WASHINGTON — President Donald Trump on Tuesday backed a plan by Republican lawmakers to replace the Obamacare healthcare statute that faces obstacles to becoming law from across the U.S. political spectrum.
Republicans in the U.S. House of Representatives on Monday unveiled legislation that would eliminate the requirement that most Americans obtain medical insurance and create a system of tax credits to encourage people to purchase private insurance on the open market.
Trump said the draft bill was open to negotiation, adding that he was working on a system to cut drug prices.
The unveiling of the lawmakers’ plan marked a key step toward carrying out pledges by Trump and congressional Republicans to dismantle Obamacare, former Democratic President Barack Obama’s signature domestic policy achievement. But lawmakers face pressure from constituents not to throw America’s healthcare system into chaos.
Obamacare, formally known as the Affordable Care Act, is popular in many states, even some controlled by Republicans. It has brought health insurance coverage to about 20 million previously uninsured Americans since it became law in 2010, although premium increases have angered some.
Democrats and some moderate Republicans said the new House measure would hit the poor by rolling back the Obamacare expansion of the Medicaid health insurance program for the poor. Some conservatives complained it did not go far enough in removing government from the healthcare industry, with one Republican senator dubbing it “Obamacare Lite.”
Trump, who has previously called for lower drug prices, added, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” He gave no details. His comment sent shares of drugmakers lower.
The president also said there would be additional action to allow people to buy health insurance across state lines “in phase 2 & 3 of healthcare rollout,” although it was not immediately clear when or how that addition would come.
House Democratic leader Nancy Pelosi said the House Republican effort would take millions of people off health insurance rolls and benefit the wealthy.
Shares of health insurers, whose industry is anxiously awaiting any changes, were mixed in early morning trading.
Insurers have said that Obamacare does not work.
Many including UnitedHealth Group Inc, Aetna Inc and Humana Inc have exited most of the states where they sold individual insurance plans created under the law.
Hospitals have been concerned about losing government payments from customers, particularly those in the Medicaid program, under any new healthcare law. That has weighed on shares of companies such as Tenet Healthcare Corp and Community Health Systems.
Republicans control both Congress and the White House but the future remains uncertain for the plan. It must win approval in the House and the Senate, where it faces a higher bar for passage, before it could go to Trump for his signature. In the Senate, Republicans hold a narrower majority and some conservatives have already expressed doubts.
The Heritage Action advocacy group, influential among conservatives, said the new bill was only a half measure.
“Rather than accept the flawed premises of Obamacare, congressional Republicans should fully repeal the failed law and begin a genuine effort to deliver on longstanding campaign promises that create a free-market healthcare system that empowers patients and doctors,” the group said.
The bill met with skepticism from some moderate Republicans concerned about its tax credits and Medicaid provisions.
Trump was due to meet with the team of House members charged with tracking support for legislation on Tuesday as lawmakers on two key House committees prepared to review the bill on Wednesday.
White House Office of Budget and Management Director Mick Mulvaney said the plan should pass the House before lawmakers break in mid-April.
Republican Senator Rand Paul of Kentucky, who has proposed his own alternative healthcare plan, criticized the House plan as a windfall for private insurers, dubbing it “Obamacare Lite.”
“So much of their bill is a bailout for the insurance companies,” Paul told Fox News.
Four other moderate Senate Republicans have also raised concern over Medicaid. Nearly half of the previously uninsured Americans who gained coverage under Obamacare got it through the expansion of Medicaid, which would end in 2020 under the Republicans’ new plan, then face funding caps.
The plan also would remove the penalty paid by Americans without insurance coverage and roll back government subsidies that helped lower-income people purchase insurance through government-run exchanges.
Some industry groups have expressed concern that lawmakers are moving forward without knowing how much the new proposal will cost or how it will affect healthcare coverage. Mulvaney told CBS he expected the Congressional Budget Office’s review of the bill in a few days.
Pelosi, appearing on the CBS program “This Morning,” said, “Show us the numbers about what the impact is personally on people. Show us the numbers as to how many people will be thrown off.”
The proposal preserved two popular Obamacare provisions: prohibiting insurers from refusing to cover people with pre-existing medical conditions and allowing people up to age 26 to remain on their parents’ insurance plans.
The plan does not eliminate the healthcare exchange where people can buy coverage on the healthcare.gov website.
Instead of current income-based subsidies to buy a plan, Republicans proposed tax credits, which would range from $2,000 to $4,000. Their plan also seeks to encourage people to buy insurance with the age-based credits that are capped at upper-income levels.