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Obamacare Repeal Vote Put Off In Stinging Setback For Trump

President Donald Trump speaks during a meeting on women in healthcare in the Roosevelt Room of the White House in Washington, March 22, 2017.
Associated Press
President Donald Trump speaks during a meeting on women in healthcare in the Roosevelt Room of the White House in Washington, March 22, 2017.

Trump Tries To Close Health Care Deal With GOP Skeptics
Trump Tries To Close Health Care Deal With GOP Skeptics GUESTS:Kenny Goldberg, health reporter, KPBS News Bob Hertzka, health care policy instructor, UC San Diego School of Medicine

The top story on the one, this marks the seventh anniversary of Obamacare. Republican leaders had planned to make this the day that the American healthcare act passed the house. There is uncertainty whether the vote on the bill will take place tonight there are 26 Republican representatives say they will not vote for the measure. The GOP can only afford to lose 22 votes facing a block of democratic opposition. Joining me is Kenny Golder. Welcome. Thank you. We have a practicing physician and healthcare policy instructor at the San Diego school of medicine. Welcome to the show at I am happy to be here. Kenney, you surveyed the Congressional delegation. Where do they stand? Duncan Hunter will port. He is enthusiastic about. And Darrell is on the fence. He said that he did not like the bill but he felt that Obamacare needed to be repealed so he will vote for with a lot of reservation but now I am told he might vote against it. We will wait and see. The Democrats are planning to vote against it. Remind us how central the repeal of Obamacare is to the Republican agenda. How may times that they try to repeal the past? They have voted to repeal it. It is central to their agenda. Heap said they would get rid of Obamacare. It is a flop. They are going hell-bent to get rid of it. Considering that, considering the GOP, they voted to repeal this, why is this getting this to the house such a challenge? Some of my people like to say, they are firing with real bullets. Or years, they could put together just about anything that pleased the base knowing that whatever they put the bill, however crazy it might be, it was going to be vetoed by the president. Now, this bill matters. The various divides are showing up within the party in the most major fight, you have Republicans that just do not believe that the government has business helping low income people supporting them get health insurance. That is a fundamental point. That is what is holding these people out. They do not want to improve or replace. They want to completely make this idea go away. I think that is out of the mains stream with the American people. That is not weird Darrell ice is betting that is creating an impasse right now. What are they after in this bill that they are not seing? Back they seem to want to repeal core ideas of the affordable care act. Think the people in the freedom Caucus are trying to remove provisions related to conditions. Right now, someone can hurt their me in the summer and wait until the enrollment and sign up and get orthopedic care. That drives premiums up. The people in exchanges are ill this proportionately. The freedom Caucus wants to remove those provisions. I think that is challenging because under the reconciliation rules in the Senate, that is not allow. President Trump said he was not going to touch pre-existing conditions. That is my best understanding of where the impasse is. That is a big and a hard thing to copper mice. That is what they are working on now. That is the latest comments, there will not be a vote today or the Boca be late tonight or tomorrow or Saturday. Speaker can keep the house there as long as he wants to keep it in session. We have been reporting on town halls in San Diego's. People go to the town halls and telling representatives and many Republicans representatives, that they do not want health insurance take away or text. Is that right? That is right. The way that bill is structured right now, the repeal bill, people would get lower subsidies under the revised tax credit situation because the Republican bill, it would be based on age and not income or where you live. In other words, people that live in high-cost areas of California like Santa Cruz or Monterey, they will not get extra subsidies because they live in a high-cost area as opposed to Los Angeles. That is a real problem. People do not like that. Since the opposition to this healthcare bill seems to be crucial, right the very heart of the benefits that it offers, what is the delay? If they do not go tonight, if they wait until the weekend to vote or There are ways to navigate this. There may not be ways to do it in the next four hours. There are ways to do it in the next 44 hours. They are going to keep this going until they round up the boats. It would be a political blow for the house not to post -- peasant. This is not lawful. This is what you sent to the Senate. At some point, they can come up with language. I want to touch a point. The subsidies do change and they worry quite a bit remember, the subsidies and at 400% of poverty means 70 making $50,000 gets no subsidy and according to the health-care, if you make $50,000 per year and you go to the exchange, there is a 2% likelihood that you sign up. There were people who make $50,000 who benefit under the bill. They do not make, they are not coming to the town hall say this is great. People on the losing end are coming to the town hall. You do think that the Republicans are going to pull this out because it is too important? Back if it is where I put my $20, yes. I think it could take until Saturday but this goes over to the Senate in some form. I have been speaking with the healthcare policy instructor at the school of medicine. Also Lee Goldberg. Thank you. Thank you.

Where local representatives stand on GOP health care bill:

In Favor

Duncan Hunter, Republican, 50th District

“I don’t believe in guaranteed healthcare. I believe in guaranteed access to healthcare that people can afford.”

Opposed

Juan Vargas, Democrat, 51st District

"In Congress, it is our responsibility to ensure that Americans have access to affordable health care. Trumpcare hurts seniors and other vulnerable communities by raising costs and limiting access to coverage. We should work toward solutions and improvements to the Affordable Care Act that will reduce costs and expand health care coverage for all Americans. I will be voting against the Republican bill and urge my colleagues to do the same."

Scott Peters, Democrat, 52nd District

"I stand here willing and ready to work in a bipartisan way to address today’s market conditions to provide more access to affordable care for all Americans. This doesn’t do the job."

