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Conservative Groups Jeopardize GOP Plan to Repeal Affordable Care Act

5 Mar 2017 9:58 pm
By Michelle Hackman 

WASHINGTON -- Conservative groups are raising alarms over central provisions of the House GOP's emerging plan to repeal the Affordable Care Act, pushing lawmakers to buck House Speaker Paul Ryan and oppose the Republican blueprint.

The groups -- including Heritage Action, the Club for Growth and Freedom Partners, an organization funded by billionaire industrialists Charles and David Koch -- are troubled by the notion of refundable tax credits to help consumers pay for health insurance, a central tenet of Mr. Ryan's plan that President Donald Trump appeared to endorse in his address to Congress last week.

They also are deeply opposed to a commitment to temporarily maintain an expanded form of Medicaid, as numerous GOP governors are demanding.

Those elements limit the number of people who may lose health coverage through repeal -- a major political consideration for Republicans -- but significantly drive up the bill's price tag, an outcome anathema to the party's Tea Party wing. Conservatives would prefer to see Congress take up a 2015 repeal bill passed by both chambers of Congress as a starting point before considering any components of a replacement plan. That bill was vetoed by President Barack Obama in early 2016.

The split means Republicans seeking repeal are fighting on two fronts. The existing health-care law has broad backing among Democratic lawmakers and rising support from the public -- the past two Wall Street Journal/NBC News polls have shown that for the first time since the law was enacted, more Americans think it was a good idea than those who think it is a bad idea.

Reps. Mark Walker (R., N.C.), chair of the Republican Study Committee, and Rep. Mark Meadows (R., N.C.), chair of the Freedom Caucus, both announced their opposition to the Republican leadership's plans last week. Each of those groups includes dozens of conservative lawmakers, meaning if either bloc votes against Mr. Ryan's plan, it almost certainly wouldn't pass.

Since those high-profile defections, outside groups have added their voices of disapproval. Aides to several organizations say they are considering steps, including protests and ads, to let leaders know of their discontent and to offset demonstrations led by ACA supporters.

"To the extent that they're doing something else with this plan other than full repeal, the concerns that conservatives in the House are expressing are completely valid," said Michael Needham, chief executive of Heritage Action.

Since 2010, conservative activists have led the charge to repeal the law they call Obamacare, working against Republicans who backed anything other than a wholesale dismantling. In 2015, they campaigned against House Republicans' initial repeal blueprint, helping push them toward a broader bill that included eliminating the Medicaid expansion and the requirement that individuals obtain insurance.

Until now, conservatives have largely held their fire against Mr. Ryan (R., Wisc.), a figure respected by the party's right flank. That silence frustrated some House conservatives, who were relying on groups like Heritage for political cover to speak out against their leadership, according to several GOP aides.

From the other end, a group aligned with Mr. Ryan, American Action Network, has begun airing television ads against members of the Freedom Caucus, pressuring them to sign onto the GOP plan. AAN is a group of Republican moderates headed by former Sen. Norm Coleman (R., Minn.), who is closely aligned with Mr. Ryan.

Republican leaders say the conservative groups had more influence when Mr. Obama was in office and Republicans were focused on opposing him.

"The dynamics have changed," said Rep. Dennis Ross (R., Fla.), a member of the GOP leadership team. "If the president decides that he's going to come down here and do his advocacy with certain members of Congress, that will probably be more effective than any special interest group."

Yet Mr. Trump so far hasn't intervened in the intraparty disagreements. And as House committees prepare to tackle repeal measures in earnest this week, the outside groups are beginning to openly attack the Republican leaders' approach, just as centrist Republicans earlier refused to go along with repeal proposals they saw as too far-reaching.

"Fully repealing Obamacare needs to be Congress' top priority, but raising taxes to create a new entitlement in its place keeps Washington at the center of our health-care system and leaves Obamacare's crumbling foundation largely intact," said Nathan Nascimento, Freedom Partners' vice president of policy.

Conservative mistrust of the GOP leadership grew last week when the House Energy and Commerce Committee held a meeting on a secretive plan for Medicaid. Lawmakers could view the proposal, but not take copies with them.

Americans for Prosperity, a Koch-backed sister organization to Freedom Partners, is planning a "you promised" rally at the Capitol Tuesday, aiming to pressure lawmakers to revert to the 2015 repeal bill. A spokesman said they are also planning to launch a door-knocking campaign to deliver their message against Mr. Ryan's plan.

Heritage Action, which has amassed its own nationwide team of organizers, is also considering more public moves.

Mr. Walker acknowledged such actions would be unlikely to overcome Mr. Trump's opinion, if he chooses to weigh in more forcefully on such issues as the tax credits and Medicaid expansion. It isn't clear, however, whether the president will ultimately consider such intervention to be in his interest.

"If the president comes out and says, 'This is the exact plan, this is the way we're going' -- obviously that's going to impact it," Mr. Walker said.

--Kristina Peterson contributed to this article.

(END) Dow Jones Newswires

March 05, 2017 16:58 ET (21:58 GMT)

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