Policy

Congress, Industry Hit Reset After Obamacare Repeal Fails

Rep. Mark Meadows, R-N.C., leaves a meeting of the House Republican Conference in the Capitol on July 28, 2017. (Tom Williams/CQ Roll Call)

By LAUREN CLASON and ANDREW SIDDONS

House Republicans appeared divided and frustrated Friday morning about their next steps on health care legislation, hours after their Senate colleagues fell short of passing a scaled-back repeal.

House Republicans attending a conference meeting Friday morning described a disappointed mood hanging over them as Speaker Paul D. Ryan of Wisconsin read lyrics from the song “The Wreck of the Edmund Fitzgerald.” The ballad, by Gordon Lightfoot, is about a Great Lakes shipwreck that the song suggests could have been avoided if the crew had decided to keep sailing through a storm.

Earlier Friday morning, GOP Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona had voted against a “skinny repeal” amendment, forcing Majority Leader Mitch McConnell, R-Ky., to pull the bill from the Senate floor.

Some House Republicans appeared ready Friday to move on to a tax overhaul and fiscal issues, while others insisted the health care effort could be revived.

Those who were optimistic that work on health care could continue differed about the shape it would take. While moderates such as Reps. Charlie Dent, R-Pa., and Leonard Lance, R-N.J., stressed the importance of working with Democrats, more conservative members advocated continuing a Republican-only approach.

Rep. Mark Meadows, leader of the conservative House Freedom Caucus, thought the Senate would keep working out its differences. “I’m still optimistic we’ll have another motion to proceed and put something on the president’s desk,” he said. “The reconciliation process is not dead.”

Some House members vented about their frustrations with the Senate’s inability to come together on a repeal.

“It’s a huge disappointment,” said Rep. Richard Hudson, R-N.C. “How dare these senators not deliver on the promise we all made, that they all campaigned on? They can’t stop now.”

Republican Study Committee Chairman Mark Walker, R-N.C., suggested there should be some kind of consequences.

“Senate guys are part of our team so we can’t be out saying this or whatever, but there’s still a lot of frustration that exists,” Walker told reporters. “And I think at some point, accountability is not out of order for our Senate companions.”

‘More work to do’

But other Republicans suggested the need to move on to other health care priorities with the hope that aspects of repeal could be addressed at the same time.

A number of health care insurers have abandoned marketplaces in several states, citing the uncertainty in Washington as a major factor.

“We’ve got more work to do going forward, clearly, to rescue these markets,” said Rep. Greg Walden, R-Ore., chairman of the Energy and Commerce Committee.

Walden noted that a variety of legislative efforts could be vehicles for aspects of repeal legislation, including an expected renewal of expiring funding for the children’s health insurance program or reauthorization of community health centers. He thought that a repeal of the Independent Payment Advisory Board, a controversial commission the 2010 health care law called for but which has never been established, could still have traction in Congress. He noted the importance of paying the law's cost-sharing reductions, which the Trump administration controls and insurers say are critical.

Walden did not rule out working with Democrats.

Any pieces of health care legislation also will be targets for industry groups who were disappointed along with Republicans last night. JC Scott, chief advocacy officer for the medical device trade group  Advanced Medical Technology Association, said the group is examining the calendar to see where a repeal of the medical device tax might fit in, noting that members on both sides of the aisle support the repeal.

The trade group America’s Health Insurance Plans, which has stayed largely neutral during the repeal debate, said it will continue to work with both parties going forward.

Tax legislation

Ryan indicated in a statement that the House is moving on to a tax overhaul and urged the Senate not to give up on changing the health care law.

“We have so much work still to do, and the House will continue to focus on issues that are important to the American people,” he said in a statement. “At the top of that list is cutting taxes for middle class families and fixing our broken tax code. I’m glad that members will now take time to hear directly from those they represent and make the case for historic tax reform that we intend to pursue in the fall.”

But doing tax legislation without completing a health care bill first will be tricky, Rep. Trent Franks, R-Ariz., acknowledged.The health care bill would have repealed taxes, leaving fewer tax changes to be addressed in the tax bill.

“Obamacare was the biggest tax increase in the history of the human family,” he said. “We have to deal with that so we have a baseline to deal with the tax code. I’m afraid at this point we’re going to have to work around that, because I’m not sure there’s going to be time.”

Given the outcome on in the Senate, it seems unlikely that any health care repeal legislation could pass the Senate. Hours before the vote Thursday, McCain told reporters he would not vote for the bill, but then backtracked.

“I never voted for a bill that I didn’t want to become law,” he said.

McConnell indicated he thought Democrats would face a political pushback on their health care policy ideas.

“It’s time for our friends on the other side to tell us what they have in mind,” he said in a speech after the vote. “And we’ll see how the American people feel about their ideas.”

Mary Ellen McIntire and Sandhya Raman contributed to this report.

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