GOP healthcare plan clears first hurdle
Story highlights
- Republicans are holding the line to block Democratic efforts to delay the bill to repeal Obamacare
- The bill has already drawn criticism from rank-and-file lawmakers
- Democratic Rep. Lloyd Doggett said the GOP bill had been kept "as secret as Donald Trump's tax returns."
Washington (CNN)After
an 18-hour session, the House Ways and Means Committee has become the
first to approve the Republicans' Obamacare repeal bill.
White
House and Republican congressional leaders had sought to fast track the
legislation through Congress. Democrats made clear it wouldn't be easy
-- dragging out a grueling day of committee sessions well into the early
morning hours. The House Energy and Commerce Committee is still
debating.
Opposition to the
Republican health care bill had strengthened Wednesday, as key industry
groups that had supported Obamacare said the replacement backed by
President Donald Trump could harm vulnerable Americans.
In
both committee rooms, GOP lawmakers dismissed questions about the
bill's cost and claims it would result in millions of Americans losing
insurance coverage. Democrats mixed assaults on the legislation with
diversionary tactics meant to embarrass Trump -- such as highlighting
his refusal to release his tax returns.
The
action on Capitol Hill comes against a backdrop of pitched controversy
over the legislation, which is posing a crucial first test to Trump's
capacity to move his agenda through Congress and as conservative
Republicans complain that the initiative does not go far enough in
erasing his predecessor Barack Obama's signature domestic achievement.
The
American Medical Association, which bills itself as the largest
organization of doctors in the nation, sent a letter to the two
committees, detailing its critique of the bill, known as the American
Health Care Act.
"While we agree
that there are problems with the ACA that must be addressed, we cannot
support the AHCA as drafted because of the expected decline in health
insurance coverage and the potential harm it would cause to vulnerable
patient populations," the letter stated.
Major
hospital organizations, including the American Hospital Association and
the Federation of American hospitals have also come out against the
bill. The largest seniors organization, the AARP had warned on Tuesday
the measure would weaken Medicare and Medicaid. Some conservative
medical lobby groups have supported the measure.
White House spokesman Sean Spicer shrugged off the building opposition from the medical establishment.
"We
would love to have every group on board," Spicer said, adding, "This
isn't about figuring out how many special interests in Washington we can
get paid off. It's about making sure that patients get the best deal,
that lowers prices and brings back cost."
Trump
also showed willingness to jump into the fray, meeting with the leaders
of conservative groups that have lined up against the bill.
"This
is going to be great. You're going to make it even greater," the
President told the group, sources at the White House meeting told CNN.
"I'm going to work hard to get it done."
But
should the bill eventually fail, Trump outlined a backup plan: Allow
Obamcare to fail and let Democrats take the blame, sources said.
Working late
It
was a full day -- and night -- for lawmakers on Capitol Hill. Two
committees started their markups Wednesday morning at 10:30 a.m. and
worked past 4 a.m.
Twelve hours in,
the Energy and Commerce Committee was still debating the first
Democratic amendment -- which was to change the name of the bill. The
Ways and Means Committee ended debate on the second of five subtitles in
the bill shortly before 11 p.m.
In the Ways and Means meeting room, there were signs that the long day was wearing on lawmakers.
Around 8 p.m., the panel's chairman, Rep. Kevin Brady, leaned back in his chair and put in eye drops.
Later,
as restless staffers' side conversations rose to regular volumes rather
than whispers, Brady had to call the room to order. Shortly before 4:30
a.m. Thursday, they voted 23-16 to approve their portion of the House
legislation.
Aides sat with
blankets in their laps or around their shoulders in the overly
air-conditioned room. One snuck in a box of Dunkin' Donuts "Munchkins"
to share.
The long day unfolded
with a series of dry-as-a-bone discussions about health care policy and
Democratic procedural measures to make the process as painful as
possible for their Republican colleagues.
At
one point, the minority forced the clerk of the House Energy and
Commerce Committee to read the full bill -- a procedure that took about
an hour. Democrats have promised at least 100 amendments, most of which
have no chance of passage. For instance, one defeated measure would have
blocked health care reform coming into force unless it ensured coverage
for every taxpayer and all their dependents.
