GOP Makes Healthcare Changes To Attract Votes As Trump Declares "Obamacare Is Dead"

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This morning President Trump hosted a brief media appearance in the oval office, along with a group of conservative lawmakers, to, among other things, declare his “100% support” for the GOP’s Obamacare replacement plan.  During the discussion, Trump indicated that concessions had been made to the GOP’s legislation to attract the support of several conservative lawmakers and guarantee the bill’s passage when it come up for a vote in the House.  And, in a not so surprising twist, Trump also took a couple of shots at the media.

“I want people to know ObamaCare is dead; it’s a dead healthcare plan,” Trump said in the Oval Office during a meeting with conservative lawmakers.

 

“Only because everyone knows it’s on its last, dying feet, the fake news is trying to say good things about it, the fake media. There is no good news about ObamaCare. ObamaCare is dead.”

 

“I want to let the world know: I am 100 percent in favor,” Trump said.

 

“I also want everyone to note that all of these no’s, or potential no’s, are all yes’s…every single person sitting in this room is now a yes.  And, we made some changes, and frankly little, although the block grant is very important because I want the states to get the money and to run their program, if they want to run it.  Because they can do it better than the federal government.”

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Meanwhile, GOP sources told The Hill that the White House won the support of the Republican Study Committee members by agreeing to give states the option to impose work requirements on Medicaid recipients and the option to block grant Medicaid instead of the cap system in the bill.

Separately on Friday, Health and Human Services Secretary Tom Price privately told House Republicans in a closed-door meeting that changes could include alterations to tax credits and the optional Medicaid work requirements.

 

Changes to the tax credits, optional Medicaid block grants and Medicaid work requirements have risen to the top of changes that House Republicans are discussing to change their bill as they try to round up 216 GOP votes.

 

“The Speaker said this a minute ago, he didn’t say the specifics of it, but he said that some tweaks will be made to the tax credits and probably that’s the older — old geezers like me that are 55 and up,” said Rep. Phil Roe (R-Tenn.), leaving a House Republican Conference meeting Friday morning.

For those not familiar with Medicaid block grants, here’s a quick primer courtesy of Kaiser:

It’s called “block granting.” Right now, Medicaid, which was expanded under the 2010 health law to insure more people, covers almost 75 million adults and children. Because it is an entitlement, everyone who qualifies is guaranteed coverage and states and the federal government combine funds to cover the costs. Conservatives have long argued the program would be more efficient if states got a lump sum from the federal government and then managed the program as they saw fit. But others say that would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.

 

Currently, states share the cost of Medicaid with the federal government. Poorer states pay less: In Mississippi, for instance, the federal government pays about three-fourths the cost of the program, compared to 50 percent in Massachusetts.

 

The federal funding is open-ended, but in return, states must cover certain services and people — for instance, children, pregnant women who meet income criteria and parents with dependent children. Under a block grant, states would have more freedom to decide who qualifies, and for what services.

 

The block grant system is a radical shift from how Medicaid has worked previously. Republicans say it could save the government billions of dollars. But other analysts note those savings could limit access to health care if the funding becomes squeezed. Thanks to the 2010 health law, which led states to expand Medicaid eligibility, more people would face the brunt of those cuts.

 

The fiscal impact: The non-partisan Congressional Budget Office estimates recent Republican block grant proposals could cut Medicaid spending by as much as a third over the next decade. The cuts would start small, growing larger over the years.

 

Many Republicans say that, because states will have greater flexibility, they can innovate with their Medicaid programs.

Meanwhile, in a show of confidence that they have the 216 votes required to pass the House, GOP sources told Politico that a vote on Ryan’s Obamacare replacement bill has been scheduled for next Thursday.

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