The Public Pulse: Republicans now own health care mess

House Paul Ryan of Wis. speaks during a news conference at Republican National Committee Headquarters on Capitol Hill in Washington. Ryan said he will seek changes to a divisive GOP health care bill to provide

The House Budget Committee voted narrowly Thursday to advance the troubled Republican health care bill, with defections by three GOP conservatives underscoring the obstacles party leaders face in maneuvering to avoid a stinging setback to their showpiece legislation. House Speaker Paul Ryan is aiming for a full House vote later next week on the legislation.

The GOP's American Health Care Act "provides nearly no new flexibility for states, does not ensure the resources necessary to make sure no one is left out, and shifts significant new costs to states", the governors wrote in a letter to Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan.

After a White House meeting between President Donald Trump and around a dozen House Republicans and late night telephone talks, a leader of one group of House conservatives said he and others were now backing the legislation.

But it's not clear whether the AHCA now has enough votes to pass the House. It predicted Monday that 24 million people would lose health coverage by 2026 but that there would be a cut to the federal budget deficit of $337 billion over the first decade.

Now, the big question: What do House Republicans do?

Despite Trump's claims, the embattled Republican bill, the American Health Care Act, is by no means certain to end up on his desk for signing into law, because of opposition among some GOP lawmakers, whose party holds the majorities in both chambers of Congress.

It seems that proponents of the AHCA are not listening to the message that citizens in MI and nationally are giving policy makers: fix the ACA so that it can provide better quality, more accessible and lower-cost health coverage. The tricky part was that they needed to find a way to help people immediately upon the bill going into place, but not risk pushing Americans out of insurance plans they could not afford without government aide that the Affordable Care Act helped to provide them. They have also pushed for the bill's proposed freeze on Obamacare's Medicaid expansion to be accelerated from 2020 up to 2019 or 2018.

In a new complication, Sen.

Several Republicans have expressed deep reservations, putting the outcome of the vote in doubt. That left House moderates angry over being asked to take a politically risky vote for legislation that seems likely to be significantly altered.

Representative Charlie Dent, following a meeting of moderate Republicans with Pence, told reporters that speeding up the termination of the Medicaid expansion was a "non-starter".

In recent weeks, Trump administration officials and Republican lawmakers have criticized what they said were overly optimistic estimates from the CBO of the number of Americans who would sign up for health insurance on government-run exchanges. This was called the "individual mandate". It would cut Medicaid, repeal the law's tax increases on higher earning Americans and require 30 percent higher premiums for consumers who let coverage lapse.

Most recently, the budget office scored the Republican's replacement plan to Obamacare, the American Health Care Act, and projected that 14 million Americans would become uninsured due to the legislation. Medicaid covers more than 70 million people, and its future is expected to be a central issue in the Senate.

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