The day after the American Health Care Act got its first full vetting from critics, pundits, and the media, it’s clear work needs to be done to shore up support from Republicans.
Conservative opposition could be reduced if certain amendments addressing key concerns were added to the bill. But conservative lawmakers on Capitol Hill were reluctant to suggest changes on or even off the record — so great is the grassroots opposition many Republicans won’t risk appearing even open to getting behind the health care bill.
“I am not convinced the House leadership is really taking input from conservatives.”
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For now, the White House is stressing that the AHCA is an essential first step in pulling back Obamacare.
“We’re in full ‘sell mode,”’ said White House press secretary Sean Spicer, speaking to reporters Wednesday afternoon.
Despite criticism from top conservative groups including Heritage Action and the Club for Growth, a number of influential players in GOP circles have rushed to the bill’s defense.
The U.S. Chamber of Commerce, Grover Norquist’s Americans for Tax Reform, and the inventor of the “Laffer’s Curve,” former Reagan economic adviser Art Laffer, have all expressed support for the plan unveiled Tuesday night by GOP leadership.
Still, Trump better be prepared to sell hard. Conservatives across the nation are not happy with many aspects of the bill, which is the first feasible shot the party has taken at repealing large parts of 2010’s Affordable Care Act, aka Obamacare.
Complaints reverberated across the Capitol on Tuesday and Wednesday. The charge was led by U.S. Sen. Rand Paul (R-Ky.), who has dubbed the repeal bill “Obamacare Lite.”
Many conservative lawmakers on Capitol Hill were quick to produce a list of bad things from Obamacare that are left in the AHCA.
One GOP congressional office gave LifeZette its complaints. They include:
- A new version of the hated individual mandate. The bill imposes a 30-percent penalty for people who didn’t but insurance, payable to the insurance company through higher premiums.
- The AHCA keeps the plan’s mandates. There still won’t be cheaper insurance.
- It keeps the so-called “Cadillac tax” on elite private plans, although the tax has been suspended until at least 2020.
- It keeps Obamacare subsidies, but calls them “refundable credits.” Lawmakers say these credits will be even more expensive than the Obamacare entitlement.
Conservative lawmakers would like to see those items deleted from the books, either in the AHCA, an alternative reform bill or in “Phase 2 and 3” of the process. (The second part of the process is said to be in the court of Tom Price, secretary of Health and Human Services, who can affect up to 1,400 health-care regulations. The third part will be all the items that cannot be shoved into budget reconciliation and must pass the senate under regular order.)
In another worrisome sign for conservatives, the White House is waging a very public effort to prematurely dismiss the findings of the Congressional Budget Office, the nonpartisan agency which will “score” — or estimate the cost of — the AHCA.
Spicer told reporters that after failing to score Obamacare properly, the CBO has little authority or credibility on the GOP reform package.
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“If you are looking to the CBO for accuracy, you are looking in the wrong place,” said Spicer.
Meanwhile, conservative critics are being told by Laffer to get what they can in the first cannon shot, and then continue to fight for more.
“The tax on earnings is gone. The tax on medical devices is gone,” Laffer told LifeZette on Wednesday. “This is so much better than Obamacare.”
Laffer said he didn’t get everything he wanted when he advised President Reagan on the 1981 tax cuts. Over time, the GOP “cleaned house” in the 1986 tax reform, the last significant tax reform.
“Life is not a sprint, it’s a marathon,” Laffer said from his Nashville office.
It’s also a negotiation. On Wednesday morning, U.S. Sen. Ted Cruz (R-Texas), who had stayed out of the main press conferences on Tuesday criticizing the AHCA, told reporters: “As drafted, I do not believe this bill would pass the United States Senate. But I am encouraged and optimistic that we can resolve these differences.”
Not long after that remark, President Donald Trump invited Cruz to a Wednesday dinner meeting.
Beforehand, he met with leaders from a number of longtime conservative activist groups: David McIntosh of Club for Growth; Jim DeMint of The Heritage Foundation; Tim Phillips of Americans for Prosperity; Adam Brandon of FreedomWorks; Mike Needham of Heritage Action; and Jenny Beth Martin of Tea Party Patriots.
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McIntosh later told Fox News that the president agreed that the AHCA “needs to be changed.”
And McIntosh had some concerns about how Ryan gathered consensus.
“I am not convinced the House leadership is really taking input from conservatives,” said McIntosh.