Health Care Plan Moving Through Congress

WASHINGTON (AP) -- House Republicans scored a pre-dawn triumph Thursday in their effort to scuttle former President Barack Obama's health care overhaul.

After nearly 18 hours of debate and over two dozen party-line votes, Republicans pushed legislation through the Ways and Means Committee abolishing the tax penalty Obama's statute imposes on people who don't purchase insurance and reshaping how millions of Americans buy medical care.

It was a victory of high symbolism because Obama's so-called individual mandate is perhaps the part of the statute that Republicans most detest.

Even so, the White House and Republican leaders confront a GOP and outside groups badly divided over the party's high-stakes overhaul crusade.

The American Medical Association, the American Hospital Association and AARP, the nation's largest advocacy group for older people, were arrayed against the measure. Seven years ago their backing was instrumental in enacting Obama's health care statute, which President Donald Trump and Republicans are intent on erasing.

The hospitals - major employers in many districts - wrote lawmakers complaining about the bill's cuts in Medicaid and other programs and said more uninsured Americans seem likely, adding, "We ask Congress to protect our patients." Groups representing public, children's, Catholic and other hospitals also expressed opposition.

America's Health Insurance Plans, representing insurers, praised the legislation's elimination of health industry taxes but warned that proposed Medicaid changes "could result in unnecessary disruptions in the coverage and care beneficiaries depend on."

The legislation would defang Obama's requirement that everyone buy insurance by repealing the tax fines imposed on those who don't. That penalty has been a stick aimed at pressing healthy people to purchase policies. The bill would replace income-based subsidies Obama provided with tax credits based more on age, and insurers would charge higher premiums for customers who drop coverage for over two months.

"That's what this whole bill was about, kicking people who weren't politically popular," Ways and Means Chairman Kevin Brady, R-Texas, said of Obama's overhaul.

Ways and Means members worked till nearly 4:30 a.m. EST before approving the final batch of tax provisions in a party-line 23-16 vote. The Energy and Commerce Committee panel continued working Thursday morning, tackling a reshaping of Medicaid.

Conservative lawmakers and allied outside groups claimed the bill took too timid a whack at Obama's law. Numerous GOP centrists and governors were antagonistic, worried their states could lose Medicaid payments and face higher costs for hospitals having to treat growing numbers of uninsured people.

Ramping up pressure on GOP dissidents, a political group close to House Republican leaders said it is launching a TV ad campaign targeting 30 conservative lawmakers, mostly members of the hard line conservative House Freedom Caucus. The American Action Network said it was spending $500,000 on an ad contrasting the Republican bill with Obama's law. It ends with the announcer urging viewers to tell their representative "to vote with President Trump."

The extra billions Washington has sent states to expand the federal-state Medicaid program would begin ending in 2020, and spending on the entire program would be capped at per-patient limits. Around $600 billion in 10-year tax boosts that Obama's statute imposed on wealthy Americans and others to finance his overhaul would be repealed. Insurers could charge older customers five times more than younger ones instead of the current 3-1 limit, but would still be required to include children up to age 26 in family policies, and they would be barred from imposing annual or lifetime benefit caps.

The measure would also repeal taxes Obama's law imposed on segments of the medical industry to help pay for his statute's expanded coverage.