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Congress presses ahead on dismantling health care law

  • ASSOCIATED PRESS

    Senate Majority Leader Mitch McConnell of Kentucky during a news conference on Capitol Hill on Jan. 4.

WASHINGTON >> Congress is poised to complete its initial step toward dismantling President Barack Obama’s health care law, as Republicans divided over how to replace it face pressure from Donald Trump for quick action.

“We have a responsibility to step in and provide relief from this failing law,” Speaker Paul Ryan, R-Wis., told reporters today. “And we have to do it all at the same time so that everybody sees what we’re trying to do.”

But at the same time, Ryan said there were no “hard deadlines” for a GOP replacement in tandem with the repeal effort, underscoring the difficulty for Congress despite the president-elect’s call to both repeal the law and replace it with legislation to “get health care taken care of in this country.”

That action will be almost impossible to fulfill in the complicated web of Congress, where GOP leaders must navigate complex Senate rules, united Democratic opposition and substantive policy disagreements among Republicans.

By a near party-line 51-48 vote early today, the GOP-run Senate approved a budget that eases the way for action on subsequent repeal legislation as early as next month. The Republican-controlled House planned to complete the budget on Friday, despite misgivings by some GOP lawmakers.

Republicans are not close to agreement among themselves on what any replacement would look like.

The 2010 law extended health insurance to some 20 million Americans, prevented insurers from denying coverage for existing conditions and steered billions of dollars to states for the Medicaid health program for the poor. Republicans fought the effort tooth and nail, and voter opposition to the law helped carry the GOP to impressive victories in 2010, 2014 and last year.

Today’s Senate procedural vote will set up special budget rules allowing the repeal vote to take place with a simple majority in the 100-member Senate, instead of the 60 votes required to move most legislation.

That means Republicans, who control 52 seats, can push through repeal legislation without Democratic cooperation. They’re also discussing whether there are some elements of a replacement bill that could get through at the same time with a simple majority. But for many elements of a new health care law, Republicans are likely to need 60 votes and Democratic support, and at this point the two parties aren’t even talking.

Kentucky Sen. Rand Paul, unhappy that the measure endorsed huge budget deficits, was the sole Republican to vote against it.

Increasing numbers of Republicans have expressed anxiety over obliterating the law without a replacement to show voters.

Sen. Susan Collins, R-Maine, said she wants at least to see “a detailed framework” of a GOP alternative health care plan before voting on repeal. She said Republicans would risk “people falling through the cracks or causing turmoil in insurance markets” if lawmakers voided Obama’s statute without a replacement in hand.

Collins was among a handful of Republicans to occasionally break ranks to support some Democratic amendments aimed at supporting such things as rural hospitals and a mandate to cover patients with existing medical conditions. They were all shot down by majority Republicans anyway.

Ryan and other GOP leaders appeared confident that the measure would easily clear the House. In the House, both conservatives and moderates wanted to get more of a guarantee that they would have a greater sense of what a GOP substitute would look like — or putting some elements of the replacement measure in the repeal bill.

“We need to be voting for a replacement plan at the same time that we vote for repeal,” said Rep. Mark Meadows, R-N.C., an influential conservative.

Some more moderate House Republicans were unhappy, too, including Rep. Tom MacArthur, R-N.J., a leader of centrists in the House Tuesday Group. He said he would oppose the budget because there was too little information about the replacement, including whether people receiving expanded Medicaid coverage or health care subsidies under the existing law would be protected.

“We’re loading a gun here,” MacArthur said. “I want to know where it’s pointed before we start the process.”

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    • Repeal will return us to a time where thousands of Americans will needlessly die every year because they are without health insurance. Many of those who voted for Trump will lose their health insurance. Republicans have no plan to replace Obamacare because it is already a barebones Republican plan first introduced by Richard Nixon then the Heritage Foundation.

