First Edition: March 24, 2017
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Late Move To Dump ‘Essential’ Benefits Could Strand Chronically Ill
A last-minute attempt by conservative Republicans to dump standards for health benefits in plans sold to individuals would probably lower the average consumer’s upfront insurance costs, such as premiums and deductibles, said experts on both sides of the debate to repeal and replace the Affordable Care Act. But, they add, it will likely also induce insurers to offer much skimpier plans, potentially excluding the gravely ill, and putting consumers at greater financial risk if they need care. (Hancock, 3/24)
Kaiser Health News:
Popular Guarantee For Young Adults’ Coverage May Be Health Law’s Achilles’ Heel
The Affordable Care Act struck a popular chord by allowing adult children to obtain health coverage through a parent’s plan until their 26th birthday. ... The policy has proven to be a double-edged sword for the ACA’s online health exchanges because it has funneled young, healthy customers away from the overall marketplace “risk pool.” Insurers need those customers to balance out the large numbers of enrollees with chronic illnesses who drive up insurers’ costs — and ultimately contribute to higher marketplace premiums. (Heredia Rodriguez, 3/24)
The New York Times:
Trump Tells G.O.P. It’s Now Or Never, Demanding House Vote On Health Bill
President Trump issued an ultimatum on Thursday to recalcitrant Republicans to fall in line behind a broad health insurance overhaul or see their opportunity to repeal the Affordable Care Act vanish, demanding a Friday vote on a bill that appeared to lack a majority to pass. (Hirschfeld Davis, Pear and Kaplan, 3/23)
The Wall Street Journal:
Trump Says If Vote On Health-Care Bill Fails, Obamacare Stays
The decision to bring the bill to the floor appeared to put an end to days of negotiations, amounting to a calculation that lawmakers would view the vote as a do-or-die moment and opt to follow through on campaign promises to replace former President Barack Obama’s signature legislation with a more conservative alternative. (Peterson, Hughes and Radnofsky, 3/24)
The Washington Post:
Trump Delivers Ultimatum To House Republicans: Pass Health-Care Measure On Friday Or He’ll Move On
For Trump, who campaigned as a skilled negotiator capable of forging a good deal on behalf of Americans, it could either vindicate or undercut one of his signature claims. If the measure fails, it would be a defeat for Trump in his first effort to help pass major legislation and it may also jeopardize other items on his wish list, including a tax overhaul and infrastructure spending. Defeat would also mean that Obamacare — something that congressional Republicans have railed against for seven years — would remain in place. (DeBonis and Eilperin, 3/23)
Los Angeles Times:
Trump Threatens To Leave Obamacare In Place If GOP Bill Fails
"The message is tomorrow it's up, it's down — we expect it to be up — but it's done tomorrow,” Mulvaney said Thursday night. It remained unclear whether Trump’s extraordinary ultimatum was real or a pressure tactic designed to bring unruly Republicans in line. Despite personal appeals from the president and a flurry of last-minute negotiations with House Speaker Paul D. Ryan (R-Wis.), wary GOP lawmakers remained unconvinced, leaving leaders shy of the votes needed to advance the legislation. (Mascaro and Levey, 3/23)
NPR:
Trump Ultimatum For House GOP: Vote On Health Bill Or Obamacare Stands
Trump, famous for his deal-making abilities, has tried to woo both unhappy factions of the GOP conference with little success. No consensus was reached during a meeting with the president and the roughly 40 members of the House Freedom Caucus at the White House earlier Thursday. Vice President Pence met with the maybe two dozen moderates in the so-called Tuesday Group, many of whom are also opposed to the bill. (Montanaro and Taylor, 3/23)
The Associated Press:
House Sets Risky Health Care Vote After Trump Demands It
In a gamble with monumental political stakes, Republicans set course for a climactic House vote on their health care overhaul after President Donald Trump claimed he was finished negotiating with GOP holdouts and determined to pursue the rest of his agenda, win or lose. House Speaker Paul Ryan set the showdown for Friday, following a nighttime Capitol meeting at which top White House officials told GOP lawmakers that Trump had decided the time for talk was over. (Fram and Alonso-Zaldivar, 3/24)
