House Republicans plan all-or-nothing Friday vote on Obamacare repeal

March 24--Congressional Republicans will try again Friday to repeal-and-replace Obamacare in an all-or-nothing, high stakes vote on Capitol Hill.

President Donald Trump turned to Twitter this morning, criticizing opposition from the conservative Freedom Caucus in the House. The president first tweeted:

"After seven horrible years of ObamaCare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!"

"That missive was followed by this one:

"The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!"

The House GOP plan to blow out the candles on Obamacare's seventh birthday cake with a massive dismantling of the health law collapsed under splits within the party and failed to get to a vote Thursday. Late Friday night, the White House and House Speaker Paul Ryan said there would be no more negotiations, and they pressed for an up or down vote.

Thursday's outcome disappointed repeal supporters in South Florida and raised doubts about whether Trump and Republicans in Congress can deliver on a core campaign pledge. One Democratic member said the real problem is a "sick and devastating" bill that raises costs for many older and lower-income consumers to pay for huge tax cuts.

For her part, Debbie Carlstrom, of Jensen Beach, a constituent of U.S. Rep. Brian Mast, R-Palm City, wants the repeal and replacement plan to succeed.

"I want it gone," Carlstrom said of the Affordable Care Act. "I want it to go back to the way it was before it was passed."

She and her husband are self-employed but make too much money to qualify for subsidies under Obamacare, she said. They paid $600 to $700 in monthly premiums with a $1,000 deductible for coverage before the health law, she said, but now pay almost $1,500 in premiums with a $12,500 deductible. She said ACA requirements for health plans mean the family is forced to buy things like vision coverage though their daughter does not wear glasses.

The premium alone "costs twice as much as our mortgage payment," she said. "We are not wealthy."

Word that no final vote was coming on Trumpcare on the symbolic occasion of the ACA anniversary came amid fierce disputes within the GOP that Trump's personal lobbying proved unable to budge by the self-imposed deadline.

One difficulty has been trying to balance factions that want bigger tax cuts and regulation rollbacks against others concerned about constituents who could lose coverage or have to pay more in health costs. Amid the infighting, one poll released Thursday showed only 17 percent of Americans approved of the GOP plan.

"It signifies what a sick, devastating bill this is," said U.S. Rep. Lois Frankel, D-West Palm Beach. "It's almost a hoax. Here you have these Republicans who have voted to repeal the Affordable Care Act over 60 times and they can't even get their act together."

She said she does not doubt the House will pass a plan eventually, but, "the bottom line is, you pay more, you get less, it's going to affect everybody across the country."

The pause gave members including Mast, Carlstrom's congressman, more time to weigh the still-developing legislation.

He is hearing from constituents on both sides of the issue. The average Florida consumer buying policies on the ACA marketplace would pay $3,278 more out of out pocket annually under the House plan, even with higher tax credits proposed this week to help older consumers, the Washington-based Center on Budget and Policy Priorities calculated.

"I'm continuing to review changes to the bill as it's being negotiated and continuing to collect feedback from people in our community as to how the bill will impact them," Mast said.

Whether the votes will come together as early as today or get pushed off into next week or later remained unclear. No new date was announced for a vote, as far as Mast's office was aware.

As of Thursday morning, U.S. Rep. Tom Rooney, R-Okeechobee, had not committed either way on the bill, a spokeswoman said.

Trump met with members of the Freedom Caucus conservatives in the House to explore changes they wanted, such as reducing required benefits in health plans. The president urged members to keep working to overhaul "the disaster known as Obamacare."

Democrats portrayed the move to reduce required coverage in health plans as the further hollowing out of insurance to pay for what amounts to a huge tax cut for the wealthy.

The Congressional Budget Office projected the bill could save taxpayers $323 billion over 10 years but cause 24 million people to drop out of coverage. Proposed tweaks this week have been designed to soften the financial effects to groups such as people 50 to 64. Florida has more people in that category receiving subsidies on ACA marketplace plans, more than 450,000, than any other state.

"We just found out the president of the United States wants to play let's make a deal with people's health insurance," said U.S. Rep. Ted Deutch, D-Boca Raton.

He said the president is willing to bargain away basic requirements for health plans that make "insurance worth having," he said -- outpatient care, emergency room visits, hospitalization, maternity and newborn care, mental health and addiction treatment, prescription drugs, preventive care and more.

"The president is prepared to pass a bill that makes insurance policies worth nothing," Deutch said. "This is appalling. This is embarrassing."

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