Donald Trump and his pick to lead the Obamacare repeal effort, Rep. Tom Price, share a vision that the current health care system needs to be completely uprooted.
But the two men have articulated wildly divergent visions for what comes next — and that’s making it hard for Hill Republicans to figure out where to start on a coherent replacement plan once Obamacare is gone.
Over the weekend, Trump said he wants to substantially expand coverage once Price is confirmed as Health and Human Services secretary — “insurance for everybody” as he put it to the Washington Post. But as a House member and former chairman of the House Budget Committee, the Georgia Republican wrote one of the most conservative visions for health care, although his plan never included universal coverage as a stated goal.
Congressional Republicans are caught in between, racing to repeal Obamacare while receiving mixed signals from the incoming administration about what will replace it. Several key Republicans have already indicated Price’s approach won’t undergird the legislative process.
Senate Finance Chairman Orrin Hatch (R-Utah) stopped to greet Price warmly late last week, then said in an interview that Price’s bills from last Congress aren’t indicative of where Republicans are at.
“No. I don’t know what it will be. We’ve got a new element in Donald Trump,” said Hatch, the Senate Finance Committee chairman. “We still don’t know exactly what they want to do.”
GOP lawmakers, including Price, stress they are less concerned about matching Obamacare’s coverage gains, which drove the nation’s uninsured rate to a historic low of 9 percent. They would rather people have access to affordable insurance only if they want it, hoping to avoid Obamacare’s individual mandate.
But Trump indicated that he wants his plan to match Obamacare, if not exceed it, when it comes to expanding health care coverage. One of the chief GOP criticisms of Obamacare is that while it expanded insurance coverage, high deductibles and narrow networks reduced actual access to doctors and hospitals.
Some Republicans expect Price to take a different tack when he takes a post in the executive branch.
“I don’t know what his bill said two years ago. My guess is that Tom Price as head of HHS will approach things vastly different than Tom Price who was introducing legislation that was never going to become law, OK?” said Sen. Bob Corker (R-Tenn.).
Price’s plan would provide consumers tax credits to help them buy insurance coverage — everyone would get at least $1,200 a year, increasing with age, regardless of income. No one could be denied coverage by an insurance company as long as they maintain coverage — otherwise insurance companies could deny coverage or charge a significant penalty for entering the insurance market post-Obamacare, a point Democrats already strongly oppose. Health Savings Accounts would also be expanded.
A number of Senate Republicans echoed Corkers’s statement, saying they do not view Price’s plan as the starting point for the GOP. But thus far, Hill Republicans have not echoed Trump’s call for all Americans to enjoy access to insurance either.
And in the House Republicans are much more receptive to their colleague’s plan. And because Trump selected Price as his HHS secretary, they view his bill as a logical jumping off point.
“Dr. Price was a leader of our better way agenda on health care and helped shape … much of what…