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KHN First Edition: March 24, 2017

KHN

First Edition

Friday, March 24, 2017
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Late Move To Dump ‘Essential’ Benefits Could Strand Chronically Ill
A last-minute attempt by conservative Republicans to dump standards for health benefits in plans sold to individuals would probably lower the average consumer’s upfront insurance costs, such as premiums and deductibles, said experts on both sides of the debate to repeal and replace the Affordable Care Act. But, they add, it will likely also induce insurers to offer much skimpier plans, potentially excluding the gravely ill, and putting consumers at greater financial risk if they need care. (Hancock, 3/24)

Kaiser Health News: Popular Guarantee For Young Adults’ Coverage May Be Health Law’s Achilles’ Heel
The Affordable Care Act struck a popular chord by allowing adult children to obtain health coverage through a parent’s plan until their 26th birthday. ... The policy has proven to be a double-edged sword for the ACA’s online health exchanges because it has funneled young, healthy customers away from the overall marketplace “risk pool.” Insurers need those customers to balance out the large numbers of enrollees with chronic illnesses who drive up insurers’ costs — and ultimately contribute to higher marketplace premiums. (Heredia Rodriguez, 3/24)

The Wall Street Journal: Trump Says If Vote on Health-Care Bill Fails, Obamacare Stays
Republicans prepared to take a high-stakes gamble Friday, when they are expected to bring to the House floor—at President Donald Trump’s urging—a GOP bill to replace the Affordable Care Act without knowing whether the vote will produce a victory or an embarrassing defeat. ... The decision to bring the bill to the floor appeared to put an end to days of negotiations, amounting to a calculation that lawmakers would view the vote as a do-or-die moment and opt to follow through on campaign promises to replace former President Barack Obama’s signature legislation with a more conservative alternative. (son, Hughes and Radnofsky, 3/24)

The Washington Post: Trump Delivers Ultimatum To House Republicans: Pass Health-Care Measure On Friday Or He’ll Move On
For Trump, who campaigned as a skilled negotiator capable of forging a good deal on behalf of Americans, it could either vindicate or undercut one of his signature claims. If the measure fails, it would be a defeat for Trump in his first effort to help pass major legislation and it may also jeopardize other items on his wish list, including a tax overhaul and infrastructure spending. Defeat would also mean that Obamacare — something that congressional Republicans have railed against for seven years — would remain in place. (DeBonis and Eilperin, 3/23)

Los Angeles Times: Trump Threatens To Leave Obamacare In Place If GOP Bill Fails
It remained unclear whether Trump’s extraordinary ultimatum was real or a pressure tactic designed to bring unruly Republicans in line. Despite personal appeals from the president and a flurry of last-minute negotiations with House Speaker Paul D. Ryan (R-Wis.), wary GOP lawmakers remained unconvinced, leaving leaders shy of the votes needed to advance the legislation. (Mascaro and Levey, 3/23)

NPR: Trump Ultimatum For House GOP: Vote On Health Bill Or Obamacare Stands
Trump, famous for his deal-making abilities, has tried to woo both unhappy factions of the GOP conference with little success. No consensus was reached during a meeting with the president and the roughly 40 members of the House Freedom Caucus at the White House earlier Thursday. Vice President Pence met with the maybe two dozen moderates in the so-called Tuesday Group, many of whom are also opposed to the bill. (Montanaro and Taylor, 3/23)

The Associated Press: House Sets Risky Health Care Vote After Trump Demands It
In a gamble with monumental political stakes, Republicans set course for a climactic House vote on their health care overhaul after President Donald Trump claimed he was finished negotiating with GOP holdouts and determined to pursue the rest of his agenda, win or lose. House Speaker Paul Ryan set the showdown for Friday, following a nighttime Capitol meeting at which top White House officials told GOP lawmakers that Trump had decided the time for talk was over. (Fram and Alonso-Zaldivar, 3/24)

USA Today: Damn The Torpedoes: GOP Sets Friday Vote On Health Care Despite Opposition
Rep. Chris Collins, R-N.Y., told reporters at the Capitol that Mulvaney’s message was: “The president needs this, the president has said he wants a vote tomorrow. If for any reason (it fails) we’re just going to move forward with additional parts of his agenda. This is our moment in time but the president is insisting on a vote one way or the other.” Collins said the message from the administration — Stephen Bannon, Reince Priebus and Kellyanne Conway also attended the meeting — was that negotiations were over and it was time to act. (Kelly, Collins and Shesgreen, 3/23)

