Paul Ryan defends health plan amid CBO score furor

Senate Republicans said they’ll write a new health care bill over the Memorial Day recess, shunning the House GOP’s legislation a day after congressional scorekeepers said it would leave tens of millions of Americans without coverage.

With Democrats united in opposition, Senate Republicans are struggling to find unity among themselves on a plan to repeal and replace Obamacare.

But one area of agreement for the GOP is that the House bill won’t go anywhere in their chamber, after the Congressional Budget Office said it would leave 23 million more Americans without coverage in a decade, and while it would lower premiums for most Americans, it would hike costs for older and sicker customers.

Sen. Dean Heller, Nevada Republican, faulted the House plan as “not the solution,” while Sen. Lindsey Graham said Republicans should back off altogether and let Obamacare collapse, which he said would force Democrats to the bargaining table.

Sen. Susan Collins, Maine Republican, said changes to the Medicaid program would dent efforts to combat the opioids epidemic, while Sen. Bill Cassidy, Republican Louisiana, said Congress will need to find more money to subsidize costs if Congress keeps the part of the House plan that lets states charge sicker people more.

While healthier Americans see “significantly lower premiums” in some states that waive Obamacare requirements, sicker people could struggle to find affordable plans in those states, the CBO analysis said.

“You can make insurance more affordable for those who are younger, that’s important,” Mr. Cassidy said. “But it does potentially destabilize the market for those with preexisting conditions.”

Senators who’ve been negotiating behind closed doors said their staff will work over the vacation.

“At the outset, we said we’re not going to set any artificial time deadlines,” said Sen. Ted Cruz, Texas Republican, a key conservative on the working group.

Some Republicans want a gentler transition away from Obamacare’s vast expansion of Medicaid coverage for the poor, or to bolster tax credits for people whose costs would rise under the House plan.

Conservatives are more interested in rolling back as much of Obamacare as they can. One option they would like to see is to have states opt into the 2010 law’s insurance regulations rather than waiving them, as the House bill allows.

Senators had been waiting to see whether the House plan that passed earlier this month on a 217-213 vote would meet budget rules allowing Republicans to fast-track the bill and avoid a Democratic filibuster.

The CBO on Wednesday said the House bill saves — $119 billion — more than enough to clear the budget threshold.

Now, senators are looking at the policy.

“The House made a stab at it, but that’s not going to be what the Senate votes on, at least initially,” said Sen. John Cornyn, Texas Republican.

Senate Minority Leader Charles E. Schumer said Republicans wouldn’t get very far.

“The bottom line is very simple: unless you’re a healthy millionaire, Trumpcare is a nightmare,” he said, using the Democrats’ moniker for the plan. “And I think that’s why our Republican colleagues are having such trouble putting together their own bill.”

House Speaker Paul D. Ryan defended his bill Thursday, saying the new analysis shows Republicans can cut premiums below Obamacare’s ballooning rates.

He also didn’t put much stock in estimate of 23 million more uninsured, saying the CBO analysts were guessing at how states and customers would react.

Yet the plan is already politically toxic, according to a Quinnipiac University poll that found 44 percent of people are less likely to vote for a senator or House members who supports the House version. Only 20 percent said it would make it more likely.

As the Senate works, insurance companies called on the Trump administration to keep pumping money to compensate insurers for covering poor customers’ out-of-pocket costs, known as cost-sharing payments. Insurers said that without certainty of those payments, they’ll be forced to tack 15-20 percent onto their premiums.

That’s essentially what happened in North Carolina on Thursday, where Blue Cross Blue Shield said it was requesting a 22.9-percent rate hike on its Obamacare plans next year.

The company said if the payments had been fully funded, they would have requested an 8.8 percent hike.