President Trump appeared to reshuffle his legislative agenda again this week by saying that Congress has to pass an Affordable Care Act replacement bill before undertaking any other major priorities such as tax reform.
After suffering through a failed health care repeal-and-replace effort last month, Trump said he was content to move on to overhauling the tax code. But during an interview with Fox Business this week, Trump said tax reform will be politically much easier once the roughly $1 trillion in taxes that are part of the ACA have been repealed.
“Health care is going to happen at some point,” Trump said. “Now, if it doesn’t happen fast enough, I’ll start the taxes. But the tax reform and the tax cuts are better if I can do health care first.”
White House officials – including Vice President Pence and budget director Mick Mulvaney – are involved in brokering a deal with congressional Republicans, including the conservative Freedom Caucus that was largely responsible for the earlier bill failing to secure enough support.
Freedom Caucus members want to repeal as much of the ACA as possible, including allowing states to opt out of two important provisions in the ACA: essential health benefits, a menu of minimum services that insurers must cover; and community rating, which prevents insurers from demanding higher premiums from patients with pre-existing conditions.
With prompting from the White House, House leaders tweaked their health care bill just before leaving on a two-week recess last week by adding an amendment providing for “high-risk pools” to subsidize coverage for people who are seriously ill and have high medical costs. To fund the risk-sharing pools, Republicans have proposed giving states more than $100 billion in federal “stabilization” funds.
House Speaker Paul Ryan (R-WI) said the recent tweaks are a “step in the right direction.”
“It’s closer toward the final goal and agreement,” Ryan said. “And we’re going to keep talking and working on it until we get it right.”
As expected, congressional Republicans are getting no help in their efforts to repeal the ACA from Democrats. Earlier this week though, Trump suggested the government may end cost-sharing reduction subsidies, used to help lower-income people afford medical services, if Democrats don’t come to the negotiating table.
“President Trump is threatening to hold hostage health care for millions of Americans, many of whom voted for him, to achieve a political goal of repeal that would take health care away from millions more,” Senate Minority Leader Chuck Schumer (D-NY) said in a statement. “This cynical strategy will fail.”