      • Don’t be surprised if the Donald replaces Obama care with a single pay system. Just as it took an anti commie to open up China, it may just take a conservative businessman to get a single pay system through. I mean healthcare is probably the biggest expense of having an employee for a business. Why not shove it off on the government?

        Makes sense to me.

        • That’s an interesting idea. There may be an American version that would work.

          I am not sure if a system exactly like they have in Canada could work here.

        • Regardless, it is absolutely critical to:

          i) get rid of the individual mandate which is an evil attempt to destroy individual freedom
          ii) move it to the states and get the federal government completely out of direct management
          iii) remove any involvement of the IRS

        • Thanks for the Nixon reference.
          I just read his plan at http://khn.org/news/nixon-proposal/

          I am not sure if I completely agree with it, but my first impression is that was much better than Obamacare

          For one thing it avoided the idea of an individual mandate, which is just dripping with alt-left authoritarianism

      • “”Repeal will return us to a time where thousands of Americans will needlessly die every year because they are without health insurance.””

        Total bs. An emergency room cannot turn people away.

        • lol, and who will pay for this? Be thankful you are not in a red state. Heard may of their hospitals are under pressure.

        • Good grief – can you actually be this dense? First of all, like a lot of Republicans, you think that ER care is free, and that no one eventually has to pay for it. That’s been one of their many Big Lies all along.

          Emergency rooms must stabilize someone, but they have no obligation whatever for providing follow on treatments for anything. Not cancer – nothing.

          Try learning something today. From this comment, learning anything would help.

        • Good grief – can you actually be this dense?

          Do you think ACA – Obamacare was free? It was a failure of Biblical proportions.

          What I said was true. People will not be turned away from a hospital for a medical emergency. Nobody said it was free.

          The health care insurance should have been left up to the states. Hawaii didn’t need ACA.

        • @Keolu, it’s not “BS.” A hospital can’t turn you away if it’s emergency (though it still happens; a friend of mine was bitten by a rattlesnake and the 1st hospital we took her too refused her because she had no insurance. Fortunately there was another not too far away). But they can turn you away if you have a chronic condition, like cancer. That’s what people will die of. That’s what an acquaintance is going thru in Florida; no insurance, he’s been waiting over half a year for medicaid coverage to start, in the meantime, though he was given six months to live, he was sent home w/no pain medication, no help, nothing.

      • Rubbish

        Health care has always been available one way or the other,
        Clinics, emergency rooms, county hospital.

        I read that 30% of the population of California is on Medicaid and that will still be there for the time being.
        This is where the poor are.

        In the meanwhile the middle class is getting screwed with penalties and policies that are unusable because of large deductibles

        • You are beyond hope, with no ability to think.

          If the goal of your comments here was to make people feel sorry for you, it worked.

    • The sad thing is that Republicans are taking away life-saving insurance for millions of poor and working class Americans. As usual, Trump voters slit their own throats. He spits on all of them and just lied to get elected.

        • That is true but who to provide health care? Lets leave it to health fairs to provide it. Right Keolu? That is what they are for after all.

      • Allie, you’re being a little dramatic this morning. Per chance, you don’t watch MSNBC do you? I’m wondering where you get you’re talking points from.

      • allie, your hero will be on 60 Minutes this Sunday. It seems one farewell speech wasn’t enough for Barry. Since CBS will devote the entire show to to him, you’ll have an hour to fawn. Enjoy.

      • Allie , bitterness and anger are not good for your health , and as you are so sure healthcare is now doomed , I guess you are to . Bye Bye ………….. Or embrace the better way and flourish.

        You might be surprised .

      • Allie, when you are finished reading the revision to our health care program that Trump has put out, let us all read it-Since you seem to know what the outcome will be.

        • Gonefishin, link to Trumpf health plan or GOP plan. Mahaloz. Is it the YUGE Health Plan? Simultaneously delivery. Boom,boom done? Everybody happy? Link please.

