Speaker Ryan urges 'critical first step' toward ending health law

Washington (AP) — Speaker Paul Ryan urged the GOP-controlled House to pass a "critical first step toward delivering relief" from President Barack Obama's signature health care law as the chamber steamed ahead on legislation that is the first step toward repealing it and replacing it with something else.

The law's main architect, Minority Leader Nancy Pelosi, D-Calif., accused Republicans of having an "ideological obsession" that would take away health care and economic security from millions of Americans.

Friday's vote would clear the way for a subsequent repeal bill to advance in the Senate without the threat of a Democratic filibuster.

The legislation doesn't need to be signed by the president and wouldn't actually change a word of the hotly contested health care law. But its passage is crucial if Republicans controlling Congress are to keep their long-standing promise to scuttle the law, which has delivered health coverage to about 20 million people but is saddled with problems such as rapidly rising premiums and large co-payments.

"The law is collapsing. The insurers are pulling out. People can't afford it. The deductibles are so high it doesn't even feel you have insurance in the first place," said Ryan, R-Wis. Republicans promise to "repeal and replace" the law but have yet to unite behind an alternative.

"For six years, they have had a chance to propose an alternative," Pelosi said. "We've seen nothing, but what we have seen is their cut and run. They want to cut benefits and run."

Rep. John Shimkus, R-Ill., said during debate that the public sent a clear message in the November election that the health care law should be repealed. "This is going to happen," he said. "And we know there's going to be a replacement."

Timing for the subsequent binding repeal measure is uncertain, but Republicans want to pass it as quickly as possible. The House legislation would let a repeal bill pass without having to clear the 60-vote filibuster hurdle in the Senate, where Republicans control 52 seats and where Democrats are gearing up for an epic battle.

After pressure from both President-elect Donald Trump and rank-and-file lawmakers, House GOP leaders are now promising to advance legislation to repeal the health law and replace it with something else at the same time.

"We have a responsibility to step in and provide relief from this failing law," Ryan told journalists Thursday. "And we have to do it all at the same time so that everybody sees what we're trying to do."

Trump is promising the public he will sign legislation to repeal and replace the law soon. Republican leaders are trying to deliver, but it seems as if Trump may be overpromising, given the enormity of the task and the political stakes involved.

Senior Republicans including Senate Majority Leader Mitch McConnell, R-Ky., aren't setting a timetable but promise that the early repeal bill would "begin to make important progress" and that a replacement measure will come in "manageable pieces, with step-by-step reforms."

The Senate approved the preliminary repeal measure early Thursday morning on a near party-line 51-48 vote, and Trump spurred on House Republicans. "The 'Unaffordable' Care Act will soon be history!" Trump tweeted.

The controversial law has provided health care subsidies and Medicaid coverage for millions who don't get insurance at work. It has required insurers to cover certain services like family planning and people who are already ill, and has curbed rates that the sick and elderly can be charged.

GOP leaders hope to use their first bill to void and rewrite as much of Obama's law as they can, but so far they've provided little detail.

Republicans want to end the fines that enforce requirements that many individuals buy coverage and that larger companies provide it to workers — mandates that experts say were needed to stabilize insurers' rates. They also want to erase the taxes the law imposed on higher-income people and the health care industry, eliminate its subsidies that help people buy policies and pare back its Medicaid expansion.

But they face internal disagreements over policy, such as how to pay for their new statute and how to protect consumers and insurers during what may be a two- or three-year phase-out of Obama's overhaul.

By Andrew Taylor, Associated Press. Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

The Gayly – January 13, 2017 @ 1 p.m.