USA Today:
Damn The Torpedoes: GOP Sets Friday Vote On Health Care Despite Opposition
Rep. Chris Collins, R-N.Y., told reporters at the Capitol that Mulvaney’s message was: “The president needs this, the president has said he wants a vote tomorrow. If for any reason (it fails) we’re just going to move forward with additional parts of his agenda. This is our moment in time but the president is insisting on a vote one way or the other.” Collins said the message from the administration — Stephen Bannon, Reince Priebus and Kellyanne Conway also attended the meeting — was that negotiations were over and it was time to act. (Kelly, Collins and Shesgreen, 3/23)
Politico:
Trump Demands Friday Vote On Health Care Plan
The move by Trump and Ryan is an enormous gamble, setting up a real cliffhanger when the legislation hits the floor on Friday. ... A loss on the House floor would be a glaring embarrassment for the new president and House speaker — one that could undermine other parts of the GOP legislative agenda, including tax reform. A victory, on the other hand, would provide not just a shot of badly-needed momentum for both men, but undermine the House Freedom Caucus, the group of conservative hard-liners who've fought the GOP health care plan because it doesn't go far enough. (Bade, Cheney and Dawsey, 3/23)
Reuters:
Trump Demands Support In Do-Or-Die Friday Vote On Healthcare Plan
However, the vote has been seen by financial markets as a crucial test of Trump's ability to work with Congress to deliver on his other priorities, such as tax cuts and infrastructure spending. Even if their replacement plan does eventually get approval from the House, the legislation faces a potentially tough fight in the Republican-controlled Senate. The House and Senate had hoped to deliver a new healthcare bill to Trump by April 8, when Congress is scheduled to begin a two-week spring break. (Cornwell and Becker, 3/24)
The New York Times:
Trump The Dealmaker Projects Bravado, But Behind The Scenes, Faces Rare Self-Doubt
President Trump, the author of “The Art of the Deal,” has been projecting his usual bravado in public this week about the prospects of repealing the Affordable Care Act. Privately he is grappling with rare bouts of self-doubt. Mr. Trump has told four people close to him that he regrets going along with Speaker Paul D. Ryan’s plan to push a health care overhaul before unveiling a tax cut proposal more politically palatable to Republicans. (Thrush and Haberman, 3/23)
The Wall Street Journal:
Health Vote’s Outcome Carries High Stakes For Trump Presidency
The health-care bill now stalled in Congress is proving an early test of whether the deal-making skills that made President Donald Trump rich in the business world will also work in the legislative realm, where lawmakers face competing pressures and require different sorts of incentives to reach agreement. (Nicholas, Lee and Radnofsky, 3/23)
Politico:
Delayed Vote A Setback For Trump The Dealmaker
Most Republicans appeared comfortable with the delay, taking the lumps of a single negative news cycle, so long as the legislation eventually passes. But some worried that if Trump can’t muscle the first major bill he’s backed through a single chamber in a Republican-controlled Congress, it could devastate his agenda and weaken his authority moving forward. “This is a reputational deal,” said Scott Reed, the chief strategist for the U.S. Chamber of Commerce. “We have a lot riding on this.” (Goldmacher, Dawsey and Palmeri, 3/23)
Politico:
Trump Vs. The Freedom Caucus
The House Freedom Caucus has threatened to tank the House GOP Obamacare replacement bill unless they get what they want. But Trump is now calling their bluff. White House officials told members of the group on Thursday they have one shot: If they help defeat the American Health Care Act, the Trump administration is going to move on — meaning the Freedom Caucus could be pinned with actually saving Obamacare. The White House is betting that they will cave, given that saving Obamacare is something these conservative Republicans will never be able to stomach. (Bade and Bresnahan, 3/23)
The Associated Press:
New Congress, All-GOP, Same Political Divisions