Susan Davis, Democrat, 53rd District

"It is clear the Republican healthcare repeal will hurt more people than it will help. The CBO reports their bill will result in 24 million Americans losing access to healthcare."

Equivocal

Darrell Issa, Republican, 49th District

The Los Angeles Times says Issa is "leaning no," reporting that "Issa said last week he's not prepared to vote for the bill" and "his staff said Tuesday that even with changes, he still has reservations."

Source: As Vote On GOP Health Care Bill Nears, Find Out Where Members Of Congress Stand

After seven years of fervent promises to repeal and replace "Obamacare," President Donald Trump and GOP congressional leaders buckled at a moment of truth Thursday, putting off a planned showdown vote in a stinging setback for the young administration.

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The White House insisted the House vote would still happen — Friday morning instead — but with opposition flowing from both strongly conservative and moderate-leaning GOP lawmakers, that was far from assured.

The delay was announced after Trump, who ran for president as a master deal-maker, failed to close the deal with a group of fellow Republicans in the first major legislative test of his presidency.

Still, leaders of the conservative Freedom Caucus said they were continuing to work with the White House late Thursday on their demands to limit the requirements on insurance companies now in place under former President Barack Obama's Affordable Care Act.

"I can tell you at this point we are trying to get another 30 to 40 votes that are now in the 'no' category to 'yes.' Once we do that I think we can move forward," said Freedom Caucus Chairman Mark Meadows of North Carolina.

The figures quoted by Meadows were startling since Republicans can lose only 22 votes in the face of united Democratic opposition. A tally by The Associated Press counts at least 31 solid "no" votes.

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Moderate-leaning lawmakers were bailing, too, as the demands from conservatives pushed them even further from being able to support the GOP bill. The legislation would eliminate some of the requirements, taxes and penalties from Obama's health care law, but also would mean millions would lose their health insurance, older voters would pay higher premiums and Medicaid coverage would shrink for many low-income voters across the country.

GOP leaders planned to meet into the night to figure out how to try to resuscitate the bill. At the White House, Trump insisted just before the delay was announced that "we have a great bill and I think we have a very good chance."

As word trickled out that the vote was delayed, one reporter asked the president for a reaction, and Trump just shrugged. White House press secretary Sean Spicer had insisted earlier that Thursday's vote would happen and the bill would be approved.

There was "no plan B," the White House said.

The drama unfolded seven years to the day after Obama signed his landmark law, an anniversary GOP leaders meant to celebrate with a vote to undo the divisive legislation. "Obamacare" gave birth to the tea party movement and helped Republicans win and keep control of Congress and then take the White House.

Instead, the anniversary turned into bitter irony for the GOP, as C-SPAN filled up the time as the House recessed and lawmakers negotiated by playing footage of Obama signing the Affordable Care Act.

"In the final analysis, this bill falls short," GOP Rep. Jaime Herrera Beutler of Washington state said in a statement Thursday as she became the latest rank-and-file Republican, normally loyal to leadership, to declare her opposition. "The difficulties this bill would create for millions of children were left unaddressed," she said, citing the unraveling of Medicaid.

The Republican legislation would halt Obama's tax penalties against people who don't buy coverage and cut the federal-state Medicaid program for low earners, which the Obama statute had expanded. It would provide tax credits to help people pay medical bills, though generally skimpier than Obama's statute provides. It also would allow insurers to charge older Americans more and repeal tax boosts the law imposed on high-income people and health industry companies.

The measure would also block federal payments to Planned Parenthood for a year, another stumbling block for GOP moderates.

In a danger sign for Republicans, a Quinnipiac University poll found that people disapprove of the GOP legislation by 56 percent to 17 percent, with 26 percent undecided. Trump's handling of health care was viewed unfavorably by 6 in 10.

House Minority Leader Nancy Pelosi, D-Calif., who as speaker was Obama's crucial lieutenant in passing the Democratic bill in the first place, couldn't resist a dig at the GOP disarray.

"You may be a great negotiator," she said of Trump. "Rookie's error for bringing this up on a day when clearly you're not ready."

Obama declared in a statement that "America is stronger" because of the current law and said Democrats must make sure "any changes will make our health care system better, not worse for hardworking Americans." Trump tweeted to supporters, "Go with our plan! Call your Rep & let them know."

Congressional leaders have increasingly put the onus on the president to close the deal, seemingly seeking to ensure that he takes ownership of the legislation — and with it, ownership of defeat if that is the outcome.

Yet, unlike Obama and Pelosi when they passed Obamacare, the Republicans had failed to build an outside constituency or coalition to support their bill. Instead, medical professionals, doctors and hospitals — major employers in some districts — the AARP and other influential consumer groups were nearly unanimously opposed. So were outside conservative groups who argued the bill didn't go far enough. The Chamber of Commerce was in favor.

Moderates were given pause by projections of 24 million Americans losing coverage in a decade and higher out-of-pocket costs for many low-income and older people, as predicted by the nonpartisan Congressional Budget Office. In an updated analysis Thursday, the CBO said that late changes to the bill meant to win over reluctant lawmakers would cut beneficial deficit reduction in half, while failing to cover more people.

And, House members were mindful that the bill, even if passed by the House, faces a tough climb in the Senate, where Majority Leader Mitch McConnell has made clear it will need to change to win the support needed to pass.