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March 08, 2017 12:00 AM

Obamacare replacement and repeal: 4 things to watch now

Virgil Dickson
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    Ryan has promised the House will repeal most of the ACA via an expedited budget reconciliation bill passed on a party-line vote by early April.

    The American Health Care Act was unveiled on Monday, with two markups in the U.S. House of Representatives today. The House Republican bill includes controversial proposals to repeal Affordable Care Act reforms that had received support from federal and state lawmakers. But, some factions of the GOP are still divided on many of the bill's proposals.

    Here are the key players and points to watch as the bill moves through Congress:

    1. Dissent within GOP House ranks: The Freedom Caucus, a group of nearly 40 ultra-conservative House members who have taken issue with the bill's tax credit provision and could have the votes to take down the bill.

    2. Crumbling Senate support: Four GOP senators, Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska, have already vowed to vote against the proposed law unless it is updated to address their Medicaid expansion concerns. Without their support, the bill could die in the Senate.

    3. More letters written in protest: Freedom Partners and Americans for Prosperity in a joint letter on Tuesday said the proposed law creates a new entitlement in the form of tax credit subsidies, turning the American Health Care Act essentially into Obamacare 2.0.

    4. Continued arguments on how to pay for healthcare: Sen. Marco Rubio (R-Fla.) told hospitals attending a health policy conference hosted by the Federation of American Hospitals that Republicans need to develop some policy option to help low-income individuals buy insurance. If they don't fund tax credits, the federal government will be on the hook to help cover the inevitable increase in uncompensated-care costs incurred by hospitals.

    It's unclear how the impasse will end, but the American Health Care Act has received an endorsement from President Donald Trump via tweet, which could embolden Republican lawmakers to move forward with the bill, mostly as is, despite the pushback from their more conservative colleagues.

    For ongoing coverage of the House markups today, check out our story in progress, "Dems open ACA repeal bill hearing with slashing attack."

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