Health Insurance bill by Donald Trump

Republican lawmakers have finally unveiled a plan to repeal the major parts of Obamacare, capping years of attacks on the health insurance law, and a month-long debate that has exposed deep rifts within the GOP. Now comes the hard part.

House Republican leaders must seriously begin the difficult task of selling the new plan for the overhaul of the US health insurance and health care system to colleagues in both chambers on Capitol Hill, where there’s a myriad of conflicting interests. They will have to convince a skeptical public is worth it, just seven years after Congress passed the Affordable Care Act.

The political ramifications could not be more significant. Perceptions that the Republicans and President Donald Trump do not move forward with a wholesale repeal Obamacare would anger vast areas of the base of the party, while the possibility of millions of Americans who lose coverage could emerge as a superior liability for Republicans ahead of the midterm elections of 2018.

Trump is expected to offer a more robust embrace of the House GOP health care plan Tuesday when he meets with the team deputy whip in the White House, in the afternoon, an administration official told CNN Tuesday.
If Trump is committed to repeal and replace Obamacare political challenge remains a central issue.
“He’ll work hard to get this done,” said the administration official, including pushing reluctant conservatives helping to build support for this bill in their districts.
This is one reason Texas Sen. Ted Cruz was invited to the White House for dinner on Wednesday night. And ‘one of the skeptical conservatives who believe that the new bill is essentially a new mandate.
In the coming days, the key committees of the house will hold extended sessions to discuss and review a bill until Monday night was closely watched – including being held in a home office for legislators to view, but not copy. These meetings will provide plenty of opportunity for political grandstanding by the Democrats as they look to cast Republicans as responsible to take away the people’s health insurance.
The legislation unveiled Monday would scrap the individual mandate, an important pillar of Obamacare, replacing it with refundable tax credits for individuals to purchase health insurance. It would also restructure Medicaid and defund Planned Parenthood.
The proposal – dubbed the “American Health insurance Act” – tries to keep the Obamacare protections for people with pre-existing conditions, but it should allow insurers to charge higher premiums for people whose coverage has lapsed. The bill should also keep in place the so-called “Cadillac” tax on employers who provide generous health insurance plans.

Americans are pretty much divided on the individual mandate, with 48% in favor of removing the requirement to obtain coverage or pay a penalty, and 50% want to keep it, according to a CNN / ORC poll released Tuesday morning.
Other aspects of Obamacare are much more popular. A large majority, 87%, support maintaining the protections of the law for people with pre-existing conditions, and 61% are opposed to a replacement bill that would curb funding for the expansion of the Medicaid program.
Health Insurance bill by Donald Trump
Here are the Republican leaders political obstacles are about to face in trying to get this bill through the House and Senate.

Millions at risk of losing coverage

The ramifications of the real world of Obamacare repeal are complicated to say the least.
But most experts agree on this health insurance: Millions of Americans at risk of losing their coverage under the new GOP plan.
It will be a hard pill for many Americans to swallow seven years after the passage of the Affordable Care Act. The law was very controversial since its inception, but the reality is that about 20 million people have had coverage because of it – in particular low-income Americans.
The leading Republican has already veered off-message on this front: Trump. While Trump wants to eliminate Obamacare, the frustrated president his colleagues when he promised earlier this year that the GOP plan would offer “insurance for all.”
Tevi Troy, deputy secretary of Health insurance and Human Services under President George W. Bush, said greater challenge GOP is “meet expectations” on the cover.
“They need to keep the levels of coverage so you do not have a large number of people who say, ‘I was covered under Obamacare and I’m not covered now,'” said Troy CNN.

More critical point: the Medicaid expansion

The changes that House Republicans propose to Medicaid are not sitting well – including some Republican colleagues.
Thirty-one states expanded Medicaid under the Affordable Care Act, extending the coverage to about 11 million low-income adults. Drastically limiting the program would leave many of those people without coverage – an outcome that has a lot of governors and GOP lawmakers on board.
The plan should review the entire program, covering over 70 million people, by sending states a fixed amount of money per enroll, known as a cap per capita.
GOP Sen. Lisa Murkowski said that his party has to find a “just and humane” way to treat those who have gained coverage through the Medicaid expansion.
In Alaska, we have 27,000 people who are now eligible for coverage who did not have before. You really have nowhere else to turn,” said Murkowski. “And so I’m trying to figure out a way that treats these people in a fair and humane.”
Senator Orrin Hatch, the top Republican on the Senate Finance Committee, said the intra-party over Medicaid division was a “problem.”
“The Democrats are not going to help us. So it’s a problem,” Hatch told journalists shortly before the House bill was issued.

