Trump barnstorms to push healthcare plan; signs of conservative support

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By Susan Cornwell and Emily Stephenson

<span class="articleLocation”>U.S. President Donald Trump used his
barnstorming strategy on Wednesday to try to build momentum for
his first legislative initiative, a healthcare overhaul, by
holding a massive rally in Nashville, Tennessee, reminiscent of
his campaign events.

Back on Capitol Hill, Republican leaders negotiated behind
closed doors, held media conferences and gave cable-news
interviews as they tried to push forward their plan to dismantle
the Affordable Care Act, commonly called Obamacare.

After Republican House Speaker Paul Ryan unveiled the new
plan last week, fault lines appeared within the party as some
conservatives said it did not go far enough and others rejected
it entirely.

Trump used campaign-like language in his Wednesday night
speech, pledging “to repeal and replace horrible, disastrous
Obamacare.”

Speaking to reporters aboard presidential plane Air Force
One after the rally, Trump expressed optimism about his plan’s
chances in Congress.

“We’re going to come up with something. We always do,” he
said.

Republicans control both Congress and the White House for
the first time in a decade, but the overhaul still faces
political battles to be fought by a president new to governing.

White House spokesman Sean Spicer told reporters before the
rally the Trump administration had been in talks with Ryan and
congressional leaders and was flooding the media with interviews
with administration officials to help advance the plan.

Ryan, the top Republican in the House of Representatives,
also continued to champion the legislation, saying on cable news
he was open to making “improvements and refinements,” but also
adding “the major components are staying intact.”

He told a news conference later in the evening the House
would hold votes on repealing and replacing Obamacare but
refused to provide a timetable.

RELUCTANT CONSERVATIVES

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

Signs emerged on Wednesday that the White House was winning
over reluctant conservatives who initially questioned the
legislation on the grounds that it too closely resembled
Obamacare, the signature domestic policy achievement of former
President Barack Obama.

The administration indicated it was open to revisiting the
plan’s treatment of Medicaid, the government health insurance
program for the poor, during a meeting with a conservative wing
of the party.

Specifically, conservatives want Obamacare’s expansion of
Medicaid to end sooner than proposed in the Ryan plan, and want
to introduce Medicaid work requirements for able-bodied adults
without children.

State governments run Medicaid with reimbursements from the
federal government. Obamacare expanded its eligibility and
increased funding for it, which enabled about 10 million
previously uninsured Americans to obtain medical insurance.

Vice President Mike Pence advocated for the plan earlier on
Wednesday behind closed doors with the Republican Study
Committee, a large group of House conservatives.

Republican Representative Phil Roe said after the Pence
meeting the bill would probably be changed to move up the end of
the Medicaid expansion by one year, to 2019.

The conservative group’s members were “very close to signing
off” on the legislation, its leader, Representative Mark Walker,
told reporters.

Speaking on CNN, Ryan mentioned “giving states better
chances at more flexibility with Medicaid,” but provided no
details.

Just as the party’s conservatives began expressing optimism
about the proposal’s fortunes, Republican moderates raised
concerns that tax credits currently in the bill intended to help
people buy health insurance were not sufficient.

Representative Charlie Dent, following a meeting of moderate
Republicans with Pence, told reporters that speeding up the
termination of the Medicaid expansion was a “non-starter.”

“MORTALLY WOUNDED”

Senate Republicans have also voiced rising unease.

“As written, the House bill would not pass the Senate. But I
believe we can fix it,” Senator Ted Cruz told reporters.

Republican Senator Lindsey Graham told NBC’s “Today” show: “It is mortally wounded.”

The conservative advocacy group FreedomWorks held a rally
amid snow flurries and a frigid wind outside the Capitol, where
several House and Senate Republicans, including Cruz and Senator
Rand Paul, voiced dissatisfaction with the bill.

Paul later told reporters: “The White House has been much
more open to negotiation on this” than House leaders.

A libertarian, Paul posted an op-ed on the Breitbart News
website later on Wednesday calling Ryan’s plan “Obamacare Lite”
and suggesting smashing it to “smithereens.”

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

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



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