As the Easter recess looms, House Republicans face new armtwisting by the White House to back a newly revised version of the Obamacare repeal and replace bill that collapsed two weeks ago.
But many House and Senate Republicans are more worried about the reception they'll face when they go home for the two-week recess. It's likely they'll encounter protests by constituents upset and angry about GOP efforts to roll back health coverage under the Affordable Care Act. Healthcare provider groups also may come calling.
At the same time, the lawmakers may face fire from conservative voters furious they have failed so far to fulfill their seven-year-old promise to wipe out the law.
Pro-ACA activists are organizing people to turn out at town hall events held by congressmen and senators around the country, and at so-called “with you or without you” events in districts where congressional Republicans aren't scheduling town halls. Some House Republicans being targeted include California congressmen Jeff Denham and Tom McClintock, Kentucky's Jim Comer, Randy Hultgren in Illinois, and Virginia's Bob Goodlatte.
“We'll be showing up at Rep. Goodlatte's open-door meeting on April 13,” said John Schaldach, of Harrisonburg Indivisible, a liberal-leaning protest group. “He knows he's out of line with his district on this one.”
“People will be raising their voices during the recess that they want members to move on from repealing the ACA and find bipartisan proposals to keep people covered, lower costs, and protect people with pre-existing conditions,” said Claire McAndrew, director of campaign strategy for Families USA, a pro-ACA advocacy group.
Republicans aren't looking forward to these encounters, after getting skewered at town hall events in February over their ACA repeal efforts. They had many uncomfortable faceoffs with people who told them Obamacare had saved their lives. Some of those encounters were captured on video and went viral. That's at least partly why GOP leaders had hoped to pass ACA repeal-and-replace legislation before the Easter recess, to reduce the chances their members would lose their nerve after getting a blast of face-to-face anger from voters.
This time House Republicans are just as worried about fierce attacks from the right over their failure to achieve anything.
Rep. Mark Amodei of Nevada told Bloomberg News he doesn't even know what to tell his constituents or healthcare industry representatives back home because “I don't know what the latest iteration of the bill is.” He said he would have preferred having the House hold hearings featuring industry experts discussing the potential impact of the legislation. No such hearings were held.
“We expect this issue to be brought up at any town hall Congressman Amodei hosts,” his spokeswoman told Modern Healthcare.
Republicans from conservative districts are more immediately concerned about anger from GOP base voters who sent them to Washington to roll back the ACA, said Robert Blendon, an expert on healthcare politics at Harvard University.
“The Republican bill isn't very popular,” he said. “But the biggest problem they'll have is they promised to do something and did nothing. That's very hard to explain.”
They are “going to go home and get hammered for not repealing Obamacare,” Tom Scully, former CMS administrator in the George W. Bush administration, told Kaiser Health News.
That explains why the White House and some House Republicans were still talking Thursday about returning early to vote on the amended version of the American Health Care Act.
The revisions, for which no bill text has been released, reportedly would let HHS grant waivers to states to relax the ACA's insurance rules such as minimum essential benefits and community rating. The idea is to let insurers sell cheaper, stripped-down health plans that would attract healthier consumers. In addition, the amended bill would provide an extra $15 billion over 10 years to establish high-risk pools or pay insurers for the costs of their sickest and most expensive enrollees.
House ultraconservatives and relative moderates remain divided over the bill's provisions. Most hospital and physician groups are sharply critical of the legislation because it would cause a big increase in the number of uninsured Americans and sharply increase costs for many consumers, particularly those who are older and have chronic conditions.
The latest Kaiser Health Tracking Poll, conducted last week, illustrates the whipsaw of public opinion congressional Republicans face. It found that 64% of the public overall said it was a good thing Congress did not pass the American Health Care Act. But 54% of Republicans saw the failure as a bad thing. And 58% of Republicans said the AHCA didn't pass mainly because it didn't go far enough to end Obamacare.
On the other hand, three fourths of the public, including 51% of Republicans, said the Trump administration should do what it can to make the current healthcare law work.
Blendon said Republicans face different problems with different groups of voters over healthcare. When the 2018 mid-term elections get closer, they could encounter highly energized Democrats and independents who turn out to vote against them based on their unpopular healthcare bill.
But as they ponder going home this weekend, it's their base voters who dislike Obamacare that they're most worried about, Blendon stressed. “They're saying, 'I can't go home and say I passed nothing.' ”