Brain trust in Trump's health care says no thanks

President Donald Trump has promised a new plan to replace Obamacare. But the four Republicans in the Senate he hired for the job do not jump occasionally.

Senator Rick Scott (R-Fla.) Said that any new plan was to come from the White House – and that he had not been warned that Trump was planning to incorporate him into the group. health policy. Mitt Romney (R-Utah) will say no more than he and his colleagues "are working on health care". John Barrasso (R-Wyo.), Questioned on the Republican plan, referred the issue to the opposition, saying: "Democrats want to participate in the government's complete takeover of health care."

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And Senator Bill Cassidy (R-La.), The fourth member of the Trump team, has nothing but "conversations with colleagues" about affordability of health care.

It is clear that a week after the start of the transformation prescribed by Trump as a "health care party," few lawmakers want the ownership of a problem proven to be toxic to the political future of Republicans. The GOP is deadlocked over the replacement of its position since the cancellation of its highly publicized cancellation project in the fall of 2017. This has left the party paralyzed – reluctant to contradict Trump, but fears of embarking on a another campaign cycle without a consistent message in health. Those most qualified to develop a plan have no interest in the work, while others who want another repeal effort do not gain popularity.

Barrasso, the Republican in Senate No. 3, has been meeting regularly with the White House over the past week. But there is no indication that these discussions have led to conclusions other than the realization that it is easier to shift attention to the Democrats.

Barrasso said a GOP plan would include a guarantee that people can "buy insurance that works for them and their families and is affordable."

Such platitudes – contrary to Trump's vows of confidence that the GOP would effectively replace Obamacare with a "really great" plan in 2020 – only accentuated the gaping gap between the White House and the Republicans Hill on a file that seems ready to fire the party.

"This will be part of the campaign, the debate," said Sen. John Cornyn, of Texas, Republican in the Senate and re-elected for next year. "That someone likes it or not."

Everywhere on the Capitol, there is a little more enthusiasm but even less consensus on starting points.

"It is desirable to convene working groups to define policy positions," said Representative Tom Reed (RN.Y.), who described the GOP as being in the phase of "digesting, listening and compiling ideas ".

House freedom caucus chair Mark Meadows (RN.C.) said that he and other conservative lawmakers were working on their own ideas, but he added that they "will more conceptual than the current legislative text ".

Republicans are not completely devoid of ideas. But they still have to overcome the divisions between centrists and conservatives that led to their last repeal effort. In its budget request for the 2020 fiscal year, the White House had resumed the outlines of the failed Graham Cassidy plan, which sought to repeal Obamacare in favor of granting federal grants to the states. to establish their own insurance markets.

This legislation – which provoked protests against projections that it would cover millions of people – is not getting enough support, even among Republicans. Cassidy, who helped develop the plan, has since declared the proposal "dead". His office then said that Republicans needed to develop something new.

Representative Kevin Brady (R-Texas), a top Republican on the House Ways and Means Committee, on Wednesday called for "a fresh start for health care." It does not have much to offer, however, beyond calls to revive old legislation. Obamacare repeals the failed bills in 2017 and the Trump administration rules that deregulate the insurance market that the courts have blocked.

A new and concrete proposal presented by a Hill Republican: Arkansas Rep. Bruce Westerman's legislation loosening the Obamacare regulation and codifying Trump's key policies, giving a conservative aspect to the existing law. But the bill, which was released in February, has no co-sponsors.

External conservative groups are not doing much better, even though they have spent more than a year trying to support their ideas in Congress and the White House. The "Health Care" proposal developed by leading right-wing think tanks would provide lump-sum grants to states to cover residents – a concept that, according to the authors, can begin the process of realizing Trump's commitment to tackle the problem after 2020.

"There is a perception problem that what was done in 2017 lacked a clear direction other than fulfilling a campaign promise," said Marie Fishpaw, Director of Policy Studies. interior to the Heritage Foundation. "President Trump is therefore right to challenge his party to come up with a plan, because you can not hold another election where you say," Give us power. You must do the work now, and we are doing the work. "

The group is still facing a well-known problem: the Conservatives claim that the plan did not go far enough to repeal Obamacare and that more moderate Republicans fear violating their promises to protect people with pre-existing diseases.

Obamacare would assume that health insurance plans cover essential benefits such as hospitalization and prescription drugs, and would once again allow insurers to charge much higher rates to older clients than young registrants – a provision that the supporters of Obamacare call "age tax".

Some conservative Republicans, for their part, balk at its inability to get rid of the law more.

"It would take a lot of convincing to join us," said Jason Pye, Vice President of Legislative Affairs for FreedomWorks, adding that any GOP proposal needed to eliminate basic Obamacare patient regulations and impose a higher cap. strict on the funding of Medicaid. "This is not a repeal plan, and any suggestion otherwise is purposely false."

Last year, the White House told Republican groups that it would not support the Health Care Choice plan without the consent of the entire conservative community. And few lawmakers polled this week said they have already heard of this proposal.

"One would think that any conservative plan would eventually reach the freedom caucus, so maybe that's the news here," Meadows said.

Trump's congressional allies, such as Meadows, insist that the party must make health care a top priority, as Democrats are required to use Obamacare as a club after feeding their mid-term victories. Senate Republicans are facing a much stricter electoral map in 2020, and Democrats have made it clear that they will continue to pound the GOP for trying to eliminate the popular protections of patients in Congress and in front of the US. courts.

"If you look at eight years of the Republican majority, they have never come up with an alternative," said House Budget Chairman John Yarmuth (D-Ky.). "We will continue to emphasize the fact that they have no solution and have never done so."

The Republicans who were at the opening of the conference room were convinced that they could exploit – attacking the proposals of the "Medicare for All" regime of the Democrats as a senseless threat to private insurance – had been compromised by the Trump's new offensive against Obamacare.

"The president has a chair of tyrant, he is an unconventional leader. We do not always know what he's going to say, "said Rep. John Shimkus (R-Ill). "So, surprise! He hands us the ball and we have to run with her now. "

This leaves some vulnerable Republicans looking for answers inside.

"Republicans must make it very clear to the American people, in health care, that we will have a solution to the problem," said Senator Thom Tillis (RN.C.), who is to be re-elected to a key state. "If you look at the proposals we looked at when we were about to repeal Obamacare, it will probably be these and some new ideas."