Even Trump May Be Backing Away From Trumpcare
For the past eight years, the mantra coming from the GOP has been “repeal Obamacare!” Over the last few years, this has been changed to “Repeal and Replace Obamacare.” The repeal part is easy, Congress can do that fairly quickly. The replacement is not as simple. To repeal the key provisions that pay for the Affordable Care Act or Obamacare, the Senate can use a budget mechanism called, “reconciliation” and pass their bills with a simple majority. Everything else, such as a replacement plan will need 60 votes in the Senate to get cloture. This is the problem supporters of the “American Healthcare Act” are facing.
From the outset, it has been clear that the president would have to get at least some Senate Democrats to cross over and vote for the new bill. While that seemed unlikely, the problem they bill is having is that many people in President Trump‘s own party are not on board. Some of these legislators believe the bill, dubbed, “Trumpcare” by some, is too much like Obamacare. They have been calling the plan, “Obamacare Lite.”
Republicans Want to End the Medicaid Expansion Now
One issue that upsets many on the right is the Medicaid expansion portion of the law. Under President Obama‘s plan, the number of people who were eligible for the health care program was expanded. This is a plan that the Republicans have loved to hate since it was created in 1965. Traditionally, states and the federal government share the cost of people who are covered. One GOP proposal has been to change that to just give states funding for the program in one lump sum rather than by the number of enrollees and the actual cost of their health care.
As it was introduced, Tumpcare maintains the Medicaid expansion funding until 2020. That is a big problem for many Republicans. They would like to see the expansion end immediately. For his part, Trump has shown a lot of willingness to be flexible on the details of his health care plan. This includes allowing the conservatives to have their way with Medicaid expansion. The provision that would phase out the expansion rather than end it right away was put in the bill to get more support.
Only time will tell how much change the president will accept to change Trumpcare or how these will affect the ever changing calculus of the Congressional negotiations.
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