President Donald Trump and his top health official praised the new House Republican health care legislation on Monday, even as surging conservative opposition complicated party leaders' drive to sell the proposal to rank-and-file lawmakers and the public.
Trump's morning tweet lauding "our wonderful new Healthcare Bill" kicked off the day. Shortly afterward, Health Secretary Tom Price wrote to the chairmen of the two House committees that wrote the measures, saying "they align with the President's goal of rescuing Americans from the failures of the Affordable Care Act", former President Barack Obama's prized 2010 law.
Yet by lunchtime, conservative lawmakers and others were blasting the bill, underscoring the challenge Republicans face in pushing one of their top priorities to passage.
The legislation would primarily affect some 20 million people who purchase their own private health plans directly from an insurer and the more than 70 million covered by Medicaid, the federal-state program for low-income people.
In the first official though partial measurement to emerge of the bill's financial impact, Congress' nonpartisan Joint Committee on Taxation estimated it would cut more than 20 taxes imposed by Obama's law at a cost of nearly $600 billion over a decade. The bulk of the savings would go to the wealthy.
The estimate did not include the cost of tax credits the measure proposes to help people buy coverage. Republicans say they've not yet received an estimate of the bill's overall cost or the number of people it would cover from the Congressional Budget Office.
"What Obamacare did was make insurance affordable but care impossible to actually afford," White House budget chief Mick Mulvaney said on NBC's "Today Show." ''The deductibles were simply too high. So people could say they have coverage but they couldn't actually get the medical care they needed when they get sick."
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"Obamacare" plans did typically come with high deductibles, but the law also provided cost-sharing subsidies to people with modest incomes. Those subsidies will be eliminated under the Republican plan, and it's unclear how high the deductibles would be under the new approach.
House committees planned to begin voting on the legislation Wednesday, launching what could be the year's defining battle in Congress and capping seven years of GOP vows to repeal the 2010 Affordable Care Act. Before prevailing, leaders will have to heal internal divisions.
In his letter, Price commended GOP plans to provide millions of Americans with a refundable tax credit — meaning even people without tax liability would receive the assistance. Congressional conservatives have opposed a refundable credit, saying it would create a new entitlement program the government cannot afford.