What’s next in the GOP drive on health care reform

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Republican leaders continue to forge ahead with their plans to overhaul the Obama health law, even as some GOP lawmakers raise more red flags about the details, as the health care bill is slated to go before a third U.S. House committee in coming days, with prospects still somewhat uncertain.

Here is where we stand on the House GOP health care plan:

1. Waiting on the Congressional Budget Office. One of the biggest moments this week will be the expected release of the “score” by the CBO, giving Congress estimates not only on how the GOP plan will impact the federal deficit, but also how the changes to the Obama health law alter the number of people who have health insurance coverage. Both parties are guilty of hyping numbers that align with their views. With many expecting the numbers to undermine the GOP effort, Republicans and the White House have been going after the CBO in advance.

2. Next stop is the House Budget Committee. After winning approval in two House committees last week, the GOP health care plan is slated to go next to the Budget Committee, which will meet to markup the health care reconciliation bill on Wednesday morning.

“I am willing to stick my head out there, my neck out there for this plan,” said Rep. Diane Black (R-TN), who is the chair of the Budget panel.

3. A blunt warning from a GOP Senator. While several Republican Senators have signaled that they are uncomfortable with details in the GOP health care bill, Sen. Tom Cotton (R-AR) laid it out in very stark terms on Sunday, saying that if Republicans in the House go forward with this plan, they will be booted out of office by the voters in 2018. “I’m afraid that if they vote for this bill, they’re going to put the House majority at risk next year,” Cotton said on ABC’s “This Week.”

4. GOP Governors worry about the Medicaid details. Along with questions from Republicans in the Congress, the emerging GOP health care plan still faces skepticism from Republican Governors in states that expanded Medicaid under the Obama health law. On Sunday, Ohio Gov. John Kasich once more made the case for that extra money to be maintained in any GOP health bill, arguing it serves people in his state dealing with everything from drug addiction to mental illness. Kasich also warned Republicans not to repeat the mistake of Democrats eight years ago, and pass a one sided bill. “When you jam something through, just one party over another, it’s not sustainable.”

5. But some GOP lawmakers want to shut off that extra Medicaid money right away. One of the big stumbling blocks right now for Republicans is the issue of Medicaid expansion – the GOP health bill would end that extra funding in 2020. But some lawmakers want to shut that off this year, arguing Medicaid was not intended to serve such a large population. “I’ve been in Congress 31 years,” Rep. Joe Barton (R-TX) told reporters just off the House floor, as he argued for pulling back on Medicaid expansion. “I think this would be good for the country.” But GOP leaders don’t want to change those provisions, worried that it may cost them votes.

6. Democrats doing all they can to sow doubt. While Republicans wrestle with each other about how best to replace the Obama health law, Democrats are spending every day lobbing as many verbal and mental grenades at the GOP as possible. Every time a Republican says anything sideways about the GOP health bill, Democrats are making sure it gets as much play as possible. Many are zeroing in on individual Senators, trying to highlight disagreements among Republicans that in some cases could be difficult to solve. The GOP took that same route eight years ago, but fell short. Democrats hope for a different outcome this time around on major health care legislation in the Congress.


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