  • I am sure many of the more than 6 million people who depend on the ACA for medical insurance voted red. Losing their medical coverage is their reward…as their “elected representatives” have the best health care available.

    • No kidding, what were they thinking, as no longer having adequate or any coverage will hit them where it really hurts, literally. Just wait and see if the Republicans really replace it with anything substantial and see the premiums go up even more if they do. Probably gone will be the pre-existing conditions and lifetime cap on coverage clauses. Saw a political cartoon where the Republicans said if you like your pre-existing condition you can keep it (but not your coverage!).

      • agree…people are just beginning to wake up to what trump actually is: a treasonous, arrogant anti-American who will do anything to hurt the middle and working classes. So sad.

        • @ allie
          my reply to ICEEBEAR goes for you too.
          Again don’t forget it’s YOUR DEM’s MESS!

        • Perhaps you could just make up a list of your name-calling epithets and put it on-line with a link to it.

          You would then have some space for saying something thoughtful and constructive, if that is possible.

        • What’s really sad is the students who have allie as a teacher. Just hope allie doesn’t teach critical thinking.

      • @ ICEebear
        Excerpt from 1-11-17 presser on OBAMACARE:

        TRUMP: Finally, Obamacare, I thought it was never gonna be asked.

        QUESTION: (OFF-MIKE) though if you have outlined a plan for what you want the replace package to look like, would it guarantee coverage for those who have gotten health insurance through the current Obamacare law?

        “TRUMP: You’re gonna be very, very proud, as not only the media and reporters, you’re gonna be very proud of what we put forth having to do with health care. Obamacare is a complete and total disaster.

        They can say what they want, they can guide you anyway they wanna guide you. In some cases, they guide you incorrectly. In most cases, you realize what’s happened, it’s imploding as we sit.

        Some states have over a hundred percent increase and ’17 and I said this two years ago, ’17 is going to be the bad year. It’s going to be catastrophic. Frankly, we could sit back and it was a thought from a political standpoint, but it wouldn’t be fair to the people.

        We could sit back and wait and watch and criticize and we could be a Chuck Schumer and sit back and criticize it and people would come, they would come, begging to us please, we have to do something about Obamacare. We don’t wanna own it, we don’t wanna own it politically. They own it right now.

        So the easiest thing would be to let it implode in ’17 and believe me, we’d get pretty much whatever we wanted, but it would take a long time. We’re going to be submitting, as soon as our secretary’s approved, almost simultaneously, shortly thereafter, a plan.

        It’ll be repeal and replace. It will be essentially, simultaneously. It will be various segments, you understand, but will most likely be on the same day or the same week, but probably, the same day, could be the same hour.

        So we’re gonna do repeal and replace, very complicated stuff. And we’re gonna get a health bill passed, we’re gonna get health care taken care of in this country. You have deductibles that are so high, that after people go broke paying their premiums which are going through the roof, the health care can’t even be used by them because their deductibles bills are so high.

        Obamacare is the Democrats problem. We are gonna take the problem off the shelves for them. We’re doing them a tremendous service by doing it. We could sit back and let them hang with it. We are doing the Democrats a great service.

        So as soon as our secretary is approved and gets into the office, we’ll be filing a plan. And it was actually, pretty accurately reported today, The New York Times. And the plan will be repeal and replace Obamacare.

        We’re going to have a health care that is far less expensive and far better. OK.”

        Bottom line it’s a DEM PROBLEM

        • Actually it is a national problem, that has existed ever since Nixon first proposed Nixon care. It will now be a republican problem as they are repealing it and now they need to replace it. Good luck which is why I say don’t be surprised if the Donald proposes a single pay system.

        • My comment is awaiting moderation.