Conservative reaction

Republican conservatives are not making things easy.
Their concern: The proposal does not go far enough for evisceration Obamacare.
In recent weeks, lawmakers GOP like Senator Rand Paul and members of the Conservative Caucus Freedom House have raised hell over the bill, and it became clear Monday night that a provision which rails against – refundable tax credits – remains in the final design.
The Conservatives say that the tax credits refundable amount to just another entitlement program.
“I still have not seen an official version of the replacement house Obamacare bill, but by press reports this seems certain, as Obamacare Lite!” Paul Twitter Monday night.
Analysis on the bill issued by the staff for the Republican Study Committee, a group of fiscal conservatives focused on tax credits, referring to them as “a republican social right”
“Writing checks to people to buy insurance is, in principle, Obamacare,” the RSC note, obtained by a GOP source said.
Meanwhile, the Conservatives may also have problems with the other provisions of the bill, such as the fact that the house plan does not discard the Obamacare taxes until 2018 or the fact preserves the Cadillac Tax – which has never been implemented – but did even it has been a point of contention for the Democrats and Republicans.
Freedom Caucus Member Rep. Jim Jordan said specifically cited frustration with the fact that the House bill would keep Obamacare taxes in place until 2018, instead of immediately as a measure to repeal 2015 repeal and replacement vetoed by President Barack Obama would.
“We put on the desk of President Obama a bill that got rid of all taxes … and a Republican Congress is going to put on the desk of a Republican president a bill that keeps the taxes in place?” Jordan, R-Ohio, said.
House GOP leaders may lose only about 20 Republican votes, when the bill comes to the floor later this month. The Conservatives are under pressure from external pressure groups like Heritage Action and the Club for Growth and will be reluctant to support the bill unless their main areas of interest have been addressed.
“The real debate between the House GOP members who want to make substantial changes to the ACA but making getting rid of it will be very problematic and partners who … generally want to get rid of everything and go back to the way things were” , said Andy Slavitt, former head of drama Centers for Medicare and Medicaid Services. “It is not possible.”
In recent weeks, the committee’s staff have gone back and forth with the Congressional Budget Office. While there was no official score, sources say the first returns to CBO were not positive – both in terms of cost and coverage. Many of the major changes in the bill language, in fact, were led by GOP efforts to ensure better final score, sources said.

House bill will not fly in Senate

House GOP leaders have coordinated with their Senate counterparts and insist that they are mostly all on the same page.
But the president of the Ryan House and the Senate Majority Leader McConnell face different dynamics in their rooms, and a bill that can pass in the house is not necessarily a bill that can pass the Senate.
A potential robbery in the Senate will be over funding Planned Parenthood.
Many conservative House and outside groups are concerned that in the upper chamber, where Republicans hold a narrow majority, the leaders will be forced to strip the provision of defund the group to get support more centrist GOP senators like Susan Collins of Maine.
Another issue that has divided the Senate and House Republicans is the proposed revision to the Medicaid program. Even before the House bill was released, four Senate Republicans – Murkowski, Rob Portman of Ohio, Shelly Moore Capito of West Virginia, and Cory Gardner of Colorado – written a letter to McConnell expressing concerns that the legislation would cut those relied Medicaid to address opioid dependence and mental health problems.
We believe Medicaid must be reformed, but reform should not come at the cost of interruption in access to health insurance for the most vulnerable and the most serious of our country,” the senators wrote.
House GOP aides indicate the provision that existing subscribers grandparents and allows them to keep their coverage. But it is not clear if the details in the House bill will address these concerns, which have the potential to derail the bill as it works its way through the legislative process.

How Trump will help Health Insurance?

House Republican leaders will need all the help they can get in the coming weeks as they try to feed the Obamacare bill through Congress.
It is unclear whether such support will come from the White House. House GOP aides have repeatedly stated that they are working “hand in glove” with the White House, and in the course of drafting the final troubled days, it was true. There was deep involvement of several senior officials of the executive over the weekend.
A tweet from the official account of Trump on Monday was not exactly a full-throat.
“House just introduced the bill to Repeal And Replace #Obamacare. It’s time to end this nightmare,” said the message.
Meanwhile, the White House spokesman Sean Spicer said in a statement Monday night that the House bill was an “important step” in fixing the health insurance system – but did not go so far as to offer an explicit or strong support.
And Tuesday morning, Trump was still characterizing his support for “our bill,” saying it was out to “review and negotiation.”
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