Republican House Leaders Will Try Again To Replace Obamacare

May 4, 2017
Originally published on May 4, 2017 11:21 am
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RACHEL MARTIN, HOST:

And we're going to turn now to health care. House leaders plan to vote today to repeal and replace the Affordable Care Act, something we have heard about before. They backed out of a vote on it before because they didn't have the votes. This time, they say they're really going to do it. They're trying to scale back Obamacare enough to satisfy the most conservative lawmakers without rolling back so much that they lose more mainstream Republicans. Just yesterday, two Republicans visited President Trump, and they proposed adding money to help cover insurance costs for people with pre-existing conditions.

NPR's politics editor Domenico Montanaro has been keeping us up to date on all these developments. He's in the studio now. Hi, Domenico.

DOMENICO MONTANARO, BYLINE: Hi, Rachel.

MARTIN: I'm going to put you on the spot right off the bat. You have been saying for days that House Republicans didn't have the votes...

MONTANARO: And I was right.

MARTIN: ...To move this forward. Do you still think you're right?

MONTANARO: No, I was right.

MARTIN: (Laughter).

MONTANARO: It changed - it changed yesterday.

MARTIN: So what happened?

MONTANARO: There was a - the logjam was broken with this $8 billion that has been added to high-risk pools from congressmen from Michigan and Missouri. In addition to that, there have been a lot of personal appeals from President Trump to some of these members. The other piece of this is that they're actually heading into recess. And they know this bill is going to change when it gets to the Senate, and they want to give President Trump something to hang their hat on.

They're going to have to vote again because if it changes in the Senate, they have to pass exactly what the Senate did. So some members are throwing their hands up and saying - fine, I'll vote for this thing because it's going to come back anyway.

MARTIN: So there has been this debate about whether or not pre-existing conditions are really protected in this new language, in this new bill. What's the final word on that? What does the bill say on this?

MONTANARO: Well, we don't know exactly whether or not pre-existing conditions will be - I think it's still up for debate somewhat because when you move this to high-risk pools - and they've had a spotty record in the past. They've been continuously underfunded. The whole point of Obamacare was to set up something that, if you got sick and you tried to get care, A, you couldn't be discriminated against to get care, but you also could afford that care. If it moves into high-risk pools, the problem a lot of moderate Republicans and Democrats have is they think that by doing that, you wind up raising the costs and lowering the benefits.

MARTIN: Elsewhere on the program, we heard Republican Representative Tom Cole on this. He was optimistic that this would pass the House. Let's listen to what he had to say.

(SOUNDBITE OF ARCHIVED BROADCAST)

TOM COLE: This thing is going to go to the United States Senate. It's going to change, in my view, in the United States Senate in some way. Then we have to have a Congress - a conference to work out the differences. If we can do that, then it has to still pass the House and the Senate again before it ever gets to the president.

MARTIN: So this is what you were saying before - a lot of House Republicans are looking at this saying, it's going to change anyway when it gets to the Senate, so politically, it's in my best interest to just push this thing forward.

MONTANARO: Yes. And in the Senate, there's an even narrower, you know, margin because there's only 52 senators. They've got to get 51. If they lose three, they're done. So there are a lot of objections, and you have very similar factions with folks on the far right who want to give more flexibility to the states and to make sure that this doesn't blow a hole in the budget. And then you have moderates who want to make sure that people with pre-existing conditions can get that kind of care that they need, and they don't want to reduce health benefits.

MARTIN: Even so, isn't it significant if they're able to pass this vote?

MONTANARO: Absolutely.

MARTIN: It's still a big deal that they were able to move the ball (unintelligible).

MONTANARO: This is incremental but a big piece of incremental, you know, incremental legislation. So it is a - it is another path forward on the check board or whatever, but it's still a long ways to go.

MARTIN: NPR political editor Domenico Montanaro - Domenico, thanks as always.

MONTANARO: Thank you.

(SOUNDBITE OF EVIL NEEDLE'S "COMFORT ZONE") Transcript provided by NPR, Copyright NPR.