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House Republicans To Vote On Measure To Repeal Obamacare


We have said this very sentence before - House Republicans plan to vote today to repeal and replace the Affordable Care Act. Last time around, they called off the vote rather than lose. This time, it's very close. And it's one of two big agenda items for President Trump on which he hopes to show some movement today. NPR White House correspondent Scott Horsley is on the line. Scott, good morning.

SCOTT HORSLEY, BYLINE: Good morning, Steve.

INSKEEP: Do they really have the votes this time?

HORSLEY: Well, we'll see. It was certainly an embarrassment for House Speaker Paul Ryan and for the president when they had to pull the bill the last time. So Paul Ryan's been adamant they're not going to try again until they have the votes. And so when House Republican Leader Kevin McCarthy announced last evening that they are planning to bring this to the floor today, that's a signal that at least the Republican leaderships - believes they have the votes. We'll see. It's going to be close.

INSKEEP: OK. We'll find out. We'll find out. Now, let's remember the whole challenge for Republicans is they want to repeal a law that has many popular provisions and provides insurance for millions. So how do you save a lot of money while also keeping the popular provisions including about preexisting conditions?

And I want to bring a voice into this conversation. Two Republicans visited President Trump and proposed adding money to the bill to help cover some of the insurance costs for people with preexisting conditions. One of them is Congressman Billy Long. Let's listen.


BILLY LONG: We're here announcing that with this addition that we brought to the president and sold him on in an over an hour meeting in here with him, they were both yeses on the bill.

INSKEEP: OK. So does the bill now protect people with preexisting conditions from losing their health insurance?

HORSLEY: Not really, at least not as emphatically as President Trump has promised. What the Republican bill does is it gives states the opportunity to opt out of some of the popular provisions. That was a nod to the most conservative members of the House. However, that lost some moderate Republican votes.

So what the president has now agreed to do is sweeten the pot a little bit by putting $8 billion in to help cover these folks in so-called high-risk pools. But critics who say, look, $8 billion is a pittance. That's over five years. It's not enough to really guarantee that people with preexisting health care conditions will be able to find affordable health care coverage.

INSKEEP: Scott, the last time they tried to vote on this, there was an independent Congressional Budget Office analysis that found that tens of millions of people would lose health insurance over time or would stop having health insurance over time. What's the analysis say this time?

HORSLEY: Well, the CBO has not had a chance to score this newest version of the bill. But those things really haven't changed, so we're still looking at 24 million fewer people with health coverage by 2026. We're still looking at higher premiums for older and especially rural people. And that's a lot of Trump voters.

INSKEEP: OK, one other item to talk about with NPR's Scott Horsley. The president is promising an executive order today on religious liberty, he says, the president following up on a promise to overturn a decades-old law that limits political activity by tax-exempt religious groups. Here's how he's previously described his promise.


PRESIDENT DONALD TRUMP: I will get rid of and totally destroy the Johnson Amendment and allow our representatives of faith to speak freely and without fear of retribution. I will do that. Remember.

INSKEEP: Scott, does this executive order change that law, the Johnson Amendment?

HORSLEY: It doesn't change the law. That's a tricky thing to do. What it does do is direct the IRS, which is the enforcer of the Johnson Amendment, to use maximum discretion in enforcing that. This is to allow churches and other tax-exempt organizations to endorse or criticize political candidates.

INSKEEP: What else is in this executive order?

HORSLEY: There's also a provision granting regulatory relief from the requirement in Obamacare that employer-provided health insurance offer cost-free coverage for birth control. That was anathema to some religious organizations. And, you know, Donald Trump got a lot of support from evangelicals, so this is something that they've been looking for.

INSKEEP: Although I guess we should point out again it's a law, so it's not clear how much the president can change things.

HORSLEY: It's regulatory relief. So it's telling the Health and Human Services Department to kind of look the other way.

INSKEEP: Within the law. OK. NPR's Scott Horsley. Thanks very much.

HORSLEY: Good to be with you. Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.
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