Even as Republicans’ health-care overhaul bill cleared another committee hurdle today, Speaker Paul Ryan (R-WI) acknowledged that the bill needs changes before it can pass the House.
Ryan has been pressing rank-and-file Republicans to support an Affordable Care Act replacement bill despite withering criticism from conservatives, Democrats and health care industry groups. After the Congressional Budget Office (CBO) finally scored the bill and projected that 24 million fewer Americans would have insurance over the next 10 years under the GOP plan, Ryan said leadership will “incorporate feedback” from fellow Republican lawmakers to make the bill more palatable.
“Now that we have our score we can make some necessary improvements and refinements to the bill,” Ryan told reporters after meeting with House Republicans this week.
Vice President Mike Pence also spoke to House Republicans this week and assured them that the White House is also open to changes that would address some of the concerns with the bill.
The bill, called the American Health Care Act (AHCA), replaces ACA subsidies with new refundable, age-based tax credits for those without employer-provided health insurance. The tax credits would begin phasing out for individuals with incomes above $75,000 and families earning more than $150,000. The plan would also freeze Medicaid expansion in 2020 and phase it out over time. Conservatives dislike the proposed tax credits, which they view as another entitlement.
The bill would eliminate the individual mandate but would attempt to encourage people to maintain coverage by allowing insurers to impose a surcharge of 30 percent on those who have gaps in their coverage. Nearly all of the ACA’s taxes would be eliminated with the exception of the “Cadillac” tax on high-cost health plans – a tax that ASAE and many other business groups opposed. The House bill would allow the Cadillac tax to take effect in 2025 as a means of trying to ensure that the legislation does not add to the deficit after 10 years. It would also strip funding for Planned Parenthood.
Despite the criticism, the AHCA cleared an important procedural hurdle earlier today when it was narrowly passed 19-17 by the House Budget Committee. Unsurprisingly, Budget Committee Democrats voted against the bill.
Rep. John Yarmuth (D-KY), ranking member on the Budget Committee, said the GOP bill “isn’t a health care bill at all. It’s an ideological document with real and incredibly damaging consequences for American families.”
The legislation now moves to the House Rules Committee, which controls how the bill is presented and debated on the floor. Ryan is still planning to hold a House floor vote next week.