Collins On WBEN: "We Have The Votes" on Repeal/Replace Obamacare

House Vote Expected Today Before Recess

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(WBEN/AP) Republican Congressman Chris Collins says they are ready to push their health care bill through the House and claim a victory for President Donald Trump, six weeks after nearly leaving it for dead and days after support from GOP moderates seemed to crumble anew.

"It absolutely does look like we have the votes," Collins said in an interview on the WBEN Liveline Thursday morning,

House leaders planned a vote Thursday on the legislation, revamped since collapsing in March to attract most hard line conservatives and some GOP centrists.

"... This is a fix to get health care going in the right direction," Collins said, adding that today's vote is a first step and that the US Senate will be making changes to the House proposal.

HEAR COLLINS on THE WBEN LIVELINE with Susan Rose & Brian Mazurowski

 

In a final tweak, leaders were adding a modest pool of money to help people with pre-existing medical conditions afford coverage, a concern that caused a near-fatal rebellion among Republicans in recent days.

The legislation would rework subsidies for private insurance, limit federal spending on Medicaid for low-income people and cut taxes on upper-income individuals used to finance Obama's overhaul.

"We are not going to ever leave somebody stranded with pre-existing conditions without insurance. Those were good political sound bites for the Democrats to use, " Collins said. 

 Collins Medicaid Amendment Survives

Like the prior bill, the latest version includes a Collins amendment that keeps states like New York from passing Medicaid costs onto counties. In Erie County, he says that would result in a $204 million savings.

During previous health care reform debates, the measure drew ire from Gov. Andrew Cuomo and others who suggested it was the "Buffalo Bribe', specifically designed to garner votes for the overall measure. 

Here are other key elements of the bill:

--Ends tax penalties Obama's law imposes on individuals who don't purchase health insurance and larger employers who don't offer coverage to workers.

--Halts extra payments Washington sends states to expand Medicaid to additional poorer Americans, and forbids states that haven't already expanded Medicaid to do so. Changes Medicaid from an open-ended program that covers beneficiaries' costs to one that gives states fixed amounts of money annually.

--Erases Obama's subsidies for people buying individual policies, based mostly on consumers' incomes and premium costs. Replaces them with tax credits that grow with age that must be used to defray premiums. The credits are refundable, which means they even go to people with little or no tax liability. Credits may not be used to buy policies that provide abortion coverage.

--Repeals Obama's taxes on people with higher incomes and on insurance companies, prescription drug makers, some medical devices, expensive employer-provided insurance plans and tanning salons. Obama's law uses the revenue to help pay for its expanded coverage.

--Requires insurers to apply 30 percent surcharges to customers who've let coverage lapse for more than 63 days in the past year. This would include people with pre-existing medical conditions.

--Lets states get federal waivers allowing insurers to charge older customers higher premiums than younger ones by as much as they'd like. Obama's law limits the difference to a 3-1 ratio.

--States can get waivers exempting insurers from providing consumers with required coverage of specified health services, including hospital and outpatient care, pregnancy and mental health treatment.

--States can get waivers from Obama's prohibition against insurers charging higher premiums to people with pre-existing health problems, but only if the person has had a gap in insurance coverage. States could get those waivers if they have mechanisms like high-risk pools that are supposed to help cover people with serious, expensive-to-treat diseases. Critics say these pools are often under-funded and ineffective.

---Provides $8 billion over five years to help states finance their high-risk pools. This late addition, aimed at winning over votes, is on top of $130 billion over a decade in the bill for states to help people afford coverage.

--Retains Obama's requirement that family policies cover grown children to age 26, and its prohibition against varying premiums because of a customer's gender.

 Sources: U.S. Congress, The Associated Press, Kaiser Family Foundation

 

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