With control of the White House and Senate and a commanding majority in the House, Republicans were supposed to brush off any challenge from the hardline Freedom Caucus and work their will with impunity. But something happened on the way to governing. Now, House Republican leaders are struggling with the same divisions that plagued them under President Barack Obama. (Ohlemacher, 3/24)
Politico:
How The GOP Could Still Salvage The Obamacare Repeal
House Republican leaders scrambling to buck up wavering members had portrayed the vote as the only shot to eliminate the GOP’s longtime boogeyman — and as an essential show of support for President Donald Trump. But in fact, they have several options to salvage the repeal effort after they couldn't muster 215 votes. (Cancryn, 3/23)
The Wall Street Journal:
In Health-Law Fight, GOP Leaders Struggle To Reconcile Factions’ Needs
After years of making the repeal of the Affordable Care Act a signature issue, Republicans are struggling to deliver on the promise, floundering amid warring factions that neither President Donald Trump nor House Speaker Paul Ryan have been able to whip into line. ... They are confronting a thorny challenge that required two things in short supply among today’s Republican rank and file: a willingness to compromise or to defer to leadership. (Hook and Epstein, 3/23)
Politico:
Trump's Obamacare Repeal Concessions Likely Can't Pass Senate
Democrats say they are certain they can kill any language in the repeal bill that erases Obamacare’s mandate for minimum benefits in insurance plans. And top Republicans are making no promise that the last-ditch changes to win over conservatives will fly in the more centrist Senate, which is beginning to write its own health care plan. (Everett and Haberkorn, 3/23)
The Washington Post:
Health-Care Overhaul Faces An Even Bigger Challenge In The Senate
Even if the House approves a GOP effort this week to repeal and replace key parts of the Affordable Care Act, the work of persuading the Senate to do the same is likely to be even harder. (Sullivan and Snell, 3/23)
NPR:
Republican Health Bill Could Remove Pre-Existing Condition Protections
When House Speaker Paul Ryan says he wants to repeal the Affordable Care Act so that people can buy insurance that's right for them, and not something created in Washington, part of what he's saying is that he wants to get rid of so-called essential health benefits. That's a list of 10 general categories of medical care that all insurance policies are required to cover under the Affordable Care Act. Getting rid of that requirement, or trimming it, is central to the Republican strategy, because they say those benefits drive up insurance premiums so much that healthy people won't buy coverage. (Kodjak, 3/23)
The Wall Street Journal:
Basic-Services Requirement Is At Heart Of Health-Insurance Split
At the heart of the last-minute negotiations over the House GOP health-care bill is a pillar of the Affordable Care Act: the requirement that most insurance policies cover a basic set of health services, including such items as maternity and mental-health care. Repealing that requirement, as many conservatives want, would topple a core element of the ACA that sought to protect patients from the high cost of using a health service not covered by their insurance. (Armour, 3/23)
Los Angeles Times:
Obamacare 101: 4 Things You Need To Know About 'Essential Health' Benefits
Among the most important — and little understood — new insurance rules put in place by the Affordable Care Act was a requirement that health plans cover a basic set of benefits. The requirement was part of a package of new consumer protections in the healthcare law, including a prohibition on insurers denying coverage to people with preexisting medical conditions and bans on annual- or lifetime-limits on coverage, which were once common. (Levey, 3/23)
USA Today:
Dropping Obamacare's 'Essential' Benefits Impacts More Than Mammograms
Eliminating required health insurance benefits, a move discussed as part of the Republican move to repeal the Affordable Care Act, also threatens to kill the ACA's annual and lifetime limits on patients' costs, which was enacted to prevent bankruptcies due to medical costs. The limits on out of pocket costs only apply to the ACA-required 10 essential health benefits, which include prescription drugs and hospital care. So eliminating the benefit requirement makes the limits "essentially meaningless," says health care legal expert Tim Jost. (O'Donnell, 3/23)
The Washington Post:
