Morning Briefing
Summaries of health policy coverage from major news organizations
Repeal Takes On A Now-Or-Never Urgency As Window To Use Reconciliation Rules Narrows
House Republican leaders and White House officials are increasingly confident about passing their long-stalled Obamacare replacement bill: More lawmakers than ever are committed to voting 鈥測es," they say, and GOP insiders insist they鈥檙e within striking distance of a majority. But the window of opportunity for Speaker Paul Ryan and his leadership team is closing fast. The House is scheduled to leave town for a one-week recess on Thursday, and some senior Republicans worry that failing to get it done by then would fritter away critical momentum. Skittish Republicans would return home to face a barrage of pressure from Democrats and progressive outside groups. (Bade, Bresnahan and Cheney, 4/30)
After weeks of debating and arm-twisting, Republicans intent on toppling the Affordable Care Act remain vexed by the same obstacle they faced when they tried to overturn the law last month: Taking away people鈥檚 guaranteed health insurance is hard to do. A renewed effort to bring a House Republican plan to the floor faltered by week鈥檚 end, a blow to President Donald Trump鈥檚 hopes of landing a health-care deal in his first 100 days. Republicans are vowing to push ahead with the bill, saying it has stalled but not died. (Armour and Peterson, 4/28)
Both President Donald Trump and Vice President Mike Pence in television interviews Sunday suggested confidence that they could win enough votes to pass a bill to undo the Affordable Care Act. But skepticism among centrist members of the party remains a stumbling block, and it鈥檚 unclear that congressional leaders have made enough progress to call a roll, as they grapple with Republicans who have expressed concern that recent changes to satisfy more conservative lawmakers may push coverage costs higher. (Radnofsky and Peterson, 4/30)
GOP leaders say they won鈥檛 call a vote until the new legislation has enough support to pass, and that new version appears to have lost the votes of centrists as it has gained endorsement from conservatives. (Sullivan and Hellmann, 4/28)
New Jersey Rep. Tom MacArthur has experienced personal tragedy and understands the need for health insurance. "I lost my mother at 4 years old. My father had no insurance and I watched him until I was in college pay off medical bills," says the two-term Republican lawmaker. Years later, MacArthur suffered the anguish over the death of his 11-year-old daughter, Gracie. "We had over $1 million of medical bills. I had insurance, but I still had a lot of uncovered expenses, and it's brutal," he says. (Freking, 4/28)
Representative Fred Upton helped guide dozens of Obamacare repeal measures through the House in recent years, but he has deep reservations about the GOP鈥檚 current bill. ... Until five months ago, Upton, a Michigan Republican, chaired the Energy and Commerce Committee, which has jurisdiction over much of health care policy. Now, he鈥檚 not ready to support the current bill and said the most recent revisions have made it worse. (John and House, 4/28)
Arizona鈥檚 Republican delegation offers an example of the ideological tug of war between the party's more moderate wing and its far-right flank as highlighted by GOP debate of the American Health Care Act. Four of the state鈥檚 five Republicans are members of the Freedom Caucus, the right-most hard-liners with about 33 members. (Hansen, 4/30)
Rank-and-file Democrats in the House aren鈥檛 satisfied with President Trump鈥檚 offer to make critical ObamaCare payments as part of a deal to keep the government funded and prevent a shutdown. They鈥檙e seeking a permanent legislative fix to the issue, something they believe would stabilize the healthcare law. And they say they don鈥檛 trust Trump to stick to his word in making the payments, which if withheld could cause havoc in ObamaCare鈥檚 exchanges. (Lillis, 4/30)
The conservative House Freedom Caucus has signed off on the newest Republican effort to alter the Affordable Care Act, but other Northeast Ohio Republicans aren't convinced that they'll vote for it. Which means it might be tough to pass in the U.S. House of Representatives. (Eaton, 4/28)
And in California --
When California health insurance companies begin setting 2018 rates, they鈥檒l be able to offer two different projections without committing to either one. Insurance Commissioner Dave Jones is inviting the 15 or so health insurance providers the state regulates to draw up rates based on different scenarios centered on how the Trump administration enforces the Affordable Care Act. (Ashton, 4/28)
With a major deadline looming, California鈥檚 health exchange and a key insurer pressed Republican leaders in Washington to clear up confusion over their commitment to key provisions of the Affordable Care Act. Health insurers participating in the Covered California exchange for individuals and families must submit initial rates for 2018 on Monday. Peter Lee, the exchange鈥檚 executive director, warned in a conference call Thursday that rates could jump by more than 40 percent if the Trump administration and Republican-led Congress walk away from crucial elements of the health law. (Terhune, 4/28)
