http://www.cnn.com/2017/02/23/politics/john-boehner-obamacare/index.html?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=43324818&_hsenc=p2ANqtz-9C9fLN0rK4GC4KdmmWnHv-okc_wBb4e7YECRpU-GCF-tFoU9S3NT2PefNssGFFgPB3RIF6OveTi7FGS6p2MSrujC6N4w&_hsmi=43324818

http://www.politico.com/story/2017/02/john-boehner-obamacare-republicans-235303?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=43324818&_hsenc=p2ANqtz-8KtlQSRQZul4ADjabrVQWksL4Jg5gFnXjByDRcBJ3hlWX3L-r4Yp-V6RAex9ClyzM6WsfFxWNGPyeeWd-LFFvLvt0Pag&_hsmi=43324818

http://www.pewresearch.org/fact-tank/2017/02/23/support-for-2010-health-care-law-reaches-new-high/

With congressional Republicans discussing proposals to replace the Affordable Care Act, public support for the 2010 health care law has reached its highest level on record.

Currently, 54% approve of the health care law passed seven years ago by Barack Obama and Congress, while 43% disapprove, according to a national Pew Research Center survey conducted Feb. 7-12 among 1,503 adults.

Throughout the law’s history, opinions about the Affordable Care Act have tended to be more negative than positive — or, less frequently, divided. As recently as December, about as many approved (48%) as disapproved (47%) of the law.

The new survey finds that when those who disapprove of the law are asked about what should happen to it now, more want GOP congressional leaders to focus their efforts on modifying the law than on getting rid of it. One-in-four adults want Republican leaders to modify the law, while 17% want them to get rid of it entirely. 

As in the past, there are deep partisan divisions over the health care law. Democrats overwhelmingly support the law, with 85% expressing approval. Among independents, about half (53%) approve of the health care law, while 45% disapprove. By contrast, Republicans broadly disapprove of the law (89%); just 10% express approval.

Republicans who disapprove of the health care law are divided on whether GOP congressional leaders should modify the health care law or get rid of it entirely. Nearly equal shares say Republican leaders in Congress should focus their efforts on modifying the law (42%) and focus on getting rid of it entirely (44%).

Among independents, nearly twice as many say Republican leaders should focus on modifying the law rather than scrapping it (29% vs. 15%).

For seven years, few issues have animated conservative voters as much as the repeal of the Affordable Care Act. But with President Barack Obama out of office, the debate over “Obamacare” is becoming less about “Obama” and more about “care” — greatly complicating the issue for Republican lawmakers.

Polling indicates that more Republicans want to make fixes to the law rather than do away with it. President Trump, who remains popular on the right, has mused about a replacement plan that is even more expansive than the original. The conservative news media are focused more on Mr. Trump’s near-daily skirmishes with Democrats and reporters, among others, than on policy issues like health care. And the congressional debate, as well as the paid advertisements on both sides, is centered on the substance of the law rather than its namesake, draining some of its toxicity on the right.

As liberals overwhelm congressional town hall-style meetings and deluge the Capitol phone system with pleas to protect the health law, there is no similar clamor for dismantling it, Mr. Obama’s signature legislative accomplishment. From deeply conservative districts in the South and the West to the more moderate parts of the Northeast, Republicans in Congress say there is significantly less intensity among opponents of the law than when Mr. Obama was in office.

“I hear more concerns than before about ‘You’re going to repeal it, and we’re all going to lose insurance’ because they don’t think we’re going to replace it,” said Representative Mike Simpson, a Republican who represents a conservative district in Idaho.

But it was not until now, with the Republicans taking control of the federal government, that the debate fully shifted from the theoretical to the tangible. It was easy for conservatives to rally against a law identified with a president they despised when he was capable of vetoing any repeal. Now that he is gone and the law’s benefits appear to be on the chopping block, the people who stand to lose the most are the most vocal.

“I’ve heard from constituents who have been harmed by the Affordable Care Act over the course of its being in existence,” said Representative Leonard Lance, Republican of New Jersey, whose affluent district Mr. Trump narrowly lost last year. “More recently, because of our discussions on repairing it, I’ve heard from those who do not wish to have the act amended. More recently, that is the preponderance of those who have contacted me.”

