WASHINGTON — The Republican plan to dismantle the Affordable Care Act moved ahead Thursday despite opposition by Democrats and the concerns of some Senate Republicans when two House panels approved it in party-line votes after working through the night.
With the majority Republicans in control, the Energy and Commerce Committee voted 31-23 for its piece of the legislation Thursday afternoon after a 27-hour session and the Ways and Means Committee approved its part of the bill in a pre-dawn 23-16 vote.
“Two House committees have now approved the American Health Care Act. Next the bill goes to the Budget Committee as part of an open, transparent process,” said House Speaker Paul Ryan (R-Wis.), who with President Donald Trump has put the act on a fast track.
Yet Ryan still faces hurdles within his own party, with the conservative Freedom Caucus saying the legislation does not go far enough in repealing what they call Obamacare, and Senate Republicans concerned about the measure’s capping and reducing Medicaid coverage.
Democrats also strongly criticized both the bill and the process on Thursday.
“Trumpcare, simply put, is a mess that gives you less for more,” said Senate Minority Leader Chuck Schumer (D-N.Y.). He called on Republicans to drop their legislation and work with Democrats to fix the problems with the current health care law.
House Minority Leader Nancy Pelosi (D-Calif.) said Ryan is pushing the legislation through without holding hearings or receiving an estimate by the Congressional Budget Office of the measure’s costs and its effects on the number of people who will have health insurance.
The legislation has also drawn opposition by the American Hospital Association, the American Medical Association and AARP, the senior citizens group.
The two pieces of the House legislation approved in committee now go to the House Budget Committee, which has scheduled a working session for next Wednesday. The bill that emerges could be on the House floor for debate and a simple-majority vote the following week.
That legislation Republicans are pushing now is the first of a three-phase process designed to get around Democratic opposition in much the same way Democrats used parliamentary procedure to pass the ACA seven years ago.
The first-phase bill is narrowly focused on budgetary issues to meet a requirement under the rules of the Senate for what’s called budget reconciliation, which would allow Republicans to pass it with 51 votes and avoid a Democratic filibuster requiring 60 votes for passage.
The second phase would involve regulatory changes made by the Trump administration. The third phase would be another bill that would include broader health care measures, but likely would need 60 votes to pass because Senate Democrats are expected to filibuster it.
The measure now in the House rescinds the taxes on insurers, medical device makers, tanning parlors and high-income individuals that the ACA imposed to pay for expanded coverage. It also would end in 2020 the extra billions of federal dollars sent to states to expand Medicaid and cap spending on the federal-state program for the needy at per-patient limits.
Schumer said the bill “is really a tax break for the rich, not a health care program,” noting that only people making more than $250,000 a year would get a tax cut. But Ryan blamed the ACA for rising health care, saying: “You’ve got to repeal the taxes in Obamacare.”
Meanwhile, Sen. Tom Cotton (R-Ark.) criticized the fast pace of the House, and four Republican senators have raised concerns that a “poorly implemented or poorly timed change” in funding for Medicaid could reduce health care services.
Senate Majority Leader Mitch McConnell (R-Ky.) urged his party to get behind the Republican health care plan. “We need to get into a governing mode and start thinking about actually achieving something rather than just kind of sparring,” he said.