President Donald Trump has reversed himself on his party’s healthcare bill this week, calling it “mean” and emphasizing the need for something “more generous.”
At a lunch meeting with Republican senators at the White House Tuesday, Trump suggested the Senate needed to “add more money” to the American Health Care Act (AHCA) in order to better protect people in the marketplace. He also reportedly called the bill a “son of a bitch.”
It’s not entirely clear why Trump has decided to backpedal from the health bill now. After it passed the House last month, he congratulated House Republicans and lauded the bill, saying:
“I will say this: that as far as I’m concerned, your premiums—they’re going to start to come down. We’re going to get this passed through the Senate. I feel so confident. Your deductibles, when it comes to deductibles, they were so ridiculous that nobody got to use their current plan, this nonexistent plan that I heard so many wonderful things about over the last three or four days after that, I mean it’s—I don’t think you’re going to hear so much right now. The insurance companies are fleeing. It’s been a catastrophe.
“And this is a great plan. I actually think it will get even better and this is, make no mistake, this is a repeal and replace of Obamacare. Make no mistake about it. Make no mistake. And I think most importantly, yes, premiums will be coming down. Yes, deductibles will be coming down, but very importantly, it’s a great plan, and ultimately that’s what it’s all about.”
Elsewhere, Trump said the bill was “very, very, incredibly well-crafted.”
A slightly different version of the AHCA was unable to muster significant support from either the left or right wings of the Republican Party. Moderates were concerned that the bill would raise insurance premiums and cause some 24 million people to lose their health insurance over the coming decade. Conservatives, on the other hand, were primarily concerned that the bill left too many patient protections in place and did not give enough flexibility to state governments.
The revised version of the bill was more attractive for conservative House members, and enabled states to choose whether they wanted to allow states to waive patient protections guaranteed under Obamacare. The revised CBO score, which came out after the bill had passed the House, determined that the AHCA could leave 23 million without health coverage by 2026. This reduction in coverage would be effected by slashing $880 billion from Medicaid over 10 years.
Edina’s representative, Erik Paulsen (R), has long been a vocal critic of Obamacare. When the original version of the AHCA was on the table, Paulsen said, “Here’s the situation: Obamacare continues to hurt more people than it’s helping. A lot of the promises that have been made have been broken … the plan that’s moving forward is a better alternative.”
Some people would consider the progress made under Obamacare – the roughly 20 million people who gained health insurance, the fact that the percentage of Americans with health coverage swelled to a a record high – as cause for celebration. But not Erik Paulsen.
There was never a vote on the original version of the AHCA. But the amended version of the bill came to the House floor last month, where it passed without a single Democrat voting in favor of it and 20 Republicans voting against it.
Rep. Paulsen, unfortunately, was not brave enough to stand up to Trump and his party. Even though Obamacare approval ratings rose to 61 percent in the days and weeks prior to the House vote, Paulsen maintained that a repeal was necessary. “This is just the latest step in reforming our health care system to be more patient-centered,” he said. “My focus remains on finding solutions that will make sure Americans have access to high quality, affordable health care.”
Paulsen’s comments are strange, since the AHCA is estimated to broadly reduce the quality of care people receive and cause premiums to explode for most people. After the bill passed, Dan McGrath, executive director of TakeAction Minnesota, said, “[Rep. Tom] Emmer, [Rep. Jason] Lewis, and Paulsen could have defeated this horrific bill. Instead of listening to their districts, they voted to make a nightmare into reality. They voted to kick millions of people off health care to finance tax cuts for the rich. This goes against every value we have. Minnesotans won’t forget.”
The AHCA is now in the Senate for markup. Like their counterparts in the House, Senate Republicans are divided over whether to completely repeal Obamacare or to extend some limited protections to the millions of Americans who benefited from the protections and subsidies provided by Obamacare. Trump’s condemnation of the current text could lend moderate Republican Senators the imprimatur they need to revise the bill to their liking.
After the Senate completes its amendments, the AHCA will go to a conference committee where both bodies of Congress will decide whether to approve it, reject it, or send it back to the House for further revision and review. No Democrats are expected to express support for the Senate’s revisions of the Obamacare rollback.