Issue link: http://palletcentral.uberflip.com/i/819351
palletcentral.com PalletCentral • March-April 2017 23 "The coverage that President Trump said he wished to have, at least as generous as Obamacare, would be undermined by accelerating that phase-out," said Sen. Bill Cassidy, who has introduced an alternative bill that would let states keep Obamacare if they want to. Even if the repeal bill appears to be doomed in the Senate, some experts expect a bill to still come from House Republicans. "I think not having any bill come out of the House is a problem for them politically," said Robert Blendon, a health policy and political-analysis professor at Harvard University. He said if the House fails to push anything forward, Republicans will be more nervous about the 2018 election. He added that if the legislation goes on to fail in the Senate, House members would be able to tell constituents they fought for repeal but senators let them down. If the Republican legislation does not move forward quickly, or at all, lawmakers could possibly turn toward administrative actions to unwind Obamacare. Judith Feder, a public- policy professor at Georgetown University and a fellow at the Urban Institute, said the Trump administration could continue to relax enforcement of the law, noting that it has already in- dicated that it could loosen enforcement of the individual mandate. But if lawmakers are going to emphasize administrative actions, then they are going to need clearer messaging from the White House, said Molly Reynolds, a fellow in governance studies at the Brookings Institution. Conservatives said they received signals from the White House that parts of the GOP plan were negotiable. But the administration has sent mixed signals about what types of changes it would support. Rep. Joe Barton said that the White House might be open to accelerating a freeze in Obamacare's Medicaid expansion. But President Trump also was reportedly enamored with a plan presented to him by Ohio Gov. John Kasich – one of the Medicaid expansion's biggest Republican champions. Administration officials, including Health and Human Services Secretary Tom Price, have said administrative changes are part of their repeal-and-replace strategy, and faulted CBO for "ignoring" additional policy changes that Republicans have not yet proposed or described. "The CBO looked at a portion of our plan, but not the entire plan," Price said Monday. "In fact, the entire plan includes the regulatory apparatus that we've got the ability to use at Health and Human Services … They also ignored completely the other legislative activities that we'll be putting into place that will make certain that we have an insurance market that actually works. So we disagree strenuously with the report that was put out." PC Erin Durkin is a health care correspondent at National Journal covering Congress. She previously was the managing editor and reporter for FDA Week covering food, drug, and device regulation. This article is published with permission from the National Journal. Erin may be reached through NationalJournal.com. NWPCA Side Note The NWPCA's Government Affairs Committee held a conference call on April 3 with guest speaker Craig Kennedy, executive director of the Association of Clinicians for the Underserved (ACU), to discuss the health care issue. Kennedy noted that although repeal of the Affordable Care Act failed, there are a lot of tax provisions in health care. Republicans are not going to give up nor admit defeat, and to keep an eye on the expected Tax Bill reform coming up next as a major issue in Congress. Kennedy, responding to a question on why it failed, pointed out that repeal would mean replacement. The timing of the replacement would place it too close to elections in two years, therefore a tactic to stall the timing and delivery of bad news caused the failure.