House Republicans are waiting anxiously for a new financialestimate Wednesday on their Obamacare repeal proposal that couldforce them into an embarrassing do-over on the bill they barelypassed early this month.

|

Related: Can transparency change the US health caresystem?

|

Speaker Paul Ryan says he is uncertain about the nonpartisanCongressional Budget Office analysis of the measure’s budget impact-- critical for meeting Senate rules that would let the GOP pass itwith a simple majority amid unanimous Democratic opposition.

|

"We have every reason to believe we are going to hit our mark,"Ryan of Wisconsin told reporters Tuesday. Still he added, "CBOscores have been unpredictable in cases in the past."

|

For the health plan to comply with requirements for using astreamlined Senate process called reconciliation, the CBO will haveto conclude that it reduces the deficit by at least $2 billion over10 years. If not, the House will have to redo the bill to meet thatstandard and vote on it again. And that won’t be easy after theweeks of negotiations and revisions that led to the American HealthCare Act’s May 4 passage by a narrow 217-213 House majority.

|

The CBO analysis may not be the final word on whether the GOPcan push a health-care bill through the Senate without facing aDemocratic filibuster. There are several other arcane budget rulesthat it must also satisfy, although the Senate parliamentariancould override some of those the rules and let the bill move aheadanyway.

A quick start

House Republicans had rushed to vote on the health bill --without waiting for the CBO analysis of last-minute changes -- sothe Senate could get a quick start on it. But Ryan then decided notto immediately send the bill to the Senate, as he normally would,in case the CBO analysis requires the House to revise parts ofit.

|

Related: American health care ranking an'embarrassment'

|

This uncertainty is evidence "of the consequences forRepublicans of trying to move as quickly as possible" to pass theObamacare replacement, said Molly Reynolds, a congressionalspecialist at the Brookings Institution in Washington. "That choicedid not come without costs."

|

Republicans have insisted for years they would repeal andreplace former President Barack Obama’s health-care law if theygained power, and President Donald Trump also made it a topcampaign promise. Many GOP lawmakers have been confronted attown-hall meetings by angry constituents who oppose a repeal,though, and a CBO analysis of an earlier version of the House billsaid 24 million people would lose insurance in 10 years.

|

Edward Lorenzen, a senior adviser for the nonpartisan Committeefor a Responsible Federal Budget, said he expects both sides totake their arguments to the Senate parliamentarian after the CBOreport is released.

Pressure from Republicans

House Minority Whip Steny Hoyer of Maryland told reportersTuesday that if the bill doesn’t meet Senate requirements, he hopesthe chamber’s parliamentarian doesn’t face undue pressure fromRepublicans to let the bill go forward.

|

Related: Trump reportedly wants to end insurersubsidies

|

"I hope so," said Hoyer. "Am I confident? No."

|

Ryan said Tuesday that Republicans want to make sure the Housebill is done correctly so it won’t have to be killed in theSenate.

|

That’s where the CBO comes in. Its report Wednesday is expectedto dive deep into the measure to see if it meets thedeficit-reduction requirements to avoid a Democratic filibuster. Toqualify, the measure must reduce the deficit by at least $2 billion-- $1 billion each in the areas covered by the Senate FinanceCommittee and by the health panel.

State waivers

Another question is whether a provision added by the GOPallowing states to waive certain Obamacare regulations may mean thebill doesn’t reduce the deficit. Lorenzen said that if the waiveris widely used, it could result in less generous benefits and lowerpremiums. That could lead more people to buy health insurance,making more of them eligible for the law’s tax credits. There areestimates that an increase of 1 million enrollments would costabout $30 billion over a decade.

|

The CBO is also expected address how many people would loseinsurance under the new House plan.

|

Democrat Jim McGovern of Massachusetts, speaking on the Housefloor on Tuesday, said the CBO report will show "how manymillions of Americans will be kicked off their health care becauseof the reckless and heartless Republican policies."

|

Given the heat some House Republicans have drawn fromconstituents since voting for the bill, some Democrats arequestioning whether Republicans could get enough of their ownmembers to pass the bill again if they have to rewrite it toconform with the rules.

|

"I will not ask you whether or not you think you still have 217votes," Hoyer jabbed at Majority Leader Kevin McCarthy ofCalifornia in a discussion on the House floor Friday.

|

Ryan said Tuesday, "We just want to make sure that we dot ourI’s and cross our T’s exactly the right way so that when we sendthe bill over to the Senate it is not, as we say, fatal."

|

Copyright 2018 Bloomberg. All rightsreserved. This material may not be published, broadcast, rewritten,or redistributed.

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.