This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.theguardian.com/us-news/2017/mar/08/healthcare-reform-trump-republican-opposition

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
How Republican opposition to healthcare reform is taking shape How Republican opposition to healthcare reform is taking shape
(35 minutes later)
Amongst his many broad-brush election year promises to voters, Donald Trump built his victory on a commitment to repeal and replace what he constantly described as the “disaster” of Obamacare. Among his many broad-brush election year promises to voters, Donald Trump built his victory on a commitment to repeal and replace what he constantly described as the “disaster” of Obamacare.
Republicans on Capitol Hill had spent much of the past six years demanding the same – a Republican-dominated House voting more than 50 times to repeal the law.Republicans on Capitol Hill had spent much of the past six years demanding the same – a Republican-dominated House voting more than 50 times to repeal the law.
Now they have their opportunity, but the realities of shaping a law that pleases all wings of the congressional GOP bring a number of challenges.Now they have their opportunity, but the realities of shaping a law that pleases all wings of the congressional GOP bring a number of challenges.
Republicans in the House have proposed the American Health Care Act (AHCA) to repeal and replace Obamacare, but many conservatives view the legislation as “Obamacare lite” and a continuation of what they see as the big government excesses of the last president’s Affordable Care Act. Others have more narrow concerns focused on specific provisions. With Republicans able to lose only two votes in the Senate and a mere 21 in the House, any defections could prove costly.Republicans in the House have proposed the American Health Care Act (AHCA) to repeal and replace Obamacare, but many conservatives view the legislation as “Obamacare lite” and a continuation of what they see as the big government excesses of the last president’s Affordable Care Act. Others have more narrow concerns focused on specific provisions. With Republicans able to lose only two votes in the Senate and a mere 21 in the House, any defections could prove costly.
These are the five most important people or groups on the fence about the proposal so far:These are the five most important people or groups on the fence about the proposal so far:
House Freedom CaucusHouse Freedom Caucus
Members of the Freedom Caucus, a group of dedicated conservatives among the House Republicans, have grave doubts about the bill. The Freedom Caucus and those affiliated with it have long been willing to take strong stances in defiance of House leadership and played an important role in the 2013 government shutdown.Members of the Freedom Caucus, a group of dedicated conservatives among the House Republicans, have grave doubts about the bill. The Freedom Caucus and those affiliated with it have long been willing to take strong stances in defiance of House leadership and played an important role in the 2013 government shutdown.
At a press event on Tuesday, where they touted their own alternative plan to repeal and replace Obamacare, members of the group derided the new proposal as “Obamacare in a different form”. With roughly 40 members, chaired by the North Carolina representative Mark Meadows, this faction of the party could use a united front to derail any legislation in the House and deny the speaker, Paul Ryan, the majority needed to pass a bill.At a press event on Tuesday, where they touted their own alternative plan to repeal and replace Obamacare, members of the group derided the new proposal as “Obamacare in a different form”. With roughly 40 members, chaired by the North Carolina representative Mark Meadows, this faction of the party could use a united front to derail any legislation in the House and deny the speaker, Paul Ryan, the majority needed to pass a bill.
However, this group is politically vulnerable. All of them have primaries in 18 months and could be attacked for being insufficiently loyal to Trump.However, this group is politically vulnerable. All of them have primaries in 18 months and could be attacked for being insufficiently loyal to Trump.
Senate conservativesSenate conservatives
Republicans are vulnerable in the Senate, too, with a slim majority of 52-48. Two defections would force Vice-President Mike Pence to cast a tie-breaking vote and three would leave them unable to pass legislation.Republicans are vulnerable in the Senate, too, with a slim majority of 52-48. Two defections would force Vice-President Mike Pence to cast a tie-breaking vote and three would leave them unable to pass legislation.
Both Rand Paul of Kentucky and Mike Lee of Utah have already voiced their opposition to the AHCA, with Lee calling it “a missed opportunity” on Tuesday. If other Senate Republicans, such as Ted Cruz, join in the effort, it would stonewall further efforts in the upper chamber.Both Rand Paul of Kentucky and Mike Lee of Utah have already voiced their opposition to the AHCA, with Lee calling it “a missed opportunity” on Tuesday. If other Senate Republicans, such as Ted Cruz, join in the effort, it would stonewall further efforts in the upper chamber.
However, while both Lee and Paul were just re-elected to six-year terms in 2016, Cruz faces an election challenge in 2018 and already has angered many Trump loyalists with his hesitancy to endorse Trump in the 2016 election.However, while both Lee and Paul were just re-elected to six-year terms in 2016, Cruz faces an election challenge in 2018 and already has angered many Trump loyalists with his hesitancy to endorse Trump in the 2016 election.
Outside groupsOutside groups
In addition to conservatives in the House and Senate, many influential outside conservative pressure groups have come out in opposition to the bill. These include the Club for Growth, Heritage Action, Freedom Works and the Koch network-affiliated Freedom Partners.In addition to conservatives in the House and Senate, many influential outside conservative pressure groups have come out in opposition to the bill. These include the Club for Growth, Heritage Action, Freedom Works and the Koch network-affiliated Freedom Partners.
These groups have significant grassroots networks which can be mobilized and many have been involved in primary challenges in the past against Republicans deemed insufficiently conservative. They have the ability to put outside pressure on members; Freedom Works has already announced a six-figure ad buy to rally opposition to the current bill.These groups have significant grassroots networks which can be mobilized and many have been involved in primary challenges in the past against Republicans deemed insufficiently conservative. They have the ability to put outside pressure on members; Freedom Works has already announced a six-figure ad buy to rally opposition to the current bill.
Republicans concerned about MedicaidRepublicans concerned about Medicaid
Four Republicans wrote a letter on Monday expressing concern about a draft version of the proposal to roll back the expansion of Medicaid, a federal health insurance program for low-income Americans. The four said that they could not support “a plan that does not include stability for Medicaid expansion populations or flexibility for states”.Four Republicans wrote a letter on Monday expressing concern about a draft version of the proposal to roll back the expansion of Medicaid, a federal health insurance program for low-income Americans. The four said that they could not support “a plan that does not include stability for Medicaid expansion populations or flexibility for states”.
The group, which consists of Cory Gardner of Colorado, Shelley Moore Capito of West Virginia, Lisa Murkowski of Alaska and Rob Portman of Ohio, kept their criticisms very narrowly focused on the issues of maintaining access during the transition away from Obamacare for those who have benefited from Medicaid expansion.The group, which consists of Cory Gardner of Colorado, Shelley Moore Capito of West Virginia, Lisa Murkowski of Alaska and Rob Portman of Ohio, kept their criticisms very narrowly focused on the issues of maintaining access during the transition away from Obamacare for those who have benefited from Medicaid expansion.
Planned ParenthoodPlanned Parenthood
Two Senate Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, have voiced their opposition to defunding Planned Parenthood as part of the health reforms. Collins and Murkowski are on the record opposing a repeal bill that would prevent the abortion provider and reproductive health organization from receiving federal funds.Two Senate Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, have voiced their opposition to defunding Planned Parenthood as part of the health reforms. Collins and Murkowski are on the record opposing a repeal bill that would prevent the abortion provider and reproductive health organization from receiving federal funds.
However, they are both outliers in a Republican party that is almost uniformly opposed to abortion rights, and while Collins voted against legislation to repeal Obamacare and defund Planned Parenthood in 2015, Murkowski supported it.However, they are both outliers in a Republican party that is almost uniformly opposed to abortion rights, and while Collins voted against legislation to repeal Obamacare and defund Planned Parenthood in 2015, Murkowski supported it.