(Bloomberg) --President Donald Trump threw his weight behind a House Republican plan to replace Obamacare, even as conservatives mounted their own savage attack on the bill, with one Republican senator declaring it “dead on arrival” in the Senate.
Trump held a White House meeting Tuesday with the House Republican vote-counting team to rally them behind the bill, setting up an unexpectedly close alliance between the president and House Speaker Paul Ryan, who defended his bill as the fulfillment of a long-running GOP promise.
“I want to thank President Trump,” Ryan told reporters Tuesday afternoon. “Doing big things is never easy, but we have made a promise and we’re going to keep that promise.”
And Trump told the House Republican vote-whipping team members he is “proud” to support the new plan. “You can choose your doctor. You can choose your plan,” he said at the meeting. “It’s called good health care.”
But that united front is being undermined by the vehemence of the measure’s GOP critics. Senator Rand Paul derided it as "Obamacare-lite," while a group of House Republicans said it would create a "Republican welfare entitlement." One conservative group labeled it “Ryancare” and said it was merely a “warmed-over substitute for government-run health care.”
Health and Human Services Secretary Tom Price acknowledged earlier Tuesday that the bill is “the beginning of the process,” one aimed at helping patients and business owners.
Price, speaking to reporters at the White House, said, “We look forward to working with them and others,” referring to conservative opponents.
“This is all about patients,” he said, arguing that the legislation must allow a transition from the insurance system created by the Affordable Care Act. He also argued that the Republican bill’s tax credits would serve to “equalize the tax treatment” of health benefits provided by employers and insurance that people buy on their own.
Employer health plans are excluded from income tax, while people who buy insurance on their own must use after-tax dollars.
Groups Opposed
The pressure is now clearly on Republicans to deliver their long-promised repeal, and the party seems deeply divided over this new draft measure. The bill was blasted by a number of influential conservative groups, including Heritage Action, the Club for Growth, FreedomWorks, and the libertarian Cato Institute.
“Everyone needs to take a step back,” wrote Michael Cannon, Cato’s director of health policy studies and a strong critic of Obamacare. “This bill is a train wreck waiting to happen.”
Trump is speaking with some Republican critics of the measure, including Paul, to persuade them to back the House GOP bill.
“I talked to the president this week and I had a great conversation and he said he was interested in my ideas and interested in conservatives’ ideas,” Paul said in an interview. “So I don’t know. I don’t think we have to be that far apart.”
The president is “all in” on making sure the repeal bill reaches his desk, House Majority Whip Steve Scalise said after meeting Tuesday with Trump.
“He’s committed to doing everything in his power to make sure this law gets to his desk,” he said.
Vice President Mike Pence told a pair of House Republicans Tuesday that the House bill can still be modified before passage, Representative Mark Meadows of North Carolina told reporters. The most important factor is the estimate, or score, of how much the measure will reduce consumer health costs, said Meadows, who is chairman of the House Freedom Caucus.
“That’s the only score that matters,” he said.
The No. 3 Republican in the Senate, John Thune, acknowledged the scope of the criticism from conservatives, but said that he expects Republicans to end up at a consensus bill that can clear both chambers.
“Everybody right now is trying to leverage their position, help shape and influence the bill in the shape and direction they want to see it go before it’s ultimately voted on,” he told reporters. “But when push comes to shove and the vote occurs over here, it’s going to be a vote for the status quo or a vote to repeal this and to move to a better way.”
‘Dramatic Improvement’
Senate Majority Leader Mitch McConnell called the House draft a “dramatic improvement over the status quo” and said it could be on the Senate floor before mid-April if the House passes it quickly. But that may be overly optimistic.
The Congressional Budget Office has yet to provide its estimates of the measure’s cost, or of how many Americans will likely lose coverage under its provisions. Democrats, along with several Republicans, said they want to see the CBO’s estimates before voting on the measure.
Those CBO estimates won’t be available until Monday, according to the office of House Democratic leader Nancy Pelosi.
The two House committees that devised the plan will begin considering it Wednesday, and the leaders of those panels were dismissive of the criticism in a news conference Tuesday morning.
Energy and Commerce Chairman Greg Walden said Republicans are "moving in the right direction," and tartly suggested critics should "actually read the bill." Ways and Means Chairman Kevin Brady dismissed the Obamacare characterizations, saying it’s "Obamacare-Gone."
‘Wrong Direction’
Even so, Ryan, Walden and Brady found themselves hastily scheduling an additional late-afternoon news conference not long after Paul and members of the conservative House Freedom Caucus scheduled their own press event to criticize the bill.
"We just want a clean repeal" and vote on a replacement later, Paul told Bloomberg TV. "We agree on repeal, we don’t agree on replace." Senator Mike Lee of Utah called the GOP draft “a step in the wrong direction.”
Before the day even began, an analysis written late Monday for an even larger bloc of U.S. House conservatives -- the 170-member Republican Study Committee -- derided a key component of a new Republican plan. It blasted as a new form of welfare entitlement the idea of offering tax credits to individuals who wouldn’t otherwise have access to health insurance.
The analysis also described "major concerns" with the legislation’s continuation of Medicaid expansion, and a lack of clarity on how language preventing the use of the tax credit money for abortions can be guaranteed.
Whether Ryan and his leadership team expected such swift and decisive blowback is unclear. But they’re hoping that the rebels in their own party will feel the pressure to deliver on their seven years of promises to repeal Obamacare.
"We just have to work through it all," said Senate Finance Chairman Orrin Hatch, downplaying the amount of turmoil. But he added what already now seems obvious. "The bill as presented is not the final bill."
