Pennsylvania GOP lawmakers divided heading into Obamacare repeal vote

March 23--Pennsylvania's congressional Republicans are divided heading into a House vote expected Thursday on the GOP plan to repeal and replace Obamacare.

President Donald Trump and House Speaker Paul Ryan won back the support of one lawmaker -- U.S. Rep. Lou Barletta of Luzerne County -- who had planned to oppose the bill. But the measure's fate remained in jeopardy late Wednesday, as Republican leaders hustled to shore up support.

If the legislation clears the House, a potential steeper climb awaits in the Senate, where a handful of Republicans already have expressed an array of concerns, and where it would be likely to see additional changes.

After a meeting late Wednesday night between centrist Republicans and House Speaker Paul Ryan, Lehigh Valley U.S. Rep. Charlie Dent -- who had repeatedly said he had "serious reservations" about the bill -- announced he would vote against the repeal legislation.

"I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals," Dent said in a statement. "We have an important opportunity to enact reforms that will result in real health care transformation -- bringing down costs and improving health outcomes. This legislation misses the mark."

Three other Pennsylvania House Republicans also said they plan to vote "no" on the bill: Reps. Brian Fitzpatrick of Bucks County, Scott Perry of York County and Glenn "G.T." Thompson of Centre County.

After changes in the bill that were offered this week to win over holdouts, the legislation, in its present form, would replace Obamacare's insurance subsidies with tax credits based on age; repeal the ACA's taxes and fines; replace the individual insurance mandate with a 30 percent premium hike if someone doesn't maintain coverage; change how Medicaid is funded and phase out dollars for the program's expansion; add a work requirement for some Medicaid recipients; and defund Planned Parenthood.

It keeps protections ensuring that people with pre-existing conditions can access coverage, and allows those under 26 to stay on their parents' insurance.

Barletta, whose 11th District includes part of Carbon County, had expressed one specific concern when he said late Monday that he couldn't support the proposal as written. He was worried that the measure wouldn't prevent those in the country illegally from receiving tax credits to offset insurance premium costs.

Trump and Ryan "agreed with me [Tuesday] night that this is wrong and must be fixed," he said. They promised to support and bring up for a vote legislation that Barletta will introduce to block any health care tax credits from going to undocumented immigrants.

"Because my concerns were met, I will vote for the bill with the understanding that my bill will receive full consideration on the House floor next month," Barletta said.

Barletta cited a Senate Committee on Homeland Security and Governmental Affairs report, which found that almost 500,000 applicants for an estimated $750 million in Obamacare insurance subsidies had the tax credits revoked because they did not verify they were lawful U.S. residents. It also criticized the process for recouping tax credits given to those later found to be ineligible.

Applicants who do not provide documentation on their legal presence, such as a Social Security number, when they apply for coverage, have a short grace period to do so. It's not clear how many of those who did not do so were in the country illegally and how many may not have submitted documents for other reasons.

Barletta's office said his legislation would require applicants for health care tax credits to provide valid Social Security numbers before they receive tax credits. Those numbers will be verified by the Social Security Administration.

Even with Barletta's support, the latest tallies showed the House GOP struggling to retain enough of its members to reach the 215 votes needed to pass the bill on to the Senate.

Senate Majority Leader Mitch McConnell of Kentucky has said his chamber intends to take up the health care bill next week -- and wrap it up within days in order to move on to the Supreme Court nomination of Neil Gorsuch before a spring recess.

But without help from Democrats, Senate Republicans can only lose two members. A trio of conservatives -- Sens. Mike Lee of Utah, Rand Paul of Kentucky and Ted Cruz of Texas -- have proclaimed they won't support it without changes, while others have criticized the provision defunding Planned Parenthood, and several more have expressed concerns about phasing out the expansion of Medicaid.

Neither of Pennsylvania's senators has embraced the bill moving through the House.

Democratic U.S. Bob Casey joined advocates for disabled Americans at a news conference outside the Capitol on Wednesday, calling on his fellow legislators to reject the repeal bill. He pledged to "fight like hell" against the proposed changes, particularly those related to the Medicaid program.

"It's not really a health care bill," Casey told the crowd. "It's a scheme to ration care to children, to people with disabilities, to older citizens by what they're going to do to Medicaid."

Republican U.S. Sen. Pat Toomey has said he has concerns about the bill, but has declined to detail any specific issues.

He said last week that the bill working its way through the House was "merely the first draft in the legislative process," and that he would be working with the Trump administration and other legislators "so that as much of Obamacare is repealed as possible."

WHERE THEY STAND

Here's what Pennsylvania's congressional Republicans have said publicly about how they'll vote on the Obamacare repeal bill. All five House Democrats are expected to oppose the bill.

YES or LIKELY YES (5): Mike Kelly -- 3rd District (Erie); Bill Shuster -- 9th District (Blair); Lou Barletta -- 11th District (Luzerne); Lloyd Smucker -- 16th District (Lancaster); Tim Murphy -- 18th District (Allegheny)

UNDECIDED or UNCLEAR (4): Ryan Costello -- 6th District (Chester); Pat Meehan -- 7th District (Delaware); Tom Marino -- 10th District (Lycoming); Keith Rothfus -- 12th District (Allegheny)

NO (4): Scott Perry -- 4th District (York); Glenn "G.T." Thompson -- 5th District (Centre); Brian Fitzpatrick -- 8th District (Bucks); Charlie Dent -- 15th District (Lehigh/Northampton)

Source: Morning Call interviews with legislators, staff; Associated Press

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