'Get Ready': Revised CBO Trumpcare Score, Due Wednesday, Could Trip Up GOP
Will the House be forced to re-vote on the American Healthcare Act?
The Congressional Budget Office (CBO) will release its updated assessment of the GOP-passed Trumpcare bill next week—potentially causing more problems for the Republican Party, President Donald Trump, and the much-maligned legislation.
"Get ready," Trump resistance group Indivisible wrote online. "It's going to be atrocious."
The CBO analysis will come Wednesday, the office announced Friday. Its previous report said the American Healthcare Act (AHCA) would ultimately wipe out healthcare coverage for 24 million people. Since that analysis, the bill has been significantly amended—likely changing the CBO's calculations—but GOP leaders forced a vote without a revised CBO score.
That rush to get the legislation passed may cause big problems for conservatives. As Bloomberg and NBC News reported Thursday and Friday, the updated CBO assessment could even force a re-vote on Trumpcare in the House. "It all combines to make next week's CBO report a little more dramatic," Vox wrote.
House Speaker Paul Ryan hasn't yet sent the bill to the Senate because there's a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority.
[...] According to several aides and other procedural experts, if Republicans send the bill to the Senate now and the CBO later concludes it doesn't save at least $2 billion, it would doom the bill and Republicans would have to start their repeal effort all over with a new budget resolution. Congressional rules would likely prevent Republicans from fixing the bill after it's in the Senate, the aides said.
[...] If Republican leaders hold onto the bill until the CBO report is released, then Ryan and his team could still redo it if necessary. That would require at least one more House vote of some sort.
[...] That vote could be cloaked in some kind of arcane procedural move, but it would still be depicted as a proxy for yet another vote on the same bill—and reluctant Republicans will once again be forced to decide whether to back it. Only this time, they would also be saddled with the CBO's latest findings about the bill's costs and impacts.
The wildcard is a new provision that would allow states to opt out of Obamacare's requirements that insurance plans carry a minimum package of benefits as well as its rule that insurers charge customers the same price regardless of whether they have a pre-existing condition.
The first version of AHCA saved money in part by insuring 24 million fewer people than current law, meaning they would not use a tax credit in the bill that can go toward coverage. If states opt out of Obamacare's requirements, though, millions more might be able to afford cheaper, if less generous, plans. The nonpartisan Committee for a Responsible Federal Budget estimates that if 10 million more people purchased insurance under the new version, the additional contributions to their tax credits would add $300 billion in costs.
If that happens, the House would have to vote again on changes, bringing them back to a politically charged bill that they barely carried over the finish line in a narrow 217-213 vote.
Meanwhile, the Senate continues to hammer away at its own version of AHCA, even if the House hasn't yet officially sent over its bill. According to the Washington Post on Thursday:
Senate Republicans are driving hard toward coming up with their own proposal to replace much of the Affordable Care Act. The Senate Finance Committee is currently drafting several different versions of a health-care bill, with the goal of having a menu for moderate and conservative senators to chew over and decide where they might be able to compromise.
[... Senate Majority Leader Mitch] McConnell is pretty darn determined to ultimately hold a vote on a health-care bill, members, aides and lobbyists have told me. Dissension among the Republican ranks would have to be virtually insurmountable to deter the majority leader from his quest to bring legislation to the floor, allowing Republicans to say they’ve fulfilled their Obamacare repeal promises.
In turn, Families USA chair emeritus Ron Pollack wrote this week, it's imperative that activists "focus on round two of the legislative process: Senate consideration of the health bill."
"Since Republicans only have a bare Senate majority," Pollack noted, "this is where our active opposition has its greatest prospects for success." Outlining five issues that warrant "high-priority advocacy," he concluded: "If we succeed with this agenda, we will restore peace of mind for families across the country. By winning on these issues, we can ensure that—contrary to the mean-spirited GOP House bill—families will get the care they need when they need it."