It is a longstanding rule of politics that rallying opposition to a proposal is usually easier than galvanizing support. And never is this more the case than when a widely distributed benefit is at risk of being taken away.

http://www.modernhealthcare.com/article/20170218/MAGAZINE/302189962

Divisions sharpened last week between hard-right and more pragmatic Republicans over both policy and strategy for repealing and replacing the Affordable Care Act.

Those differences—along with the apparently slow progress in drafting actual legislation that could be scored by the Congressional Budget Office on cost and coverage impact—underscore the tough struggle Republicans face in dismantling Obamacare and establishing an alternative system.

One of their biggest disagreements is over the future of the ACA’s expansion of Medicaid coverage to more than 10 million low-income adults. Conservatives want to eliminate it while a number of GOP senators and governors want to keep that coverage.

Congressional Republicans are feeling growing pressure to show progress on healthcare. Many are going back to their districts this week and holding town hall events, where they may face constituents who are upset about the potential loss of their ACA coverage. In addition, insurers are signaling they may pull out of the individual market in 2018, as Humana announced it would do last week.

House Speaker Paul Ryan promised Thursday to introduce repeal-and-replace legislation when the House returns from recess on Feb. 27, though he’s presented no legislative language so far. He said he’s waiting for the CBO and the Joint Committee on Taxation to score his proposed bill on costs and coverage levels before it’s unveiled.

Ryan has promised the House will repeal most of the ACA via an expedited budget reconciliation bill passed on a party-line vote by early April. He’s indicated it will include some replacement features, such as expanded health savings accounts and age-based premium tax credits.

GOP leaders want to erase most of the ACA taxes that fund the law’s coverage expansions and replace them with a cap on the tax exclusion employees receive for employer-provided health benefits.

Two people familiar with Ryan’s proposal told the Associated Press that employees would pay taxes on the value of coverage above $12,000 for individuals and $30,000 for families. Republicans would not confirm those amounts. But House Ways and Means Committee Chairman Kevin Brady told reporters that the “vast majority of Americans” would be unaffected. That suggests it wouldn’t raise much revenue.

That proposal is likely to trigger strong opposition from business and labor groups and from many conservative congressional Republicans, who may see it as a new tax.

http://www.pbs.org/newshour/rundown/mcconnell-intends-replace-obamacare-without-democrats/

Republicans will repeal and replace the health care law and overhaul the tax code without Democratic help or votes, Senate Majority Leader Mitch McConnell said Friday.

“It’s clear that in the early months it’s going to be a Republicans-only exercise,” the Kentucky senator said at a news conference before lawmakers left for a weeklong President’s Day recess. “We don’t expect any Democratic cooperation on the replacement of Obamacare, we don’t expect any Democratic cooperation on tax reform.”

McConnell has condemned Democrats for passing Obamacare in the first place, in 2010, without any Republican votes, claiming the partisan exercise set the law up to fail. “The mess to come was inevitable,” McConnell wrote in his memoir last year.

But now he’s promising the same approach himself, in a sign that the partisanship and polarization dividing the country and Congress under President Donald Trump will not end anytime soon.

“Clearly this is not one of those bipartisan ‘Kumbaya’ moments, and so we, as Republicans, expect that both of those issues will be — which are very big issues — will have to be tackled Republican-only,” McConnell said.

A strictly partisan approach on major legislation is a departure in the Senate, where most significant bills require involvement by both parties. Republicans plan to use a parliamentary maneuver to get health care and tax legislation through the narrowly divided Senate as part of a budget bill that requires only a simple majority to pass and can’t be blocked by Democrats.

But McConnell said the polarization in Congress is Democrats’ fault because they haven’t come to terms with the fact that Trump won the election.

“I’m hopeful that, as I said earlier, when the fever breaks, that maybe we’ll be able to move on,” said McConnell, in a turn of phrase that former President Barack Obama sometimes used to express hope that opposition from the tea party right might recede, which it never did.