Moderate Republicans face intense pressure on their party’s latest attempt to scrap Democrat Barack Obama’s health care law – from President Donald Trump, House GOP leaders, medical professionals and outside political groups.
Back home, their constituents provide little clarity.
In interviews, Associated Press reporters found views deeply held and deeply divided, reflective of dueling impulses to fulfill the seven-year-old GOP promise to repeal the law and to save many of its parts.
Meridene Walsh of Greenwood Village, Colorado, voted for Donald Trump for president last year partly because she wanted the Affordable Care Act gone. Now, she’s frustrated that House Republicans, including her own representative, Mike Coffman, are balking.
“The Republicans keep saying `repeal, repeal’ for seven years and a new president gets into office and what happens?” Meridene Walsh, 49, said with disgust as she stood outside a supermarket in the affluent Denver suburb. “I really want them to finish. Let’s get this health care thing going.”
Minutes later, David Murray left the same store and praised Obama’s law. He needed surgery to repair two discs in his back, and the law’s prohibition on insurance companies discriminating against people with pre-existing conditions is what allowed him to find a new insurer to pay for the procedure.
“If it wasn’t for Obamacare, I might not be walking,” said Murray, a 46-year-old commercial driver. “There’s no reason to change something without making it better.”
Bill makes big changes
The latest iteration of the GOP bill would let states escape a requirement under Obama’s law that insurers charge healthy and seriously ill customers the same rates. Overall, the legislation would cut the Medicaid program for the poor, eliminate Obama’s fines for people who don’t buy insurance and provide generally skimpier subsidies.
If the GOP bill became law, congressional analysts estimate that 24 million more Americans would be uninsured by 2026, including 14 million by next year.
That bill fizzled before a planned vote in March when members of the conservative Freedom Caucus found the changes didn’t go far enough to get government out of health care and moderates objected to undoing the expansion of Medicaid insurance for low-income adults.
An amended version has won over several conservatives with provisions to let states opt out of some requirements. One new wrinkle: While insurers would still have to cover people with pre-existing conditions, they would now be able to charge them higher premiums.
Constituents weigh in
The moderate Republicans who were on the fence last time are crucial to the outcome.
In Coffman’s Colorado district, hundreds flooded a local library where he was privately meeting constituents in January, and Coffman left through a rear door. After Coffman announced he supported the earlier repeal, he endured hours of boos at a town hall he held.
Rep. Rodney Frelinghuysen, the New Jersey Republican who is chairman of the House Appropriations Committee, has heard it from both sides. A group has been rallying at his office every Friday afternoon, and saving the law is one of its members’ priorities. Meanwhile, the conservative Club for Growth ran ads targeting Frelinghuysen for standing in the way of repeal.
This time around, Frelinghuysen hasn’t said publicly where he stands. His office has not responded to requests for comment.
The upset doesn’t mean that all voters are ready to oust their representatives over it.
John Marsella, a 52-year-old stay-at-home dad from Oakdale, California, said he would prefer a complete repeal of Obama’s law. But he said he won’t want Rep. Jeff Denham out of office if he continues his opposition to the current measure.
“In general, I like Jeff Denham, but I don’t want Republicans to be liars,” Marsella said. “They said they’d repeal Obamacare, and now they’re not. They’re just changing it. So the underlying problem is still there.”
In the Chicago suburb of Wheaton, Illinois, represented by Republican Peter Roskam, salesman Bruce Hoyer said the law raised health care costs for him so much that he had to switch jobs. Still, he believes that the legislation made much-needed changes, including expanding insurance coverage to people who didn’t have it.
“I think people need to be insured,” said Hoyer, who voted for Hillary Clinton, “even though it cost a lot and it hurt.”
In a South Florida district, some residents want Republican Rep. Carlos Curbelo to fight to keep some changes brought by the law.
Natalie Penate, a 30-year-old student training to be a patient care technician, wants to continue the requirement that maternity coverage remain mandatory at no extra cost for women.
“Those who are planning to increase the cost of health care because of being a woman, having more health care needs than men, should consider those women their mother, their daughter, their sister, someone close to them, so they have it in their heart knowing `wait, we can’t do that. That’s not fair.”‘
The debates can be internal, too.
Sandra Pendragon, a 48-year-old jewelry maker and business consultant, would prefer that the federal government would have less say over people’s lives. On the other hand, the Democrat in Republican Rep. Chris Smith’s New Jersey district, said, “scrapping the whole thing is just ridiculous.”