The GOP Dream Of O’care Repeal Now Hinges On Coming Up With Replacement

Speaker of the House Paul Ryan, R-Wis., meets with reporters at the Capitol in Washington, Thursday, May 26, 2016, as the Congress prepares to leave for the week-long Memorial Day recess. (AP Photo/J. Scott Applewhite)
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It’s not very often the House Freedom Caucus and moderate Republicans in the Senate are united.

But as Republicans grapple with how to repeal and replace President Barack Obama’s signature health care law, all of them are demanding the same thing from their leaders. They want their party to disclose more details on what the GOP’s replacement would look like before they vote to dismantle Obamacare.

And leadership may have no choice but to pay attention.

On Monday night at Tortilla Coast, a Mexican restaurant on the Hill, the House Freedom Caucus – a group of fiscal conservatives with a reputation for rabble rousing–came to a consensus that they wanted more insight into what the GOP’s replacement is before they vote on a budget resolution slated to be taken up Friday in the House. Meanwhile, on the other side of the Capitol, a group of five Senate Republicans asked that a deadline for Obamacare repeal be extended from January to March so that the party could have more room to discuss an adequate replacement.

Republicans are demanding that they don’t tumble into a repeal vote and emerge on the other side with no way to restore health care to millions of people who stand to lose it if Obamacare is repealed.

Leadership seems to be picking up on the heartburn among its rank and file.

On Tuesday morning, at his press conference House Speaker Paul Ryan (R-WI) hinted that pieces of replacement may actually be worked into a repeal bill and carried out through reconciliation, while some of it may be replaced with separate legislation and through regulations at HHS. Ryan announced that Republicans will work “concurrently” to repeal and replace the law.

“It is our goal to bring it all together concurrently,” Ryan told reporters adding that the House will “use every tool at our disposal through legislation, through regulation.”

The change in tone is slight, but significant given pressure leaders have been under by their rank-and-file to determine a replacement bill. Still, a House aide pushed back on questions Tuesday morning about whether Ryan was shifting the strategy.

“We have always determined the principles we support and now we are getting into the nitty gritty of how that becomes law,” the aide said, as she noted that there are still a lot of timing questions that must be decided.

House Ways and Means Chairman Kevin Brady (R-TX) told TPM that some members in the GOP’s ranks had been surprised by the complications of repealing and replacing Obamacare. It was a central campaign promise and refrain, but in action, it is far more complicated to undo.

“Only because health care is complicated, which is why the approach of taking a step-by-step approach, no 2,000 page bills like Obamacare did, no do it in the middle of the night – which is what the Democrats did– but taking it step by step with an effective transition to give families and business the peace of mind that they can chose a better option and making sure it’s ready for them is a good approach” Brady told TPM.

Peter King (R-NY) said in a closed-door conference meeting Tuesday morning that Ryan and leaders had tried to alleviate concerns about a replacement bill by assuring Republicans that blueprints like a “Better Way” as well as past efforts by the likes of Trump’s HHS Secretary nominee Rep. Tom Price (R-GA) all laid out clear replacement plans for members afraid of what is to come.

“I think there have always been replacement plans. It is more a question of timing,” said Rep. Scott DesJarlais (R-TN). “Voting for the budget will allow the reconciliation process to take place. As far as when the replacement bill coincides with the budget process is a little bit up in the air. My hope is it is sooner than later. I think there is a danger in letting too much time pass. We were sent here to repeal Obamacare, we have that opportunity. We need to do it. Delaying it for perfection in the eyes of the Democrats is going to be impossible.”

Rep. Charlie Dent (R-PA), who has been pushing leadership to come up with a clear replacement before the House votes to repeal Obamacare, said Tuesday that leadership still seemed undecided on their strategy.

“The discussions are ongoing right now. I don’t know what decision has been made. I think a lot of us have concerns about initiating this process until we get a better sense of the overall plan, and I think there’s still a lot of questions about replacement,” Dent said. “Most of us think that aspects of this law need to be repealed. Certain parts need to be reformed and overhauled , some things need to be replaced and other things are going to be maintained.”

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