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Republicans modify Obamacare repeal bill to appease conservatives

AP BUDGET HEALTH CARE A USA DC

Speaker Paul Ryan holds a news conference on Capitol Hill on March 8, 2017.(Photo: J. Scott Applewhite, AP)

WASHINGTON — Republicans released a modified health care bill Monday in an attempt to shore up support among both conservatives and moderates for their legislation to replace the Affordable Care Act before the House votes Thursday — seven years to the day after President Barack Obama signed the act.

Under the modified version of the GOP replacement bill, states would be allowed to require able-bodied Medicaid recipients without dependents to work beginning in October. And states could receive federal funding for the program as a lump sum — instead of a per capita allotment — for children and non-disabled, non-elderly adults.

Taxes imposed by the ACA on the wealthy, sectors of the health care industry and others to pay for expanded coverage would be repealed in 2017 instead of 2018.

Those changes were made to draw support from conservative members disappointed the original bill didn’t go far enough to undo the ACA, popularly known as Obamacare.

“There are several groups where it addresses their concerns, that’s why we’re doing this,” said Rep. Pete Sessions, the Texas Republican who heads the House Rules Committee which will take up the legislation Wednesday,

Republicans also said the changes will allow the Senate to expand subsidies for older people who buy coverage on the individual market. That would help offset the premium increases they’ll see once insurers are allowed to charge them five times as much as younger people for the same plan. The ACA limited the difference to three times as much and AARP has mounted a strong opposition to the GOP bill. Other groups opposing the GOP bill include associations representing doctors, nurses and hospitals.

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Despite the changes, it’s uncertain if the bill can garner enough Republican votes to pass the House. Democrats are united in their opposition to the bill.

Michigan Rep. Justin Amash, one of the bill's staunchest critics, tweeted that the revised version won't garner enough support to pass.

But in a good sign for Republicans, the House Freedom Caucus announced Monday it would not take a united position on the bill.  The conservative group has enough members to stop legislation if it votes as a bloc, and many members still may vote against it.

The revised bill did not include an updated analysis from the nonpartisan Congressional Budget Office on its cost and effect on insurance coverage.

The CBO estimated that, under the original version of the bill, the number of uninsured would grow by 24 million in 10 years. Much of that would come from reductions in Medicaid spending, though CBO also predicted millions of people would drop coverage once they are no longer required to have it.

Premiums for people who don’t qualify for a government program and aren’t offered coverage through an employer are likely to be higher than projected under the Affordable Care Act because fewer healthy people would buy insurance after Republicans eliminate the ACA’s tax penalty for not having insurance, CBO predicted.

But by 2026, premiums would be about 10% lower than projected under the ACA. That’s because the pool of people being covered is expected to be younger, because insurers could cover a lower share of health care costs than under the current law, and because the bill includes funds for states which could help reduce premiums.

But premium changes would vary by age with costs going down for younger customers and up for older ones.

White House spokesman Sean Spicer said Monday the bill is being changed “in large part because we’ve been listening and making it better.”

‘To the extent that we can make changes that I think enable us to maintain 218 votes (in the House), we will do that,” Spicer said.

Republicans can afford only about 20 GOP defections in the House and two in the Senate where several Republicans are opposed, including Kentucky Sen. Rand Paul.

Speaking at a rally in Louisville Monday night, Trump said he looks forward to working with Paul and suggested more changes to the bill are coming.

"We’re going to negotiate. It’s going to go to the Senate and back and forth," Trump said. "The end result is going to be wonderful. And it’s going to work great."

Trump is expected to meet with Capitol Hill Republicans Tuesday to urge their support.

The public remains split over whether Congress should repeal the ACA. A bare majority — 51% — oppose repeal while 45% are in favor, according to a March 6-12 survey conducted for the nonpartisan Kaiser Family Foundation. Nearly half of those surveyed thought the GOP alternative will result in fewer people having health insurance.

Ohio Rep. Steve Chabot, who was waiting for the changes before deciding if he will vote for the bill, suggested Monday Thursday’s timeline for a floor vote might slip if the votes aren’t there.

“It would be a disaster if they brought it up and it failed,” Chabot said earlier in the day.  “I think they still have some work to do.”

Contributing: Eliza Collins, Deidre Shesgreen, Donovan Slack USA TODAY.

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House Republicans have unveiled their replacement plan for the Affordable Care Act. The plan differs from Obamacare in various ways. Time

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At a meeting in the Oval Office, President Trump says Obamacare is dead. Veuer's Nick Cardona (@nickcardona93) has that story. Buzz60

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?CBO offers grim predictions under GOP health care bill | 1:11

The non-partisan Congressional Budget Office estimates that the GOP health care bill would lead to the loss of health insurance for millions of Americans. USA TODAY

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?GOP House Leaders Tout Progress on Health Reform | 1:49

A group of House GOP leaders briefed reporters Friday to tout progress on repealing Obamacare as their legislation makes its way through the committee process toward a vote on the House floor. (March 10) AP

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A closer look at the draft legislation House Republicans hope will replace the Affordable Care Act. USA TODAY NETWORK

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?U.S. Health Secretary: Changes are about patients | 0:59

The U.S. Secretary of Health Tom Price distinguished which health care plans will be changed by the proposed replacement for Obamacare during a news conference at the White House. USA TODAY NETWORK

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Trump: Obamacare Plan is 'Repeal and Replace' | 2:04

Donald Trump says a replacement for Obamacare will be offered with the confirmation of his health secretary. And he tells reporters that repealing and replacing President Barack Obama's health care law would be done "essentially simultaneously." (Jan. 11) AP

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Republican Senators push to slow Obamacare repeal | 0:48

Five Republican senators are offering a budget resolution amendment which would extend the deadline for a repeal of Obamacare. Buzz60

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?11.5 million people signed up for Obamacare | 0:31

Between November 1 and December 24 approximately 11.5 million people signed up for health plan coverage under President Barack Obama's Affordable Care Act. USA TODAY

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Paul Ryan: GOP will defund Planned Parenthood and Obamacare | 0:43

House Speaker Paul Ryan says the GOP's budget bill defunding Obamacare could include language to block Planned Parenthood's federal funds. Video provided by Newsy Newslook

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The estimate from the Committee for a Responsible Federal Budget includes the repeal's effect on the economy. Video provided by Newsy Newslook

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Trump claims transition from Obamacare will be simultaneous | 0:56

The President-elect says the Republican party 'doesn't want to own' Obamacare. He says the repeal and replace transition will happen 'essentially simultaneously'.

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Donald Trump says he’s willing to preserve parts of Obamacare | 0:48

President-elect Donald Trump, who had repeatedly campaigned on a promise to repeal the Affordable Care Act, said Friday that he would consider keeping certain parts of the health care law after meeting with President Obama at the White House. Time

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Trump suggests parts of Obamacare may stay | 0:54

Donald Trump told 'The Wall Street Journal' that he may retain certain parts of the Affordable Care Act, a shift in tone since he promised to repeal it during his campaign. USA TODAY NETWORK

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WHAT HAPPENS TO OBAMACARE UNDER TRUMP?Trump election helps spur record Obamacare signups | 0:53

Over 100,000 people signed up for Obamacare plans the day after the presidential election. It's the largest number since open enrollment starts on November 1. USA TODAY NETWORK

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Republicans modify Obamacare repeal bill to appease conservatives
Republicans modify Obamacare repeal bill to appease conservatives
Republicans modify Obamacare repeal bill to appease conservatives

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