One
Republican aide reported that Democratic leaders were pulling lawmakers
out of committees for seemingly endless adjournment votes on the House
floor, to make the process drag on even longer.
The
only break to the tedium came amid buzz over an invitation from Trump
to the House Freedom Caucus to throw down a few frames at the White
House Bowling alley in a bid to strike a deal over the group's
reservations about the bill.
Brady,
the Republican chairman of the House Ways and Means Committee, the
other panel holding a hearing, tried to keep the process on track. He
said the Affordable Care Act was collapsing but that "relief is on the
way" following a full-throated endorsement of the bill from Trump, who
is planning to mount an intense lobbying effort to get the measure
quickly out of the House and to the Senate.
"Today's
markup is a critical step to providing all Americans with affordable,
patient-centered health care that is tailored to their needs," Brady
said.
The GOP legislation unveiled
Monday would get rid of Obamacare's individual mandate and put in place
refundable tax credits for individuals to purchase health insurance. It
also proposes restructuring Medicaid and defunding Planned Parenthood.
The
bill looks to preserve some of the more popular elements of Obamacare,
including protections for people with pre-existing conditions (though
insurers would be allowed to charge higher premiums to individuals whose
coverage has lapsed) and letting children stay on their parents'
insurance plans until the age of 26.
Democrats want CBO score
Democrats
are complaining that the hearings are taking place before the
Congressional Budget Office has a chance to "score" the House
legislation, a process that will provide answers on how much it will
cost and how many people it will cover.
Rep.
Richard Neal, the top Democrat on the Ways and Means panel, cited the
lack of the report as a reason the effort should be postponed. "To
consider a bill of this magnitude without a CBO score is not only
puzzling and concerning, but also irresponsible," Neal said.
Democratic Rep. Lloyd Doggett said the GOP bill had been kept "as secret as Donald Trump's tax returns."
"It is surprising that you're so determined to hide your panacea," the Texas congressman told his Republican colleagues.
Rep.
Sander Levin of Michigan asked his fellow Republicans: "what are you
afraid of, what are you afraid of?" before answering his own question,
saying that the bill would increase the ranks of the uninsured and could
interfere with the private health care market.
GOP leaders have said that the bill will not be brought to the floor until the CBO scores the legislation.
But
while Republican Majority Whip Steve Scalise told the Energy committee
that while he is also waiting for a CBO score, he will not let
"unelected bureaucrats in Washington" slow down the Republican promise
to repeal and replace Obamacare.
Democrats forcing delays
Democrats used arcane parliamentary procedures to give a series of five-minute speeches in a bid to slow the panel's progress.
"What
we're trying to do is make sure we're having a totally transparent
process, that it's not going to be a bill that's going to be crammed
through, that the American people are gonna understand the consequences
of what the provisions are. We're gonna take the time to talk about all
the implications," said Rep. Debbie Dingell, a Democrat from Michigan.
In theory Democrats could force the chair to permit five-minute speeches on every amendment.
Back
at Ways and Means, Republicans tried to expedite the process by
offering no amendments to the bill. Brady said that was because
Republicans were happy with the bill as it stood.
"We
feel very good about not just repealing the bad aspects of the
Affordable Care Act but beginning to restore state control and more
personal control over healthcare, so we feel good about the bill," he
said.
One
Democratic committee aide said the intent is to "make some Republicans
take some really tough votes" that are "revealing" about the GOP's
priorities on health care.
Democratic
Rep. Brian Higgins highlighted a provision of the bill that provides a
tax break for health insurance companies amid criticism that it will
simply be passed onto industry executives. Higgins listed the
million-dollar salaries enjoyed by CEOs at health care giants like
Aetna, Anthem, Cigna and United Healthcare.
It's "morally reprehensible," Higgins said.
"We're sitting here talking about giving big insurance companies a tax break?"
Despite the fraught political circumstances, there was a moment of levity at the Energy and Commerce Committee.
Rep.
Jan Schakowsky, a Democrat from Illinois, said she was going to blast
the Republican plan using President Trump's Twitter vernacular.
"Bad!" she said loudly. "Sad!"
This story has been updated.
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