(AP) — A substantial 12 million people have enrolled for coverage this
year under the very health care statute that President Donald Trump and
the Republican Congress want to erase, the government said Wednesday.
a crunch-time House vote on a GOP bill replacing that law planned for
next week, Vice President Mike Pence ensured conservative lawmakers that
the administration was open to changes.
Pence's trip to the
Capitol, and an evening all-hands meeting of House Republicans to count
votes, came as GOP leaders strained to win backing for besieged
legislation that's uniformly opposed by Democrats. The bill would strike
down much of former President Barack Obama's 2010 overhaul and reduce
the federal role, including financing, for the nation's health care
"Where is the sweet spot, that's what we're working
on," said Rep. Barry Loudermilk, R-Ga., among the conservatives who met
with Pence. He said the vice president's pitch was: "The process is
open, we're still working on it, bring your ideas forward and let's get a
With opposition from conservative and moderate GOP
lawmakers endangering the measure in the House and Senate, President
Donald Trump was expected to urge lawmakers to back the bill in remarks
in Nashville, Tennessee. Health secretary Tom Price was using phone
calls to lobby Republican governors, some of whom — with home-state GOP
members of Congress — oppose the bill's phaseout of Obama's expansion of
Medicaid to 11 million additional lower-income Americans.
GOP leaders' push-and-pull problem, around 60 conservatives who met
with Pence proposed revisions in the other direction, including a
hastening of the Medicaid expansion phaseout to 2018 instead of the
"He gave us a lot of hope," said Rep. Mark Walker, R-N.C., leader of the group that met with Pence.
White House, GOP leaders and rank-and-file lawmakers were negotiating
over modifications that could be made when the bill reaches the House
floor. On CNN, House Speaker Paul Ryan, R-Wis., said changes might give
states more "flexibility" to oversee Medicaid.
In the Senate, the
GOP's 52-48 edge and widespread dissension leaves leaders little leeway.
Sen. Charles Grassley, R-Iowa, expressed worries about higher costs on
seniors and predicted the Senate would reject the bill without changes.
want deeper cuts in the overall Medicaid program than the Republican
bill plans and a work requirement for able-bodied constituents. They're
also seeking less generous tax credits for people's health care costs
and elimination of Obama's insurance requirements, including mandatory
coverage of specified services like drug counseling.
Every one of those proposals would endanger support from moderates.
"This is going to take a lot of political capital from the president" and congressional leaders, said Rep. Dennis Ross, R-Fla.
bill would enfeeble Obama's individual mandate — the requirement that
Americans buy coverage — by abolishing the tax fine on violators. It
would end subsidies that help low-income people with high insurance
premiums the most and replace them with tax credits that are bigger for
older people. It would cut Medicaid, repeal the law's tax increases on
higher earning Americans and allow 30 percent higher premiums for
consumers who let coverage lapse.
The latest government sign-up
numbers missed Obama's target of 13.8 million people for 2017. The
figures represent initial enrollment, and there's usually significant
attrition over the course of a year.
Nonetheless, experts said the
report undercuts Republican claims that the health law's insurance
markets are teetering toward collapse, which they say makes repealing
the law crucial.
"While there's a big debate in Washington about
the future of the Affordable Care Act, the law remains in place for now
and is covering millions of people," said the nonpartisan Kaiser Family
Foundation's Larry Levitt, using the formal name of Obama's statute.
official national figure of 12.2 million excludes 765,000 people signed
up under a related Obama-era law used by New York and Minnesota.
Centers for Medicare and Medicaid Services released the figures a day
before the House Budget Committee plans to advance the GOP bill in a
potentially tight vote. The committee can't make significant changes,
but Republicans were expected to approve non-binding suggestions to nail
GOP support became scarcer when the nonpartisan
Congressional Budget Office found this week that the legislation would
push 24 million Americans off coverage in a decade and shift
out-of-pocket costs toward lower income, older people. That's 4 million
more than the 20 million who've gained either Medicaid or insurance
coverage under Obama's law.
Hundreds of conservative activists
rallied outside the Capitol in sub-freezing weather to call on
congressional leaders and Trump to abandon the GOP bill and fully repeal
Obama's law. The rally was organized by FreedomWorks, a conservative
group backed by the billionaire Koch brothers.
"They're telling us
that you campaigned for Obamacare light and you want partial repeal!"
said Sen. Rand Paul, R-Ky., among conservative lawmakers who say the
House GOP bill is too timid.
"No!" the crowd replied.
GOP Gov. Brian Sandoval, who expanded Medicaid coverage to over 300,000
additional people in his state, said in a phone call, Price promised
"flexibility" in administering the program.
Press writers Erica Werner in Washington, David Pitt in Des Moines, Iowa
and Alison Noon in Carson City, Nevada, contributed to this report.