Republicans revamp U.S. health bill, boost benefits to older Americans

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By Susan Cornwell and Valerie Volcovici

Ryan said Republican leaders still planned to bring the
healthcare bill to a vote on the House of Representatives floor
on Thursday. Speaking on the “Fox News Sunday” television
program, he said leaders were working to address concerns that
had been raised by rank-and-file Republicans to the legislation.

Republicans remain deeply divided over the healthcare
overhaul, which is President Donald Trump’s first major
legislative initiative. It aims to fulfill his campaign pledge
to repeal and replace the Affordable Care Act, popularly known
as Obamacare, the signature healthcare program of his Democratic
predecessor, Barack Obama.

Democrats say the Republican plan could throw millions off
health insurance and hurt the elderly, poor and working families
while giving tax cuts to the rich.

“We think we should be offering even more assistance than
the bill currently does” for lower-income people age 50 to 64,
Ryan, the top Republican in Congress, said of the tax credits
for health insurance that are proposed in the legislation.

Ryan also said Republicans were working on changes that
would allow federal block grants to states for Medicaid and
permit states to impose a work requirement for able-bodied
Medicaid recipients.

Trump told reporters in a brief conversation aboard Air
Force One that he had meetings about healthcare reform in
Florida at the weekend and that the effort to sell the proposal
was going well.

He has been wooing lawmakers to vote for the bill and won
the backing of a dozen conservative lawmakers on Friday after an
Oval Office meeting in which the president endorsed a work
requirement and block-grant option for Medicaid.

Trump is set to meet Ezekiel Emanuel, a health policy
special adviser under Obama who helped shape the Affordable Care
Acton, at the White House on Monday, along with Ryan and Health
and Human Services Secretary Tom Price.

Block grants would give states a set amount of money to
cover people on the Medicaid program and provide flexibility in
spending decisions. However, there is no guarantee funding would
keep up with future demands.

“TRYING TO FIX BILL”

While Ryan said he felt “very good” about the health bill’s
prospects in the House, a leading conservative lawmaker,
Representative Mark Meadows, told the C-Span “Newsmakers”
program that there were currently 40 Republican “no” votes in
the House. Republicans hold a majority in the chamber but cannot
afford to have more than 21 defections for the measure to pass.

Meadows and two other Republican opponents of the bill,
Senators Mike Lee of Utah and Ted Cruz of Texas, met at Trump’s
Mar-a-Lago estate in Florida on Saturday “negotiating with the
president’s team, trying to fix this bill,” Cruz told CBS’ “Face
the Nation.”

North Carolina Republican Meadows said the changes being
considered for the Medicaid program would not go far enough if
they left it up to states to decide whether to put in place a
work requirement.

Price acknowledged the tough negotiations, telling ABC’s “This Week”: “It’s a fine needle that needs to be thread,
there’s no doubt about it.”

The healthcare bill would face significant challenges in the
Senate even if it were to pass the House.

Senator Tom Cotton, a conservative Arkansas Republican, said
the bill would not reduce premiums for people on the private
insurance market. “It’s fixable, but it’s going to take a lot of
work,” Cotton said on CNN’s “State of the Union.”

Moderate Republicans have also expressed concerns about the
bill, and their worries are often not the same as that of
conservatives.

Speaking on NBC’s “Meet the Press,” Republican Senator Susan
Collins of Maine worried the bill would harm older Americans,
and shift Medicaid costs to states – something critics say a
block-grant approach would only make worse.

Collins said coverage issues must also be dealt with, citing
a report from the Congressional Budget Office that said 14
million people would lose health coverage under the House bill
over the next year and 24 million over the next decade.

Affordability has been one of the bigger concerns that
insurers and hospital groups have raised about the legislation.
To the extent that a change in tax credits makes healthcare more
affordable for some people, insurers and hospitals could stand
to benefit.

The BlueCross BlueShield Association emphasized the need for
the replacement to be affordable when the draft of the
healthcare bill was released earlier this month. The association
represents BCBS insurers that cover the vast majority of the
roughly 10 million people enrolled in 2017 Obamacare plans.



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