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Tuesday, Mar 21 2017

Full Issue

Republicans Tweak Medicaid, Taxes, Abortion Provisions To Bring Wary Lawmakers On Board

The revisions were made to appease both the conservative wing of their party and moderates who had voiced concerns for their older constituents who would have been particularly hard hit by the first version of the American Health Care Act.

Congressional Republicans recrafted their Obamacare replacement bill on Monday in hopes of satisfying critics as U.S. President Donald Trump prepared to promote his first major legislative initiative on Capitol Hill. In a sign of deepening concern among Republicans about the bill's future, Trump will speak to the party's lawmakers in Congress on Tuesday about the healthcare overhaul, two House Republican aides said. (Morgan and Cornwell, 3/20)

Under the modified version of the GOP replacement bill, states would be allowed to require able-bodied Medicaid recipients without dependents聽to work beginning in October 鈥斅燼nd would get a funding boost as a reward for doing so. States could also receive federal funding for the program as a lump sum 鈥 instead of a per capita allotment 鈥 for children and non-disabled, non-elderly adults. Taxes imposed by the ACA on the wealthy, sectors of the health care industry and others to pay for expanded聽coverage would be repealed in 2017 instead of 2018. (Groppe, 3/20)

The bill would repeal most of the Affordable Care Act鈥檚 taxes starting in 2017, a year earlier than in the prior version. A tax on generous employer health plans, known as a 鈥淐adillac tax,鈥 would begin in a year later, in 2026. (Armour, 3/21)

The bill also includes provisions nodding at anti-abortion GOP leaders. Among other changes to the repeal bill, the amendment would delete a provision that would have allowed consumers to move leftover tax credit money into a Health Savings Account. Anti-abortion groups had raised concerns that the provision might be eliminated under the Senate's strict budget rules and inadvertently allow for taxpayer funding of abortion. (Haberkorn, Pradhan and Dawsey, 3/20)

The revisions do not include any provisions targeting high drug prices, even though Trump told a rally in Louisville on Monday night that the bill would. (Mascaro and Levey, 3/20)

House Republican leaders, trying to lock down the votes of wavering upstate New York Republicans, inserted a last-minute special provision in their health care bill that would shift Medicaid costs from New York鈥檚 counties to its state government. (Kaplan and Pear, 3/20)

New York Republican lawmakers argue this will relieve counties from having to pay into Medicaid and lead to property tax relief for constituents. But Democrats are already labelling that change a 鈥渂ackroom amendment.鈥 (Sullivan, 3/20)

House leaders praised the changes Monday night, with House Speaker Paul Ryan saying Republicans were 鈥渙ne step closer鈥 to repealing Obamacare. 鈥淚 want to thank the White House and members from all parts of our conference who have helped make this the strongest legislation it can be,鈥 he said in a statement late Monday. (Edney, Edgerton and Tracer, 3/20)

The changes seem certain to further reduce the amount of deficit reduction linked to the bill, which was at $337 billion over ten years 鈥 now that figure may drop to under $200 billion. (Dupree, 3/21)

Republicans leaders want to push their bill repealing and replacing much of the 2010 health care law through Congress by April. But the GOP must navigate a complicated path to get the proposal to President Donald Trump's desk. (3/21)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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