Republican Health Bill Clears Hurdle as House Panels Approve

The second of two key congressional committees cleared a Republican health care bill, moving the legislation to repeal and change many key parts of Obamacare a step closer to a full vote in the House of Representatives.

The House Energy and Commerce Committee, after a 27-hour session that saw tempers flare as Democrats tried to delay the legislation, approved the bill by a 31-23 vote with only minor changes. The vote came after the Ways and Means Committee wrapped up 18 hours of debate on its piece of the proposal, which it passed without any changes. The two measures will be combined and sent to the Budget Committee before heading to the floor.

The bill, the American Health Care Act, would repeal Obamacare’s requirement that individuals have, and employers offer, health coverage and would eliminate many taxes on the wealthy, insurers and drugmakers used to fund Obamacare. The proposal includes a refundable, age-based tax credit to help people buy insurance and a wind-down of an expansion of Medicaid over a period of years.

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Critics of the plan are worried people will forgo insurance without a mandate and that only the sickest will sign up. The Republican bill attempts to address that by allowing insurers to charge people as much as a 30 percent surcharge if they don’t maintain continuous coverage, though that may not be enough to entice younger, healthier people to buy insurance.

The AHCA still has major hurdles to overcome as conservatives, doctor and hospital groups, the main lobbying group for seniors and insurers have all expressed concerns or gone as far as to oppose the measure outright. Conservatives have panned the proposal because, while it repeals many parts of Obamacare, it also provides what they still see as large entitlements. Groups that lobby for doctors, hospitals and insurance companies say the AHCA wouldn’t adequately fund Medicaid, the government program for the poor, and that the tax credits wouldn’t be high enough.

Conservative Opposition

Conservatives have opposed the bill’s same provisions -- but because they say they go too far. Representative Joe Barton, a Texas Republican, proposed an amendment to try to address those concerns and potentially help bridge a divide within the GOP that has threatened the party’s health-reform efforts.

He withdrew the amendment at the request of Greg Walden, chairman of the Energy and Commerce Committee, so lawmakers could continue to work on it for possible reintroduction, Barton said after the final vote.

“I’m not going to embarrass my chairman,” said Barton, a former chairman himself.

The amendment would have frozen the Medicaid expansion next year instead of in 2020, after the mid-term elections. Thirty-one states have expanded Medicaid under Obamacare.

“There are probably some Republicans from the Medicaid expansion states that had problems with my amendment, and I respect that, but there are a lot of conservative groups, including the Republican Study Committee and the Freedom Caucus, that were very supportive,” Barton said.

His proposal may be a tough sell in the Senate, where Republicans have only a 52-48 margin and some lawmakers, including Republicans from states that expanded Medicaid, don’t want to strictly limit the program.