Health Care

GOP pushing budget limits on ObamaCare

Republicans are pushing the limits of Congress’s complex budget process to finish up an ObamaCare repeal bill in time for Donald Trump’s inauguration.

The House Budget Committee could bring back its budget resolution from April – which never made it to the chamber floor  – to deal an immediate blow to the president’s healthcare law after he leaves office.

The unusual move is among several strategies under consideration to speed up legislation to repeal ObamaCare, which has been a central GOP campaign promise since 2010.

Each of the tactics relies on an arcane process called reconciliation, which would help Republicans get major bills through the Senate without the threat of a Democratic filibuster.

Reconciliation typically takes months because of the complex — and sometimes subjective — Senate rules. But Republicans in Congress are now pitching largely unprecedented uses of the process to speed up the timeframe so Trump can check off a key campaign promise: Repealing ObamaCare on day one in office.

The party is feeling intense pressure to act quickly on ObamaCare after six years of campaign promises and more than 60 repeal votes in the House.

“If I was in leadership, I would say that is vote number one,” said Rep Bill Flores (R-Texas), who leads the powerful Republican Study Committee.

“The afternoon after we’ve all been sworn in, we vote on it, we get it to the Senate,” he said.

Not all of ObamaCare may be repealed.

Trump in an interview Friday with The Wall Street Journal said that he planned to keep two of the law’s more popular provisions – protections for people with preexisting conditions and allowing young people to remain on their parents’ plans until age 26.

“I like those very much,” Trump said. 

Those two parts of the healthcare law are popular with the public and the GOP, and would have been saved from repeal as part of the healthcare reform plan drafted last year by House Speaker Paul Ryan (R-Wis.).

Republicans in Congress have vowed to repeal the healthcare law as soon as they get one of their own into the White House, which they acknowledge has created expectations issues with their voters.

The promise to repeal the law is one they’ll be expected to keep, according to Rep. Tom Cole (R-Okla.), who is a members of House leadership.

“My political instinct is that it better be done in the first year. It’s a big Republican commitment,” Cole said.

Until now, Republicans have largely avoided legislation that addresses ObamaCare in any way.

The party has focused almost entirely on repeal votes, which have been featured during campaigns. The major exception is a bipartisan tax deal in 2015, which postponed the unpopular “Cadillac” tax and the medical device tax.  

Republicans are expected to support a reconciliation package that would repeal the major parts of ObamaCare – a process that was tested in 2015.

It eliminated the law’s individual and employer mandates, as well as its subsidies, which would essentially end ObamaCare’s marketplaces.

The bill would likely take one or two years before the law is officially repealed. That gives time for Republicans to map out their own approach to universal healthcare, which would likely have to include a transition for the 22 million people who currently have healthcare.

GOP lawmakers, as well as Trump, have released a half-dozen blueprints for what that might look like. The most concrete is a version from House Speaker Paul Ryan (R-Wis.), which is a 37-page whitepaper.

But some Republicans, like Cole, say they’re frustrated that there isn’t actual legislation ready to move.

Cole said GOP leaders should have instructed committees to write bills, get them scored by the Congressional Budget Office, and get them to the House floor.  

“They say, ‘Well it won’t get passed.’ That’s not the point. Do the exercise. We ought to at least be producing the legislation in the House and getting people used to voting for it,” Cole said.

“I don’t feel like we’ve done as much as we should’ve to do legislative language and scoring to get things done,” he said.

While he said Ryan’s “A Better Way” healthcare plan is a good start, he said “having actually written a bill would have been better.”

If Republicans in Congress take too long with repeal, outside conservative groups say they will be ready to pounce.

“Promising to deliver in October would be fairly underwhelming, and would cause the skepticism and the cynicism of the political process to start creeping back in, as opposed to what should be excitement and encouragement,” said one conservative who has been a close observer of ObamaCare.