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March 20—2017 Health Care Reform: Despite conservative Republican opposition healthcare overhaul is moving ahead

As reported by Reuters, after House Budget Committee approval by a close 19 to 17 vote—with three Republican conservative House Freedom Caucus members joining the panel’s Democrats in voting against it—President Trump’s first major legislative initiative, the American Health Care Act, still faces an uphill battle in the full House and later the Senate. Conservative Republicans want a quicker end to the Obamacare Medicaid expansion, which the bill has set for 2020, and want to add work requirements for some Medicaid recipients; they also call the age-based tax credits to help people buy insurance on the open market an unwise new entitlement. However, House Speaker Paul Ryan (R-WI) has indicated that President Trump was “deeply involved” and “helping bridge gaps” among Republican lawmakers to get a consensus plan. There are ongoing efforts by the White House and Republican leaders to satisfy conservative opponents.

After approving the legislation, the Budget Committee adopted four non-binding Republican recommendations for changes before it moves to the House floor, including:

1. adding work requirements for able-bodied, childless Medicaid recipients;
2. calling for no longer encouraging people to sign up for insurance through Medicaid;
3. giving states more flexibility in designing Medicaid programs through block grants; and
4. changing the bill’s tax credits to help lower-income people more.

The White House said it was discussing changes with House Republican leaders, and President Trump indicated much of the bill would still be negotiated, especially as it moves from the House to the Senate. Administration officials and House Republican leaders have said they hope to get the bill to the House floor by the end of the month so it can go to the Senate before lawmakers’ mid-April recess.