Mar 20, 2017

The three big things to know for repeal week

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Here's what you need to know as we head into the week of the House vote:

  • Republican leaders may be within striking distance of the 216 votes they need for Trumpcare to pass the House.
  • They're nowhere close to the votes they need in the Senate, thanks to conservatives and moderates turning against it for different reasons.
  • The one new change that seems almost certain to happen: The tax credits will be reworked to give more help to the low-income elderly.

There's still a long way to go in the House, but GOP leaders are a lot closer to nailing down the votes after President Trump struck a deal with the Republican Study Committee on Friday morning to win their support. (Caitlin Owens and Jonathan Swan give a rundown here of the Medicaid changes they've been promised.) Here's who to keep your eye on now:

  • Freedom Caucus members. Even after the Republican Study Committee got on board on Friday, the Freedom Caucus tweeted that it "still opposes the GOP replacement bill in its current form." CNN reports that the group's chairman, Rep. Mark Meadows, and Sens. Ted Cruz and Mike Lee met with top Trump aides at Mar-a-Lago this weekend to try to push the bill farther to the right.
  • Reality check: The Freedom Caucus is certainly capable of causing trouble for House Speaker Paul Ryan — they made life miserable for John Boehner. But how many would actually vote against a repeal bill when the time comes? You'll know the tide has turned if you start hearing "I don't like it but won't stand in the way" speeches.
  • Moderates. The Washington Post has a good look at what it calls the "sleeping giants": the moderates who are appalled by the estimated coverage losses. Many are from states that expanded Medicaid, and don't like how the bill handles the end of the expansion.
  • Reality check: The GOP leaders are trying to win them over, as Jonathan Swan reported yesterday — but when was the last time a bill failed in the House because moderate Republicans all stood their ground against the leadership? It's not impossible, but it doesn't happen very often.

The bigger problem is in the Senate, where senators are more independent and less likely to fall in line than in the House. Cruz and Sen. Susan Collins were on separate Sunday talk shows talking about how they can't support the bill, but from opposite ends of the spectrum: Cruz wants to knock out the Obamacare insurance regulations, while Collins is worried about lost coverage and Medicaid cuts. Try to figure out the formula that makes both happy.

But it's increasingly likely that the tax credits will be tweaked, since both Ryan and Health and Human Services secretary Tom Price floated that idea on the Sunday talk shows. Seems that "low-income elderly to pay $14,600" wasn't the headline they were looking for.

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