Price on AHCA: Everything's on the table -- except a clean repeal

Just how, exactly, will Donald Trump and Republican leadership generate an ObamaCare repeal-replace bill that can pass both the House and the Senate on reconciliation? It’ll be a “fine needle,” HHS Secretary Tom Price told George Stephanopoulos on ABC’s This Week yesterday, but the administration’s willing to play Let’s Make a Deal to get it done — with one exception:

A straight repeal of former President Obama‘s 2010 healthcare law would put “vulnerable people at risk,” Health and Human Services Secretary Tom Price said Sunday.

“That is not something that the president is willing to do. It’s not something that he said he would do,” Price said of a clean repeal during an appearance on ABC’s “This Week.”

“Certainly what he has said is that repeal and replace need to occur essentially at the same time, concurrently, and that’s what we’re moving forward with in this first phase,” Price said.

Stephanopoulos described the negotiation process for the American Health Care Act (AHCA) as a “squeeze play. “Everything you do to get votes in the House,” he pointed out to Price, “is going to cost you votes in the Senate.” True enough, Price said, but he believes that the path exists to get to full Congressional approval for a repeal-replace bill, even if it means losing Rand Paul, who insists on nothing more or less than absolute repeal first.

The AHCA will get its first public test this week. Paul Ryan told Chris Wallace on Fox News Sunday that he plans to bring the bill to the floor, but that negotiations would still take place to firm it up. One change coming will give more protection for older Americans between 50-64, who have the most to lose in the transfer between ObamaCare and the AHCA. But the hypothetical comparisons to ObamaCare miss the point, Ryan argues, because ObamaCare will collapse anyway, leaving nothing at all for older or younger Americans:

RYAN: Here’s the point: we believe that we do need to add some additional assistance with people in those older cohorts.  But the apples to oranges comparison that’s happening here is, we’re not going to make people buy something that’s so expensive that they can’t afford, that the market is not going to offer.

And so, where I dispute that comparison is it suggests that we’re going to have the same kind of plans being offered in ten years that ObamaCare would otherwise offer.  It won’t be; it is collapsing.

Ryan says he “feels good” about the AHCA’s prospects … in the House, anyway:

WALLACE: So, what would you say the prospects that you have the votes and will be able to pass it on Thursday?

RYAN: Yes, I feel very good about actually. I feel like it’s exactly where we want to be. The reason I feel so good about this is because the president has become a great closer. He’s the one who was helped negotiate changes to this bill with members from all over our caucus. I call it getting the sweet spot, you’ve got to get 218 Republicans, who come from all different walks of life, to come together to agree on the best possible plan to repeal and replace ObamaCare.

And the reason I feel very good where we are, we all, all of us, all Republicans in the House, Senate, and the president, made a promise to the American people that we would repeal and replace this faulty collapsing law, and we’re going to make good on that promise.

Wallace didn’t press Ryan on the difficulty the AHCA will face in the Senate. That’s more Mitch McConnell’s headache, and he’ll get it perhaps as soon as the end of the week. The House version of the AHCA will split the caucus, though, and McConnell can’t get any help from Democrats, who have no incentive to join in the replacement plan as long as ObamaCare remains alive. The end result may be a conference-committee process, with two very different repeal-replace plans and a handful of Republicans from both chambers tasked with blending them together well enough to produce legislation that Donald Trump can sign. Right now, though, the path to success looks like threading a fine needle hidden in a field of haystacks.

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