Health Care Law: Obamacare Wins, Trumpcare Loses

WASHINGTON, DC — Republicans on Friday killed their own legislation to overhaul the nation's healthcare system after failing to win enough votes for passage despite pleas, threats and proposed deals from President Trump, whose intense and high-profile lobbying effort ended in a publicly naked failure.

“Obamacare is the law of the land,” House Speaker Paul Ryan said after canceling a floor vote on the bill when he concluded it would fail. “It’s going to remain the law of the land until it’s replaced.”

He and other Republicans, including the president, acknowledged they have no current plans to try again.

Republican candidates for Congress had campaigned for seven years to repeal the plan, ushered through Congress by President Barack Obama who signed it into law in 2010 as the Affordable Care Act, known commonly as Obamacare. Trump too had peppered his speeches in his run for the White House with dire warnings of the program's collapse.

His negotiating skills were superior to anybody he had faced during his decades as a businessman, Trump had told voters, offering assurance his experience cutting deals would be used not only to repeal Obamacare but also to replace it with a program that would provide insurance for everybody and with better care at less cost.

Trump discovered from the health care loss that negotiating with Congress wouldn't be easy.

Following bill's death, Trump said that further attempts to change the law could wait, adding, "I never said I was going to repeal and replace in the first 61 days."

The comment was true. As a candidate and after being elected, Trump had said he would repeal Obamacare on "Day One of his presidency.

He took no responsibility for the GOP loss, instead blaming Democrats for the defeat and predicting they would practically come begging for changes after the cost of premiums increases. And he seemed to welcome the coming "chaos" he predicted would strike the country if Obamacare prevailed.

“The best thing we can do politically is let Obamacare explode," Trump said after the legislation failed. "As you know, I’ve been saying for years that the best thing is to let Obamacare explode and then go make a deal with the Democrats and have one unified deal. And they will come to us, we won’t have to come to them.”

An end to Obamacare without a planned response would be cripple every aspect of the health care system and be devastating to millions of people, including many who would likely die for lack of insurance coverage.

An estimated 20 million Americans have gained health insurance under Obamacare, reducing the number of uninsured to unprecedented levels. Under the law, insurers are barred from denying coverage for people with preexisting conditions, young adults are guaranteed coverage under parent's plans until age 26, policies with lifetime spending limits are banned, subsidies are provided to help with insurance costs and millions of dollars have been sent to dozens of states to pay for expanded Medicaid programs.

Obamacare has had its problems, though, which Democrats have acknowledged and promised to fix alongside Republicans but only on the condition that they would abandon plans for a full repeal. Increasing premiums and higher deductibles, caused mainly because fewer young people than expected have enrolled, have been chief among the complaints.

Still, with any new government program, especially one as expansive as Obamacare, hiccups could be expected, Democrats have argued. Its demise was being exaggerated, Democrats said, and even with its flaws it has helped more people than the proposed Republican plan. The Congressional Budget Office projected premium costs would stabilize within three years.

“Let’s just, for a moment, breathe a sigh of relief for the American people that the Affordable Care Act was not repealed,” said Representative Nancy Pelosi of California, the House Democratic leader.

The GOP's American Health Care Act projected that 14 million people who are currently insured would be uncovered by next year and a total of 24 million people would have no insurance by 2026. It would have cut subsidies and limited Medicaid expansion past 2020. The plan called for more than $300 billion in tax cuts, mostly for the wealthy.

"Many people don't realize how good our bill was," Trump said.

It faced trouble from the start.

With House Democrats united in opposition, hopes of passing the bill were quickly diminished when conservative Republicans ridiculed it as "Obamacare light" because it contained many of the provisions in the law it would replace, and they vowed not to vote for the bill without changes that reduced benefits.

More moderate Republicans issued conflicting demands, leery of the Congressional Budget Office’s assessment that the bill would leave 24 million more Americans without insurance in 2024, compared with the number who would be uninsured under the current law. Most of those who would have been affected live in solidly Republican voting district.

"It's an interesting period of time, I think we learned a lot," he continued. "I think we have to let Obamacare go its way for a while."

He said the administration would be moving on to other priorities, with tax reform likely next.

Ryan blamed the failure on "growing pains."

"There remains so much we can do to improve people's lives," he said in a statement. He was proud of the bill the House produced, he said, and predicted that the worst of Obamacare is yet to come.

Robert Costa, a Washington Post reporter, first broke the news about the bill being pulled, saying President Trump told him on the phone.

Ryan had scheduled a House vote on the bill for Thursday, then delayed it until Friday and then canceled it after traveling to the White House to tell Trump there were not enough votes to pass the bill.

The White House had been confidently predicting all week that the bill would pass on schedule Thursday evening.

On the floor of the House prior to the bill's demise, Rep. John Lewis, the Georgia Democrat and civil rights activist, decried the American Health Care Act.

"We will fight any bill that turns the clock back to a darker time," he said. "I oppose this bill with every breath and every bone in my body."

Trump used — what else? — Twitter to publicly pressure his party to support the bill.

Republican Rep. Rodney Frelinghuysen of New Jersey, remained undecided on whether to vote for the bill but announced Friday morning that he would vote to kill it. As chairman of the Appropriations Committee, his break with party leadership was significant.

"Unfortunately the legislation before the House today is currently unacceptable as it would place significant new cost and barriers to care on my constituents in New Jersey," he said in a statement. "In addition, to the loss of Medicaid coverage for so many people in my Medicaid-dependent state, the denial of essential health benefits in the individual market raises serious coverage and cost issues."

In the end, House leaders used a variation of the "She's not Hillary" pitch repeated during the presidential cmpaign.

This time, they argued that as bad as their bill might be, it's not Obamacare.

Ryan said his party had no plans on whether to take another run at Obamacare but he emphasized health care would no longer be a top priority.

“Moving from an opposition party to a governing party comes with growing pains,” he told reporters. “We’re feeling those growing pains today.

“Doing big things is hard.”

Associated Press Photo/Pablo Martinez Monsivais