Politico: Trump Demands Friday Vote On Health Care Plan
The move by Trump and Ryan is an enormous gamble, setting up a real cliffhanger when the legislation hits the floor on Friday. ... A loss on the House floor would be a glaring embarrassment for the new president and House speaker — one that could undermine other parts of the GOP legislative agenda, including tax reform. A victory, on the other hand, would provide not just a shot of badly-needed momentum for both men, but undermine the House Freedom Caucus, the group of conservative hard-liners who've fought the GOP health care plan because it doesn't go far enough. (Bade, Cheney and Dawsey, 3/23)

Reuters: Trump Demands Support In Do-Or-Die Friday Vote On Healthcare Plan
U.S. President Donald Trump warned House Republican lawmakers that he will leave Obamacare in place and move on to tax reform if they do not get behind new healthcare legislation and support it in a vote on Friday. It was not clear late on Thursday evening that Trump and the Republican leaders who crafted the bill had enough support to pass it, meaning they now risk defeat in their first attempt at major legislation and may fail to deliver on a key campaign pledge. (Cornwell and Becker, 3/24)

The New York Times: Trump The Dealmaker Projects Bravado, But Behind The Scenes, Faces Rare Self-Doubt
President Trump, the author of “The Art of the Deal,” has been projecting his usual bravado in public this week about the prospects of repealing the Affordable Care Act. Privately he is grappling with rare bouts of self-doubt. Mr. Trump has told four people close to him that he regrets going along with Speaker Paul D. Ryan’s plan to push a health care overhaul before unveiling a tax cut proposal more politically palatable to Republicans. (Thrush and Haberman, 3/23)

Politico: Delayed Vote A Setback For Trump The Dealmaker
“The closer,” it turns out, needs extra innings. ... The final straw for a Thursday deal was a lengthy White House meeting between Trump, his top lieutenants and the hardliner House Freedom Caucus, a group of conservatives who have pushed to strip requirements that insurance companies provide standard benefits such as maternity care in coverage plans. They couldn’t reach a deal, forcing the White House into a one-by-one effort to turn votes that one senior administration official described as “grinding.” (Goldmacher, Dawsey and Palmeri, 3/23)

USA Today: The House Health Care Battle: What's At Stake?
The House battle on overhauling health care represents the first major legislative test since Americans put Republicans in charge of Washington last November. ... The House vote on the bill, which still would need to pass the Senate, could presage how future legislative battles will play out and has ramifications far beyond health care. Here’s what’s at stake. (Slack and Korte, 3/22)

Politico: Trump Vs. The Freedom Caucus
The House Freedom Caucus has threatened to tank the House GOP Obamacare replacement bill unless they get what they want. But Trump is now calling their bluff. White House officials told members of the group on Thursday they have one shot: If they help defeat the American Health Care Act, the Trump administration is going to move on — meaning the Freedom Caucus could be pinned with actually saving Obamacare. The White House is betting that they will cave, given that saving Obamacare is something these conservative Republicans will never be able to stomach. (Bade and Bresnahan, 3/23)

The Associated Press: New Congress, All-GOP, Same Political Divisions
With control of the White House and Senate and a commanding majority in the House, Republicans were supposed to brush off any challenge from the hardline Freedom Caucus and work their will with impunity. But something happened on the way to governing. Now, House Republican leaders are struggling with the same divisions that plagued them under President Barack Obama. (Ohlemacher, 3/24)

Politico: How The GOP Could Still Salvage The Obamacare Repeal
House Republican leaders scrambling to buck up wavering members had portrayed the vote as the only shot to eliminate the GOP’s longtime boogeyman — and as an essential show of support for President Donald Trump. But in fact, they have several options to salvage the repeal effort after they couldn't muster 215 votes on Thursday. (Cancryn, 3/23)

The Wall Street Journal: In Health-Law Fight, GOP Leaders Struggle To Reconcile Factions’ Needs
After years of making the repeal of the Affordable Care Act a signature issue, Republicans are struggling to deliver on the promise, floundering amid warring factions that neither President Donald Trump nor House Speaker Paul Ryan have been able to whip into line. ... They are confronting a thorny challenge that required two things in short supply among today’s Republican rank and file: a willingness to compromise or to defer to leadership. (Hook and Epstein, 3/23)

