WASHINGTON – House Republican's efforts to vote Wednesday on legislation to repeal and replace the Affordable Care Act, got off to a rough start, as Democrats argued the votes should be delayed until the Congressional Budget Office reports on its costs and hearings are held.
CBO officials said their report on the Republican's American Health Care Act would not be finished until Monday, March 13.
But leaders of the House Ways and Means Committee and the Energy and Commerce Committee said they would not wait for the report.
The Ways and Means Committee voted along party lines, 22 to 16, against a motion by Rep. Lloyd Doggett, D-Texas, that would have postponed the vote by one week, after he complained Republicans were trying to "jam" their plan through the panel.
"What this bill needs is extreme vetting," Doggett said. "We're being asked to vote without knowing how much it costs, what it covers and what it leaves out."
"I just don't understand the rush to consider this bill today," Rep. Frank Pallone, D-N.J., said during the House Energy and Commerce Committee debate.
The Ways and Means Committee Democrats' anger grew when they discovered the first measure they were to vote on would allow insurance providers' executives to deduct a significant amount, if not all, of their compensation at a total cost of $400 million over 10 years -- money that could be used instead for health care.
"We're starting this markup with a virtual give-away to insurance executives," said Rep. Sandy Levin, D-Mich. "It's a huge giveaway to the very, very wealthy."
"Today's markup is really the Republican's first step on tax reform," Rep. Richard Neal, the committee's top Democrat. "The Republican bill absolutely provides a tax cut for the wealthy and health care industry of almost $600 billion."
The Massachusetts Democrat said estimated 400 households with the highest-income would receive tax cuts averaging about $7 million apiece each year under the bill. "At the same time the bill hurts the middle-class through less generous tax credits, cuts to Medicaid and higher premiums with less quality care," he said.
"Let's call this bill what it is: a plan that creates chaos in the insurance market that directly impacts patients and providers, hurts hospitals, the communities they serve and their regional communities," said Neal.
Doggett accused Ways and Means Committee Republicans of dividing the legislation up into five measures to deliberately limit debate and questions as well as to obfuscate the big picture of the legislation, which he, like Neal said will amount to a total $600 billion give-away to the wealthy and health care industry.
At one point, the committee meeting dissolved into a rant by Democrats over President Trump's refusal to release his tax returns. Doggett proposed an amendment to request Trump's tax returns from the Treasury Department but committee Republicans voted it down.
Democrats unsuccessfully offered numerous proposals for amendments. The amendments would have: made sure the bill would be fully paid for; not increased the number of uninsured; not resulted in job losses at hospitals, allowed states to opt out of the plan; and certified that no one would lose their health insurance.
As of 4:00 PM the House Ways and Means Committee had still not voted on its first measure.
Meanwhile, many governmental and health care groups opposed the Republican legislation. The U.S. Conference of Mayors said in a release, "The effect of repealing the Affordable Care Act will be most heavily felt at the local level …. The new GOP plan is bad for cities, bad for people who live in cities, and bad for people who provide healthcare in cities."
The mayors said they oppose the restructuring of Medicaid as a per capita cap program. "The bill slashes state funding for Medicaid and strips away protections for the most vulnerable," they said, adding, "As a result, states will be forced to end coverage and eliminate health care services for low-income seniors, people with disabilities, children and working families."
Seven groups representing hospitals and health care systems across the country said they oppose the bill. "We are deeply concerned that the proposed Medicaid program restructuring will result in both the loss of coverage for current enrollees as well as cuts to a program that provides health care services for our most vulnerable populations, including children, the elderly and disabled," said the groups, which included the American Hospital Association. "Additionally, maintaining deep provider reductions while dramatically reducing coverage will reduce our ability to provide essential care to those newly uninsured and those without adequate insurance."
Andrew Gurman, president of the American Medical Association, said the AHCA "does not align with the health reform objectives the AMA set forth in January to protect patients."
In a letter sent to leaders of the two committees, the AMA said, "We cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations."
AARP executive vice president Nancy LeaMond said in a release that the group opposes the House Republican plan because it would shorten the life of Medicare, hike costs for those who can least afford higher insurance premiums, risk seniors' ability to live independently, and give tax breaks to big drug companies and health insurance companies.
