GOP Discusses Repairing Health Law

WASHINGTON (AP) -- While insisting they've not abandoned their goal of repealing President Barack Obama's health care overhaul, Republicans are increasingly talking about "repairing" it as they grapple with disunity, drooping momentum and uneasy voters.

The GOP triumphantly shoved a budget through Congress three weeks ago that gave committees until Jan. 27 to write bills dismantling the law and substituting a Republican plan. Everyone knew that deadline was soft, but now leaders are talking instead about moving initial legislation by early spring.

And as the party struggles to translate its long-time political mantra into legislation that can pass Congress, some Republicans have started using different language to describe the effort.

"It's repairing the damage Obamacare has caused. It's more accurate" than repeal and replace, said Sen. Lamar Alexander, R-Tenn., who chairs the Senate health committee. He notes that President Donald Trump and many Republicans want to keep popular pieces of the overhaul like requiring family policies to cover children up to age 26.

"It probably lessens people's anxiety that we won't pull the rug out from under them," Rep. Pat Tiberi, R-Ohio, who chairs a House health subcommittee, said of the term "repair."

The refined rhetoric comes as much of Washington's focus has shifted to Trump's nomination of Judge Neil Gorsuch for the Supreme Court vacancy and Democratic attempts to derail GOP efforts to confirm Cabinet members. That and controversies surrounding Trump's temporary refugee ban have sapped some energy from the health care drive.

It also comes with polls spotlighting the GOP's risks. A recent Associated Press-NORC Center for Public Affairs Research poll found 53 percent want to keep Obama's law in some form, and 56 percent are "extremely" or "very" concerned that repeal means many will lose insurance.

House Speaker Paul Ryan, R-Wis., has been saying Republicans want to "rescue" the health system and Thursday embraced all of the competing phraseology, saying, "The best way to repair a health care system is to repeal and replace Obamacare."

But talk of a repair dismays other Republicans, including hard-line conservatives. They say their message since Democrats enacted the 2010 law was that the GOP would repeal it, a goal later amended to "repeal and replace."

"You've got to repeal the law that's the problem. That's what we told the voters we were going to do," said Rep. Jim Jordan, R-Ohio, a leader of the conservative House Freedom Caucus.

Jordan cites problems that have accompanied the statute, including rising premiums and deductibles and diminished insurance choices in the individual market in some communities. He says health care would improve if Obama's law vanishes.

"If you start from that premise, repair shouldn't be your mindset," Jordan said.

Democrats say the GOP's evolving language signals retreat. They say Republicans will threaten health care's availability and raise rates, angering the 20 million people who gained insurance under the law and tens of millions of others who benefit from the statute's coverage requirements.

"It puts the burden on them to come up with the so-called repairs," said No. 2 Senate Democratic leader Richard Durbin of Illinois. "What a departure from repeal it, walk away from it and America will be a better place."

Behind the scenes, Republicans continue shaping proposals to void Obama's statute. Potential targets include the law's requirement that people who don't get coverage at work buy policies, the subsidies many of them receive and the tax increases imposed to finance its programs.

But they've encountered internal disagreements.

Some Republicans want to abolish the law's broadening of Medicaid to provide health coverage to more lower-earning people, while others are from states that accepted the expansion. Most want to include language blocking federal payments to Planned Parenthood, but some don't, and some want to let states keep Obama's law intact.

There are disputes over whether to quickly repeal the law's tax increases on higher-income people and the health industry, and how to provide money so people don't abruptly lose coverage and insurance companies fearing losses don't stop selling policies.

With insurers crafting their 2018 rate structures over the coming two months, the insurance industry's leading trade group made its jitters clear to Congress this week. Marilyn Tavenner, president of America's Health Insurance Plans, told Alexander's committee that insurers need to know soon whether lawmakers will continue the federal payments that let companies reduce out-of-pocket costs for many lower-earning customers.

Losing those subsidies "would further deteriorate an already unstable market and hurt the millions of consumers who depend on these programs for their coverage," she warned.

At a hearing Thursday before a House health subcommittee, Republicans revealed four "discussion drafts" of potential bills. They included letting insurers charge older customers higher rates and shortening the law's 90-day grace period for consumers to pay premiums.

Another would replace the law's unpopular individual mandate with a requirement that people maintain "continuous" coverage if they want to avoid paying more for policies.

(KA)