‘I Wouldn’t Want To Lose My Mammograms,’ Male GOP Senator Says — Then Immediately Regrets
It’s a common question among those decrying the cost of health insurance: Why should you have to purchase a plan that covers procedures you won’t ever need? Especially if, say, you’re a guy, and your plan covers maternity care — as Obamacare requires most plans sold through an exchange to do? It’s also a philosophy in conservative circles gaining momentum as Republicans try to deconstruct Obamacare, (Phillips, 3/23)
The Washington Post:
CBO: Latest House GOP Health-Care Bill Would Mean As Many Uninsured By 2026
According to the CBO’s projections, a set of amendments that House GOP leaders agreed to support Monday night would cut the federal deficit by $150 billion between 2017 and 2026. The original version of the American Health Care Act, as the bill is called, would have curbed the deficit by an estimated $337 billion in that period. The changes would have less impact on savings because they would make it easier for Americans to deduct the cost of medical care from their income taxes and would accelerate by a year the repeal of several taxes that help pay for the ACA, including taxes on insurers, hospitals, high-income adults and tanning beds. (Goldstein, 3/23)
The New York Times:
C.B.O. Update: Health Bill Amendments Will Cost More But Not Insure More
A revised version of the Republican health care bill being considered by Congress would leave 24 million more Americans uninsured by 2026, like the original bill, but would reduce the deficit by half as much, according to a new report by the Congressional Budget Office. (Davis, Popovich and Patel, 3/23)
Politico:
CBO: Revisions To GOP Health Plan Add To Deficit Without Improving Coverage
The estimated cost of premiums would also be about the same. CBO has predicted that the average premium for an individual plan would jump between 15 and 20 percent over the next two years. By 2026, premiums would be 10 percent lower than they would have been under current law. (Ferris, 3/23)
The Washington Post:
This Is The Problem With Delaying A Vote On Republicans’ Health-Care Bill
This CBO score is one of the reasons Republicans' last-minute delay on a planned Thursday vote on the bill is so damaging for their already slim chances of getting something passed: It gives every side opposed to this bill — and there are many — more time to digest what they hate most about it. (Phillips, 3/23)
Reuters:
Uncertain Fate Of Obamacare Causes Some Hospitals To Halt Projects, Hiring
Uncertainty surrounding the Republican plan to replace Obamacare is forcing some U.S. hospitals to delay expansion plans, cut costs, or take on added risk to borrow money for capital investment projects, dealing an economic blow to these facilities and the towns they call home. (Respaut and Abutaleb, 3/23)
The Wall Street Journal:
House GOP Super PAC Pulls Support From Iowa Congressman Who Opposes GOP Health Bill
The super PAC overseen by House Speaker Paul Ryan and the House GOP leadership is yanking support from a House Republican who pledged to oppose the health-care legislation pushed by President Donald Trump and House GOP leadership. The Congressional Leadership Fund is pulling staff from and closing an office it opened last month in Iowa Rep. David Young’s Des Moines-based district. (Epstein, 3/23)
Reuters:
Obamacare Supporters Rally Against Congressional Repeal Efforts
Supporters of Obamacare staged rallies across the country on Thursday denouncing efforts by President Donald Trump and Republican congressional leaders to repeal the landmark law that has extended medical insurance coverage to some 20 million Americans. Hundreds of demonstrators turned out in Washington, Chicago and Los Angeles marking the seventh anniversary of enactment of Obamacare, as the Affordable Care Act (ACA) has become widely known. (Simpson, 3/23)
Politico:
As Repeal Vote Nears, Obama Pleads To Preserve Affordable Care Act
Former President Barack Obama, who has remained on the sidelines for much of the contentious debate surrounding the Trump administration’s plan to repeal and replace the Affordable Care Act, urged lawmakers Thursday to preserve and build on his signature legislative achievement. The lengthy statement ... celebrated the merits of Obamacare and described the legislation as a watershed moment in determining that health care is “not just a privilege for a few, but a right for everybody.” (Sutton, 3/23)