Pa. Republicans torn over whether to support health care bill

March 21--WASHINGTON -- President Donald Trump is heading to Capitol Hill on Tuesday to speak with House Republicans before even more of them withdraw support from the health care bill headed for a vote later this week.

Support is falling off from Republicans, including at least two from Pennsylvania, where 31 percent of residents are over 55 -- the age group that will be hardest hit by the GOP's proposed health insurance changes.

U.S. Reps. Glenn "G.T." Thompson, R-Centre; Brian Fitzpatrick, R-Bucks; and Scott Perry, R-York all recently came out against the American Health Care Act, even as GOP leaders worked to address concerns.

Mr. Thompson told the Centre Daily Times that parts of the bill would jeopardize services for the most vulnerable. That includes a provision allowing insurance companies to charge higher premiums for older people.

Mr. Fitzpatrick is concerned the bill doesn't do enough to address opioid addiction.

At a town hall meeting Saturday, Mr. Perry told constituents he can't support the bill because it doesn't drive down the cost of care, the Associated Press reported.

That kind of rank-and-file opposition is driving legislative leaders to reshape the legislation before bringing it to the floor Thursday. It isn't clear whether the changes will be enough.

In its current form, the Republican bill eliminates tax penalties for businesses and individuals who don't buy insurance, converts need-based subsidies to age-based tax credits, funds Medicaid through a block-grant system, allows a 30 percent penalty on premiums for people who allow coverage to lapse, repeals taxes on insurance companies and top earners and rolls back funding for state Medicaid expansion.

U.S. Rep. Mike Kelly, R-Butler, already is a solid "yes" voter. U.S. Rep. Tim Murphy, R-Upper St. Clair, expects to vote yes, too, but he would like to see more protections added for people with mental illness and drug addiction.

But other Pennsylvania Republicans, including U.S. Reps. Bill Shuster of Everett and Ryan Costello of Chester Country, still haven't committed. Aides for the two said the lawmakers still were reviewing the bill. A spokesman for U.S. Rep. Pat Meehan, R-Delaware, told the Philadelphia Inquirer the same.

Other Republican members of the state delegation did not respond to inquiries Monday, but their Democratic colleagues, who strongly oppose the bill, have heard rumblings.

"I hear they're very unsure," said U.S. Rep. Dwight Evans, D-Philadelphia.

And they should be, he said, if they consider the demographics of the state. Pennsylvania's population is the nation's sixth oldest, its poverty rate is above the national average, and 25 percent of its residents live in rural areas that tend to be underserved by medical providers.

"When you get outside Philadelphia and Pittsburgh and you look at rural Pennsylvania, you've got some real economic challenges there," Mr. Evans said. "That's why you're seeing some Republicans giving some second thoughts."

Another reason could be constituents' changing views on the Affordable Care Act. Fifty percent of Pennsylvania residents now have a favorable opinion of it, according to a Muhlenberg College poll released Monday. That's more than at any time since 2013.

Also for the first time since 2013, more respondents told Muhlenberg they're better off under the Affordable Care Act than worse off -- 27 percent to 25 percent, with 42 percent reporting no difference.

The margin of error is plus or minus 6 percent.

U.S. Rep. Mike Doyle, D-Forest Hills, keeps up with Western Pennsylvania colleagues during lawmakers' commute between Pittsburgh and Washington.

"I do fly on airplanes and occasionally my Republican colleagues are on the plane with me, and they have been expressing concerns about parts of the bill. I haven't heard from anyone saying they think it's a great bill," said Mr. Doyle, who declined to identify his seatmates.

"They're realizing that changing Medicaid to a block grant is going to make Medicaid access much [less attainable] for a lot of people, so I think members are having some second thoughts," he said. "It's going to hurt Middle America a lot more than the East Coast and West Coast, so I think a lot of Pennsylvania Republicans are struggling" with how to vote.

Washington Bureau Chief Tracie Mauriello: tmauriello@post-gazette.com, 703-996-9292 or on Twitter @pgPoliTweets.

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