Rep. Richard E. Neal of Massachusetts, the ranking Democrat on the Ways and Means Committee, said the Republican plan “forces millions to pay more for less care.”
Republicans countered that Obamacare, with all its guaranteed benefits, has become too expensive for many consumers to buy or use because of high premiums or deductibles.
“As President Trump said in his address to Congress last week, ‘Obamacare is collapsing,’ and ‘decisive action must be taken to protect all Americans,’” said Ways and Means Committee Chairman Kevin Brady, Texas Republican. “This morning, we will answer President Trump’s call to action, and we will send a clear message to all who are hurting because of this law. That message is: Relief is on the way.”
His panel is marking up a portion of the plan that would scrap Obamacare’s taxes on medical device makers, insurers and high earners while offering age-based, refundable tax credits to people who purchase coverage on their own.
Republicans beat back Democrats’ attempts to let states opt out of the plan or hold Mr. Trump to his pledge to “take care of everybody.”
Top Democrats said the plan already flouted Mr. Trump’s promise to lay off Medicare, the insurance program for seniors. It repeals a 0.9 percent tax on high earners, shortening the life of the program’s trust fund by three years, to 2025.
Democratic attempts to make sure the plan didn’t cut coverage for mental health or drug addiction treatment or raise costs for people ages 50-66 were also ruled out of order.
Elsewhere on Capitol Hill, the Energy and Commerce Committee debated consumer protections and plans to unwind Obamacare’s vast expansion of Medicaid after 2020, while capping federal spending on the insurance program for the poor.
The panel is also vetting consumer protections within the bill. It would still require insurers to accept all customers, though it lets insurers tack a 30 percent surcharge on customers who are re-entering the market after failing to hold coverage for 63 days, so they don’t wait until they get sick to start paying premiums.
Conservatives say that’s eerily similar to Obamacare’s mandate requiring people to hold insurance or pay a penalty to the IRS.
Rep. Justin Amash, a Michigan Republican who opposes the plan, said Wednesday on CNN that “the whole objective of our leadership team is to ram this through.”