Republicans who have vowed for years to repeal and replace ObamaCare are now seeking to turn their campaign pledge into reality, with markups of legislation potentially beginning this week.
With narrow majorities in the House and Senate, Republicans won’t be able to pass healthcare legislation unless they remain united.
That could prove difficult, as there are several knotty issues raised by the repeal effort that threaten to push lawmakers into opposing camps.
Here are the four biggest issues that Republicans will have to resolve before an ObamaCare repeal bill can reach President Trump’s desk.
One of the biggest sticking points for Republicans is how to provide tax credits to help people pay for health insurance.
While there is broad support in the GOP for providing assistance through the tax code, they are at odds over the details.
House Republican leaders are pushing for a refundable, advanceable tax credit — something conservatives have denounced as a new government entitlement.
“I think there is still a significant divide within the conference on how you deal with refundable tax credits,” said Rep. Mark Sanford (R-S.C.), a member of the conservative House Freedom Caucus.
“I think the refundable tax credit in its present form represents a new entitlement,” he said, adding that he would have “very, very strong reservations” about supporting a bill that included them.
Sen. Rand Paul (R-Ky.) has compared the refundable tax credits to the subsidies some people get under ObamaCare.
“The problem that I have with a new refundable tax credit is it’s essentially a subsidy by another name,” he said last month.
“ObamaCare had subsidies. If we call them refundable tax credits, have we really done anything other than change the name? So I think that’s a problem.”