GOP Bill: Repeals Parts Of Obamacare, Retains Some Subsidies

Mar 7, 2017
Originally published on March 7, 2017 8:22 am
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DAVID GREENE, HOST:

It is hard to imagine a political party being any more clear about something. Republicans have wanted Obamacare gone since the day the law was enacted. They voted symbolically to repeal it more than 60 times. Of course, the question was always, what would they replace it with? Well, now we know. House Republicans unveiled a plan yesterday.

And let's talk about it with NPR congressional correspondent Susan Davis, who's in the studio. Sue, good morning.

SUSAN DAVIS, BYLINE: Good morning, David.

GREENE: So what are the key parts of this Republican plan?

DAVIS: So the legislation is called the American Health Care Act. But Democrats are already calling it Trumpcare. The core of the bill repeals the mandate that tells individuals they have to buy insurance and phases out all of the taxidies (ph) and subsidies in Obamacare and eventually replaces it with a system of refundable tax credits that you'll get based on your income and your age.

The federal government would no longer penalize you if you don't have health insurance, but it would let your insurer impose higher penalties on you if you let your coverage lapse when you go back to sign back up for it. So there is still a bit of an incentive to encourage people to have health insurance. It just rewards insurers and not the government.

And it also keeps in place some of Obamacare's most popular provisions. It keeps the provisions that require coverage protections for pre-existing conditions. And it would still let parents keep their kids on their health care plans until they're 26. And all of this would happen over a gradual two to three-year implementation plan, so it wouldn't be fully implemented till about 2020.

GREENE: Well, I wanted to ask you about keeping some of Obamacare because, obviously, one thing we're going to be hearing a lot from Democrats is their criticism of this bill. But if it keeps part of Obamacare, are there some Republicans who are going to have trouble supporting this?

DAVIS: Absolutely, conservative hard-liners in the House and Senate have already been very critical of the plan. They don't like the subsidies. They just see it as a new entitlement program by another name. It's just more government spending. And if that opposition holds, it could be a significant problem. One of the leading voices of opposition is Rand Paul, the Republican senator from Kentucky. He's calling it Obamacare lite. He's already indicated he's likely to oppose it.

But Congress has worked really closely with the White House on this. And supporters of this bill, including the speaker of the House, Paul Ryan, ultimately believe that conservatives are not going to want to be on the wrong side of President Trump back home in their districts, where he is very popular. So they're confident, at the end, they'll be able to get the votes. But there's very little wiggle room here. Republican leaders can only lose about 19 Republicans in the House and only about two in the Senate and still be able to pass it. So there's very little room for error.

One more thing about this bill, David, that we don't know yet - we don't know how much it's going to cost, and we don't know how many people it's going to cover. We're going to find that out when the nonpartisan Congressional Budget Office weighs in. But that report will be very influential to winning over conservatives.

GREENE: Well, what do you do if you're Democrats right now, Sue? I mean, you don't control anything in Washington. Do you fight like mad to keep Obamacare? Do you work with Republicans? What position are they in here?

DAVIS: You know, they are taking almost a similar tactic that Republicans did to Obamacare. They appear to be unanimously opposed to it. Aside from the top lines of the bill that they just don't support, there's also many lower provisions in the bill that they will not vote for. For example, the bill would not let individuals - they would not let individuals get the tax subsidy if they purchase a private plan that covers abortion services. So obviously, Democrats are going to be widely opposed to that.

And remember, this was the president's signature domestic achievement. They see this fight about protecting his legacy, and they just don't believe that the bill has been, in the words of President Trump, a disaster. About 20 million more Americans do have health coverage today because of this law.

I always think it's worth reminding in this fight that it's still a very small piece of the population. Only about 6 percent of Americans get their health insurance through the individual market. So it has really been a remarkable political fight over what is a relatively small piece of the health care market.

GREENE: Well, where does this remarkable political fight go now? We have this bill from Republicans, but that's obviously just going to be just the beginning.

DAVIS: They're looking at a really ambitious timeline. House committees are going to start moving it on Wednesday. The full House could vote on it as soon as next week, maybe the week after. Then, it'll go to the Senate where they're trying to get a bill to the president's desk right before the Easter break, and that is just five weeks from now. But President Trump has publicly and repeatedly urged Congress to act and to act fast.

GREENE: OK, so we could see things move very quickly. NPR congressional correspondent Susan Davis. Thanks, Sue.

DAVIS: Thanks for having me, David. Transcript provided by NPR, Copyright NPR.