WASHINGTON - The Republican plan backed
by President Donald Trump to overhaul the
U.S. healthcare system cleared its first
hurdles in Congress on Thursday, but its
chances for passage looked uncertain and top
Republicans scrambled to bring disgruntled
In the face of opposition by Democrats,
healthcare providers and many conservatives,
two House of Representatives committees
approved the legislation that would undo
much of the 2010 Affordable Care Act,
popularly known as Obamacare, moving it
closer to a vote before the full House.
The Energy and Commerce Committee voted
31-23 along party lines, with Democrats
unified against it, to back the plan after
marathon proceedings lasting 27 straight
hours. Hours earlier, the tax-writing Ways
and Means Committee similarly voted 23-16
before dawn to approve it after working 17
House Speaker Paul Ryan sought to bolster
support among conservatives in his own
party, Senate Majority Leader Mitch
McConnell said fellow Republicans must get
in a "governing mode" while Trump denied the
bill was in trouble.
"Despite what you hear in the press,
healthcare is coming along great. We are
talking to many groups and it will end in a
beautiful picture!" the Republican president
said on Twitter.
The bill would replace Obamacare's
income-based subsidies with a system of
fixed tax credits to help people buy private
insurance on the open market, while ditching
the Obamacare expansion of the Medicaid
insurance program for the poor. It would
also end penalties for not having insurance,
though insurers would be given permission to
impose a 30 percent surcharge on customers
who let their coverage lapse for more than
two months and then seek to renew.
Hospital stocks, which has fallen after
the plan was unveiled on Monday, ended
broadly higher on Thursday, with Tenet
Healthcare up 3.4 percent. Shares of health
insurers were mixed, with most large
insurers modestly higher and
Medicaid-focused insurers ending negative,
including Molina Healthcare's 3.3 percent
While Republicans have been itching for
seven years to dismantle Democratic former
President Barack Obama's signature domestic
policy achievement, the party has failed to
coalesce behind the plan put forth by House
Republicans control the White House and
both houses of Congress for the first time
in a decade, but passage of the legislation
was not a foregone conclusion.
Conservative lawmakers and lobbying
groups have lambasted it as too similar to
Obamacare. They have sharply criticized its
proposed tax credits as an unacceptable new
government entitlement program and have
called for a quicker end to the Obamacare
The measure is the first major
legislative test for Trump and his fellow
Republicans amid questions about whether
they can govern effectively after years
spent as an opposition party under Obama.
Ryan, with his shirt sleeves rolled up
and using a video screen with facts and
figures, held what he called a "townhall-style"
presentation for reporters on the proposal.
But his intended audience appeared to be
fellow Republicans, and he said his party
must "actually make good on our word."
"The time is now," said Ryan, who long
has been the target of criticism of some
conservatives. "This is the closest we will
ever get to repealing and replacing
Obamacare," Ryan added.McConnell had a
similar message, saying, "We need to get
into a governing mode and start thinking
about actually achieving something rather
than just kind of sparring."
Democrats denounced the bill as a gift to
the rich that would force millions of people
off of insurance rolls. Republicans said it
was needed to roll back the government's
"nanny state" role in the more-than-$3
trillion U.S. healthcare system.
"Trumpcare is a loser for just about all of
America, unless you're in the top 1
percent," Senate Democratic Leader Chuck
The House Budget Committee next Wednesday is
due to merge the provisions approved by the
two committees into one bill to be voted on
by the full House before it goes to the
Senate. Republican leaders are eyeing April
for congressional passage of the bill.
'ARBITRARY LEGISLATIVE CALENDAR'
In a series of tweets early on Thursday,
conservative Republican Senator Tom Cotton
urged his House colleagues to pull back,
saying their measure could not pass the
Senate without major changes. "What matters
in long run is better, more affordable
health care for Americans, NOT House
leaders' arbitrary legislative calendar,"
But White House spokesman Sean Spicer
expressed confidence in the legislation's
prospects. "We're not jamming this down
people's throat," Spicer said. "This bill
will land on the president's desk. He will
sign it. We will repeal Obamacare."
The Brookings Institution think tank
forecast that the nonpartisan Congressional
Budget Office, expected early next week to
release its closely watched assessment of
the bill's cost and coverage implications,
would conclude that at least 15 million
people would lose health insurance.
Credit rating agency Standard & Poor's
earlier estimated 6-10 million people could
lose health insurance coverage.
Before the Energy and Commerce Committee
vote, conservatives at the request of the
panel's chairman withdrew an amendment
sponsored by Republican Joe Barton that
would move up by two years, to next Jan. 1,
the end of the Medicaid expansion. Barton
said he planned to try to offer the
amendment on the House floor.
Committee Chairman Greg Walden hailed the
unanimity of Republicans on the committee in
approving the bill.
Obamacare enabled 20 million previously
uninsured people to obtain coverage. About
half came from the Medicaid expansion.
The bill's proposed changes in Medicaid
funding could hurt smaller, less diverse
health insurers, Fitch Ratings said, and the
unintended, unforeseen consequences of a
bill this size are likely to create
uncertainty for all health insurers.
With doctors, hospitals, seniors, health
plans, Democrats, some governors and
conservative Republicans against the bill,
it may not make it out of the House, Mario
Molina, chief executive of managed care
company Molina Healthcare, said in an
"If it does, I think the Senate is going
to slow things down and really take a good
look," Molina said. "We are going to have to
hope that the Senate is more moderate."