          @ boots
          How quick you go back to Nixon…why not go back to Columbus geesh.
          ACA is your BABY boots…yours and your O. PE Trump could do nothing and let it implode..but because PE Trump is thinking of the American People he will do what’s right and fix it.
          You’re no better than allie..ungrateful “gimme gimme handouts etc.” mentality.
          Single Payer was your Crooked Corrupt hiLIARy’s ultimate plan..O wanted it but couldn’t get it.
          BUT thank you boots…for not throwing in the Stock Market mantra into this. lol

          January 20 #MAGA

        • IRT Keoni: HAHAHAHA!!! It’ll be repeal and replace. It will be essentially, simultaneously. It will be various segments, you understand, but will most likely be on the same day or the same week, but probably, the same day, could be the same hour…Babbling IDIOT…He’s trying to tell us HiS Plan and HE don’t even know when HIS plan is coming out…Hope it works ’cause I WIN…I WIN just watching you sheep…January 20, #FLOTUSvideo…#MAGA

        • IRT Keoni: HAHAHAHA!!! It’ll be repeal and replace. It will be essentially, simultaneously. It will be various segments, you understand, but will most likely be on the same day or the same week, but probably, the same day, could be the same hour…Babbling ID!0T…He’s trying to tell us HiS Plan and HE don’t even know when HIS plan is coming out…Hope it works ’cause I WIN…I WIN just watching you sheep…January 20, #FLOTUSvideo…#MAGA

        • My comment is awaiting moderation.

          @ jusris
          um…you sound like THE Babbling ID!0T…TWICE even!
          Is that what happens when you have been eating CROW since Nov. 8th?
          lol

          January 20 #MAGA!

  • Yes Nancy P we have passed it and now know first hand what is in it and the Dems gave us a worthless instrument as usual. Unlike the Democrats the insurance companies have to balance their books. Dems refuse to admit that if Obamacare is left in place the next few years will make the last few look good. It is a failed attempt to put a large tax on working men and women and destroy small businesses.

    Be glad there is a leader on deck to save the Dems from their own greed.

  • Trump voters in West Virginia and Kentucky were being interviewed this morning on television – some of them with Trump signs still on their lawns. Every person interviewed said that they knew what Trump said during the campaign about Obamacare, but they didn’t think he’d actually do anything.

    “What am I going to do for cancer treatments?” asked one.

    Good question. You voted for them to be cut off. Having second thoughts?

    • They will find it more available , can go back to their own doctor (if he survived Obamacare) and it will cast them far less with lower deductions.. things Hussain and Nancy P never thought about.

      • You are as dense as the writer. Who is going to pay for the doctor and further care if the person has no insurance? You might recall that before ACA, people with pre-existing conditions could not be insured. And insurance companies could drop a customer when they got sick.

        Do you just not read at all?

      • Really, waterman2? It’s been 6 years and the republicans still don’t have the answers. It’s unlikely they’ll be able to produce anything that provides comparable coverage. They’ll still repeal obamacare out of sheer spite, simply because they can, even if they don’t have a better alternative. This is the hypocrisy of many of the republicans.

  • I’m going to enjoy watching all the snowflakes here just explode over the next 4 years!
    Poor Allie, she’s going to run out of adjectives for Trump. Keep it fresh Allie, get your hands on a thesaurus.

    • That’s pretty unkind of you. Why invest so much energy in being mean to others? Take that energy and think instead of a telling a friend how much they mean to you.

  • “The ACA isn’t just about insurance. It’s a panoply of protections: line items that seem small on the surface but are huge to those that need them, provisions to protect women’s health, provisions to help us get free tests to prevent big diseases, coverage for autism therapy, calorie/nutrition information at restaurants. The ACA is designed to protect individuals, and not a system. It’s just the first volley, an imperfect one, but one that makes health insurance — and by proxy, health care — affordable and within reach for millions of Americans, including us poor sods in the creative class who really would rather not do without it. The ACA helps the middle-class, the lower-class, it helps women, it helps the disabled, and all of those will be disproportionately affected by its repeal.”

    http://terribleminds.com/ramble/2017/01/12/why-we-need-the-affordable-care-act-aca/

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