Ryan foresees no major changes in Republican U.S. healthcare plan

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By Susan Cornwell and David Morgan | WASHINGTON

WASHINGTON U.S. House of Representatives Speaker
Paul Ryan said on Wednesday the major elements of the Republican
healthcare overhaul plan backed by President Donald Trump will
remain intact despite conservative opposition to a bill whose
prospects remain up in the air.

The White House and Ryan struggled to shore up support among
Republican lawmakers for the legislation ahead of a key hurdle
in the House Budget Committee on Thursday. Vice President Mike
Pence was set to met with conservative House lawmakers and then
the entire Republican House membership.

Ryan, who unveiled the legislation last week and is its main
champion in Congress, said he was open to making “improvements
and refinements,” especially after an assessment on Monday by
the Congressional Budget Office, which said millions of
Americans would soon lose their health insurance under the plan.

Ryan indicated no appetite for wholesale changes, even as
conservatives demanded major shifts relating to tax credits and
the Medicaid health insurance program for the poor.

“Obviously, the major components are staying intact because
this is something we wrote with President Trump. This is
something we wrote with the Senate committees,” Ryan told the
Fox Business Network.

Senate Republicans voiced rising unease.

“As written, the House bill would not pass the Senate. But I
believe we can fix it,” Texas Senator Ted Cruz, a prominent
conservative critic of the legislation, told reporters.

“It is mortally wounded,” Republican Senator Lindsey Graham
added on NBC’s “Today” show, saying the bill was not good right
now and that his party needed to “slow down” to get it right.

Ryan’s comments follow Trump’s promise on Monday of “a big,
fat, beautiful negotiation” over the plan, the first major
legislative initiative of his presidency.

Republicans control both Congress and the White House for
the first time in a decade. But the bill, the Republicans’ first
major piece of legislation under Trump, remains in peril.

Democrats are unified against it, major medical providers
have condemned it and conservatives oppose key elements.

The legislation guts key provisions of the 2010 Affordable
Care Act, Democratic former President Barack Obama’s signature
legislative achievement popularly known as Obamacare. Obamacare
enabled about 20 million previously uninsured Americans to
obtain medical insurance.

Many conservatives call parts of the measure too similar to
the law it is supposed to replace, want a quicker end to
Obamacare’s expansion of the Medicaid insurance program for the
poor, and call the plan’s age-based tax credits to help people
buy private insurance on the open market an unwise new
government entitlement.

Two House committees last week approved the bill’s
provisions with no changes, and the Budget Committee on Thursday
will try to unify the plan into a single bill that would be sent
to the House floor. Republicans cannot afford to lose more than
three from their ranks on the committee for the measure to pass.
Three committee Republicans are members of the hardline
conservative House Freedom Caucus.

‘LEGISLATIVE QUICKSAND’

Representative John Yarmuth, the committee’s top Democrat,
said the legislation “is in legislative quicksand.”

“It is sinking of its own weight, and every time the
Republicans try to move one way or another, it is sinking
faster,” Yarmuth said.

The U.S. Department of Health and Human Services released
data showing that enrollment in the individual insurance plans
created under Obamacare have declined to 12.2 million Americans.

The CBO, a nonpartisan congressional agency, forecast on
Monday that the Republican plan would increase the number of
Americans without health insurance by 24 million by 2026, while
cutting $337 billion off federal budget deficits over the same
period.

As of the end of January, enrollment in individual
insurance plans created under Obamacare was down by about
500,000 people from 2016, it said. It is about 1.6 million
people short of Obama’s goal for 2017 sign-ups, the government
said.

The data included people who selected or were automatically
enrolled in an insurance plan between Nov. 1 last year and Jan.
31 either through the federal HealthCare.gov website or one of
the state-based insurance exchanges. About one-third of the
enrollees were new to the market.



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