Politico: Trump's Obamacare Repeal Concessions Likely Can't Pass Senate
Democrats say they are certain they can kill any language in the repeal bill that erases Obamacare’s mandate for minimum benefits in insurance plans. And top Republicans are making no promise that the last-ditch changes to win over conservatives will fly in the more centrist Senate, which is beginning to write its own health care plan. (Everett and Haberkorn, 3/23)

NPR: Republican Health Bill Could Remove Pre-Existing Condition Protections
When House Speaker Paul Ryan says he wants to repeal the Affordable Care Act so that people can buy insurance that's right for them, and not something created in Washington, part of what he's saying is that he wants to get rid of so-called essential health benefits. That's a list of 10 general categories of medical care that all insurance policies are required to cover under the Affordable Care Act. Getting rid of that requirement, or trimming it, is central to the Republican strategy, because they say those benefits drive up insurance premiums so much that healthy people won't buy coverage. (Kodjak, 3/23)

The Wall Street Journal: Basic-Services Requirement Is At Heart Of Health-Insurance Split
At the heart of the last-minute negotiations over the House GOP health-care bill is a pillar of the Affordable Care Act: the requirement that most insurance policies cover a basic set of health services, including such items as maternity and mental-health care. Repealing that requirement, as many conservatives want, would topple a core element of the ACA that sought to protect patients from the high cost of using a health service not covered by their insurance. (Armour, 3/23)

Los Angeles Times: Obamacare 101: 4 Things You Need To Know About 'Essential Health' Benefits
Among the most important — and little understood — new insurance rules put in place by the Affordable Care Act was a requirement that health plans cover a basic set of benefits. The requirement was part of a package of new consumer protections in the healthcare law, including a prohibition on insurers denying coverage to people with preexisting medical conditions and bans on annual- or lifetime-limits on coverage, which were once common. (Levey, 3/23)

USA Today: Dropping Obamacare's 'Essential' Benefits Impacts More Than Mammograms
Eliminating required health insurance benefits, a move discussed as part of the Republican move to repeal the Affordable Care Act, also threatens to kill the ACA's annual and lifetime limits on patients' costs, which was enacted to prevent bankruptcies due to medical costs. The limits on out of pocket costs only apply to the ACA-required 10 essential health benefits, which include prescription drugs and hospital care. So eliminating the benefit requirement makes the limits "essentially meaningless," says health care legal expert Tim Jost. (O'Donnell, 3/23)

The Washington Post: ‘I Wouldn’t Want To Lose My Mammograms,’ Male GOP Senator Says — Then Immediately Regrets
It’s a common question among those decrying the cost of health insurance: Why should you have to purchase a plan that covers procedures you won’t ever need? Especially if, say, you’re a guy, and your plan covers maternity care — as Obamacare requires most plans sold through an exchange to do? It’s also a philosophy in conservative circles gaining momentum as Republicans try to deconstruct Obamacare, (Phillips, 3/23)

Politico: CBO: Revisions To GOP Health Plan Add To Deficit Without Improving Coverage
House GOP leaders' amended Obamacare repeal bill would cost billions more — without covering more people, according to a new report by the CBO. The slate of changes offered by House GOP leaders this week as they sought more support for their bill to partly repeal and replace the Affordable Care Act would cost $186 billion more over 10 years compared to their initial version, according to a 10-page report from the nonpartisan scorekeeper. (Ferris, 3/23)

The Associated Press: Republican Health Bill Would Widen America's Big Wealth Gap
House Republicans' health care bill provides massive tax cuts to the wealthy while increasing taxes for many lower income families, adding to America's big income gap between the rich and everyone else. Over the past quarter century, only one group of people has seen significant increases in income — those at the very top. Families in the middle or at the bottom of the economic ladder have seen little or no increase in wages. ... The GOP health bill exacerbates those disparities, according to a new report by the nonpartisan Tax Policy Center. On average, taxes would go down for families making more than $50,000 a year, while taxes would increase for many families making less, the report said. (Ohlemacher, 3/23)

The Wall Street Journal: House GOP Super PAC P
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