Lawmakers Debate GOP Plan To Replace The Affordable Care Act

With Democrats expected to oppose the new Republican health care bill en masse, GOP leaders need to produce a bill that makes almost their entire House and Senate caucuses happy. That will be a tough task, with different Republicans coming to the debate with very different legislative goals.

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Republican leaders have drafted and released their replacement plan for Obamacare. Now comes the tough task of getting GOP lawmakers to vote for it. Republicans have a slim majority in the Senate, and it is very likely this bill won't earn a single Democratic vote. From Capitol Hill, NPR's Scott Detrow has more.

SCOTT DETROW, BYLINE: Over and over again in recent years, Republicans have voted to repeal Obamacare. Senate Majority Leader Mitch McConnell says this time it's different.

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MITCH MCCONNELL: The American people have given us an opportunity to govern. We're no longer just floating ideas or - knowing full well President Obama would not have signed them, even if we had been able to put them on his desk, which we did on a number of occasions.

DETROW: The bill introduced this week repeals language mandating that every American buy health insurance, but it keeps a lot of Obamacare in place and provides tax credits to help people pay for health care. Utah Senator Mike Lee says this is not the replacement he was hoping for.

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MIKE LEE: This is instead a step in the wrong direction. And as much as anything, it's a missed opportunity.

DETROW: Conservative activist groups were quick to slam the replacement plan in the hours after it was released. The Club for Growth called it a warmed-over substitute for government-run health care. Freedom Works and others called it Obamacare-lite. Kevin Brady calls it something else.

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KEVIN BRADY: This is Obamacare gone.

DETROW: He's the chair of the House Ways and Means Committee and played a big part in drafting the new bill. Brady pushed back against that conservative criticism.

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BRADY: As Republicans we have a choice. We can act now, or we can keep fiddling around and squander this opportunity to repeal Obamacare and begin a new chapter of freedom for the American people. House Republicans are choosing to act now.

DETROW: Republican leaders can't simply appeal to Tea Partiers like Lee. They have to keep the moderates in their caucus happy, too.

Earlier this week, four Republican senators from states that expanded Medicaid under Obamacare said they're worried. They want to know what happens to people who are now covered by Medicaid when the expansions are phased out in 2020. Republicans'

margins are tight, especially in the Senate. If just three Republicans oppose the bill, it wouldn't pass. So it's going to take a lot of work and a lot of lobbying to keep everyone in the caucus happy. That's why Vice President Mike Pence was on Capitol Hill today meeting with lawmakers and talking to reporters.

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VICE PRESIDENT MIKE PENCE: The simple fact is that Obamacare must go. And we are now on the first full day of our effort to keep that promise to the American people.

DETROW: Later on, House Republicans in charge of lining up votes went to the White House to meet directly with President Trump. The White House is going to have to sell this plan because, as Kentucky Senator Rand Paul said...

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RAND PAUL: We have to admit we are divided on replacement. We are united on repeal, but we are divided on replacement.

DETROW: In a tweet this morning, Trump said the bill is out for review and negotiation. Negotiation is the key word coming from someone who defines himself as a dealmaker. That means a lot of the language could change, even in the relatively short window that Republican leaders are hoping to get this legislation through the House and Senate and onto Trump's desk.

Scott Detrow, NPR News, the Capitol.

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