An emerging center-right coalition in the House is threatening to stall Republican leaders’ first procedural move toward repeal of President Obama’s signature health care law this year.
Members of the moderate Tuesday Group and the conservative House Freedom Caucus are separately voicing concerns that House leaders are rushing a vote to repeal Obamacare without giving members input or outlining how specifically they would replace the law.
Some are calling for Speaker Paul Ryan to delay a crucial vote scheduled for Friday on a budget resolution that would lay the groundwork for Congress to repeal Obamacare without facing the threat of a filibuster in the Senate—where some Republicans have voiced similar concerns this week.
On Tuesday afternoon, the Tuesday Group met to discuss their reservations. Rep. Charlie Dent, the group’s cochairman, said he and others believe the repeal and replacement of the law should occur as close together as possible. Members of the group are worried that House leaders will set up a repeal of the law but fall prey to political deadlock when the time comes to replace it with legislation of their own, potentially leaving their constituents without insurance coverage.
“Many of our members understand that this is the first step in the process, and before we launch this legislatively, we’d like to have a say in what the replacement package is,” Dent said. “Many of us are concerned that if we repeal Obamacare without a replacement, the leverage will be lost to replace, because there will be those on the Left who will not help us under any circumstances and there will be some on the hard Right who might view any replacement as ‘Obamacare Light.’”
House leaders are trying to assuage uneasiness over the lack of a concrete replacement plan by noting that much of the heavy lifting can be done by the administration. Vice President-elect Mike Pence told members last week that President-elect Trump plans to use executive actions to repeal parts of the law. The message from House leaders this week is that Rep. Tom Price, Trump’s nominee to head the Health and Human Services Department, can alter the law on his own, for instance by lowering the minimum standards for an insurance plan to qualify as coverage under the law.
But with Trump not yet in office and Price not yet confirmed by the Senate, members are apprehensive about initiating the repeal process. And members of the Tuesday Group are similarly concerned by ambiguity from Trump about how he would like Congress to proceed, said Rep. Chris Collins, Trump’s Capitol Hill liaison.
That concern was not helped by a Tuesday Trump interview in The New York Times, in which he said Congress should repeal Obamacare “probably sometime next week”—a week the House is not in session—and added that “the replace will be very quickly or simultaneously, very shortly thereafter.”
Members of the House Freedom Caucus have also been voicing reservations about moving the budget this week. The group’s chairman, Rep. Mark Meadows, said members want more certainty about how leaders want to replace the law.
“That would be very helpful to have legislative text. That might be an ask that is too great at this point, but at least a commitment to get it done in the 115th Congress—we’ve been consistent on that,” he said. “We believe there is no compelling reason why you can’t get this done in the 115th Congress. It is my opinion that if it is not done in the 115th Congress, it will never be done.”
He added that he would like to see certain taxes used to pay for Obamacare to be repealed immediately so Congress is not tempted to reuse them to fund a health-care-law replacement.
The group is not unanimous on this topic. Rep. Morgan Griffith, for instance, said he would vote for the budget, even though he has mixed feelings.
“It’s a vehicle to get to where we want to go, so I’m going to vote yes,” he said. “There are some who want more specifics and maybe it ought to be delayed as opposed to [voted on] Friday, and I’m sympathetic to that, but at some point we’ve got to do it because we’ve got to get that vehicle moving.”
Still, some members of the Tuesday Group combined with some members of the House Freedom Caucus could equal enough lawmakers to keep the budget from passing, since no Democrats are expected to back the measure. House Majority Whip Steve Scalise and his team have been gauging support on the budget measure, and at a morning meeting, he urged any members who have concerns to share them with him.
The House dynamics echo those in the Senate, where both moderate and conservative senators have expressed reservations about moving ahead with an Obamacare replacement before coalescing around an alternative plan.
Sen. Rand Paul said there needs to be a vote on a replacement the same day as repeal, but clarified that his goal is not to block the stripping of the health care law but to quicken the pace to a Republican alternative.
Both Sens. Bill Cassidy and Susan Collins said they need to see a detailed plan.
“In an ideal situation, we would repeal and replace Obamacare simultaneously, but we need to make sure that we have at least a detailed framework that tells the American people what direction we’re headed,” said Collins in a statement.
Efforts within the party to delay a repeal are under way. Sen. Bob Corker submitted an amendment to the budget resolution to push back the date for a reconciliation bill from Jan. 27 to March 3. Sens. Rob Portman, Lisa Murkowski, Collins, and Cassidy were cosponsors of the amendment.
Collins explained that a sense of direction is needed so as not to disrupt coverage and to allow the insurance market to adjust.
“I’m worried about the individuals who are dependent on the subsidies provided by Obamacare,” she said. “My No. 1 concern is that we not create a gap in coverage for individuals who are currently insured and who rely on that coverage. I’m also concerned that the insurance industry will not have time to adapt to the dramatic changes brought about by repeal without a framework for replacement. The insurance markets cannot turn on a dime.”