WASHINGTON (AP) — Conservatives have demanded a quick vote on erasing much of President Barack Obama's health care law, with some threatening to oppose legislation that falls short. But House Republican leaders said they were working deliberatively as the party continued its struggle to find a replacement that could pass Congress.
"This affects every person and every family in America," House Speaker Paul Ryan, R-Wis., told reporters on Tuesday. "That's why we're taking a step-by-step approach."
Ryan spoke the morning after the House Freedom Caucus — whose members are among Congress' most hard line conservatives — voted unanimously to insist on a House vote on legislation repealing much of Obama's overhaul, the group's leaders said. They said they also wanted a simultaneous vote on a GOP package replacing that law.
Rep. Raul Labrador, R-Idaho, told reporters that if forthcoming GOP legislation annulling Obama's law doesn't go as far as legislation that Obama vetoed last year, "We're not going to vote for that."
Rep. Mark Walker, R-N.C., leader of a broader group of conservatives, called the Freedom Caucus' demands "a common sense position" and said he wanted a vote "as soon as possible."
Conservatives say they're worried that this year — with President Donald Trump eager to sign repeal legislation — lawmakers nervous about angering constituents who could lose coverage might pass a watered down version instead. Internal divisions facing GOP leaders include what to do about the law's expansion of Medicaid for poor people and its tax increases, and two senators have proposed letting states choose to retain Obama's law entirely.
"If we're just going to replace Obamacare with Obamacare light, it begs the question, 'Were we just against Obamacare because it was proposed by Democrats,'" Labrador said. Doing that would be "hypocritical" and would mean "our base is going to leave the party because they're not going to be happy," Labrador said.
"At the minimum, we ought to be able to put on President Trump's desk exactly what we put on President Obama's desk," said Rep. Jim Jordan, R-Ohio, a conservative leader.
Despite their demands, conservatives share some of the same unresolved questions as other Republicans.
Conservatives said they've still not struck a unified position on what to do about Obama's expansion of Medicaid to cover more low-income people. Some states have opted to take billions in federal money to cover millions of people under the statute and would like to retain the expansion, but others oppose the program's enlargement and don't want federal money to be spent for those that did.
Though Trump said days before taking office that his plan for replacing Obama's overhaul was practically ready, Republicans have yet to unveil legislation — just as they hadn't in the years since the law's 2010 enactment. Ryan has talked about repealing the statute and having a replacement plan ready in March, and GOP leaders have been emphasizing that they want to work carefully.
"We want to get it right and we've been taking our time to do that," said Rep. Greg Walden, R-Ore., chairman of the House Energy and Commerce Committee, which is among those writing the legislation. He said his panel would begin voting on a plan "in the near future."
Lawmakers say they expect their eventual package to include many of the elements that GOP leaders have long endorsed, though without detail. These include a phasing out of Obama's expansion of Medicaid and a repeal of at least some of its $1.1 trillion in 10-year tax increases that financed the law's expanded coverage for 20 million people.
There would be federally subsidized high risk pools for sicker people who are costly to insure plus tax credits and health savings accounts to help people pay medical bills. And the proposal is expected to defang the law's unpopular fines for people who don't buy health insurance, and instead let insurers charge higher premiums for consumers who don't maintain continuous coverage.
Democrats have opposed all of those steps, saying they would leave many people uncovered and make health care unaffordable for many others.