A new analysis of the House bill repealing and replacing ObamaCare is highlighting tensions between Senate and House Republicans over one of the Trump administration’s biggest legislative priorities.
Senate Republicans have reacted to the Congressional Budget Office report by underlining their intent to move away from the House bill.
Senate staff are now drafting legislation, and GOP senators hope to have a discussion draft ready when they return from recess the week of June 3.
They are promising that whatever the bill does, it will be different from what passed the House.
“We’re going to do our own thing here,” said Sen. Rob Portman (R-Ohio).
“I think in any universe, the Senate bill will be significantly different from the House bill,” said Sen. Ted Cruz (R-Texas).
{mosads}House Republicans reacted to the CBO analysis, which warned that people with pre-existing conditions would lose coverage under their bill, with anger and defiance.
Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus, questioned how the CBO reached its conclusions.
“Some of their assumptions appear not to be backed up by real analysis, specifically as it relates to obviously the number of people uninsured,” he said.
The CBO report said the House bill would result in 23 million fewer people having insurance over the next decade. It also predicted steep premium increases for older people and price hikes for many people with pre-existing conditions.
“What was probably disappointing is that it was long on rhetoric and short on support of where that rhetoric came from,” Meadows told reporters Thursday.
Other House Republicans also defended their bill, noting the CBO did find it would lower premium costs for younger and healthier people.
“What I’m encouraged by is … the CBO says we’re going to be able to drop premiums. We’re going to give states like Wisconsin the ability to drive premiums down,” Speaker Paul Ryan (R-Wis.) said at a press conference Thursday.
Rep. Brian Mast (R-Fla.), who was undecided on the House’s healthcare bill just days before he voted in favor of it, ardently defended it following the release of the CBO’s analysis.
“The bill does cover pre-existing conditions,” he told reporters Thursday.
“I’d say there’s about four different layers that exist to cover pre-existing conditions beyond the one that isn’t even spoken about, which is one of the most important, the personal responsibility we have in our lives that’s not even mentioned in there. So I think it’s a pretty positive thing.”
The differences between the Republicans in each chamber are important because the two sides will ultimately have to agree on a single piece of legislation to send to Trump’s desk if they are to meet their goal of repealing ObamaCare.
While Senate Republicans have real worries about whether the House language would cut coverage for people with pre-existing conditions, House conservatives are determined to not budge from their determination to lower premiums for most consumers.
There are other differences too, particularly on how to handle ObamaCare’s expansion of Medicaid. The House bill would end federal support for that expansion; a number of GOP senators want to at least extend the federal support further.
Which ObamaCare taxes to repeal is another dividing point.
Many senators have indicated they want stronger protections for people with pre-existing conditions.
“You’ve got to be able to provide insurance to the people that are really worried about their families, that we’re not going to dump anybody out of insurance because let’s face it: Congress did this to people. They created a healthcare plan that is not functioning,” said Sen. Mike Rounds (R-S.D.).
“I think we need to be instructed by [the score],” said Sen. Bill Cassidy (R-La.) “If states have a lot of flexibilities, those with pre-existing conditions may not be able to get coverage, or maternity benefits may not covered.”