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A4 U.S. NEWS
Tuesday 27 december 2016
Analysis: GOP vexed by factions on replacing health law

RICARDO ALONSO-ZALDI- have to unite the groups That includes major players
VAR on complicated chang- among hospitals, insurers
Associated Press es affecting the financial and pharmaceuticals.
WASHINGTON (AP) — Re- and physical well-being Trump may have given this
publicans are united on of millions of people. For group some cover by say-
repealing President Barack some constituents in frag- ing that he wants to keep
Obama’s health care law, ile health, it’s literally a life- parts of the law, but his bot-
but ideologically and prac- and-death debate. tom line remains unknown.
tically speaking, they’re in Republicans have “a really BUDGET HAWKS
different camps over re- narrow path,” says Grace- For budget hawks, unwind-
placing it. Getting the fac- Marie Turner of the Galen ing the Obama health law
tions together won’t be Institute, a free-market is a beginning. Next they
easy. health care research or- could move on to much
Some Republicans would ganization. “They’ve got to bigger objectives like re-
revise and rebrand “Obam- deal with the politics of this, In this Dec. 1, 2016 file photo, House Ways and Means Commit- structuring Medicaid and
acare,” junking unpopular they’ve got to make sure tee Chairman Rep. Kevin Brady, R-Texas. speaks on Capitol Hill Medicare, and placing a
provisions like its require- they come up with good in Washington. cost-conscious limit on tax
ment that most Americans policy, and they also have Associated Press breaks for employer cov-
carry health insurance, process challenges.” in Brady seems unfazed will be done deliberately, erage. Budget hawks see
while preserving well-liked Success is not guaranteed, by the challenge. “It’s like in an appropriate timeta- health care as the main
parts. Others would rip up and Republicans may tax reform,” says Brady, ble.” driver of government defi-
the Affordable Care Act, come to regret that their R-Texas, explaining that Republicans say they will cits, and they are loath to
or ACA, and not replace it. party defined itself as to- many pieces will be pulled move quickly to repeal address that imbalance by
President-elect Donald tally opposed to “Obam- together. “Unlike Obam- the ACA, while suspending raising taxes. Instead they
Trump and Republican acare.” Yet House Ways acare, which ripped up the effective date to allow want to rewrite the social
congressional leaders will and Means Chairman Kev- the individual market, this them to craft a replace- compact so individuals
ment. Here’s a look at the accept more responsibil-
GOP camps and who’s in ity and risk for their health
them: care.
REVISE & REBRAND House Speaker Paul Ryan is
Many Republicans may the most prominent mem-
quietly be in this con- ber of this camp, and his
tingent, but fear being “Better Way” agenda is its
accused of promoting roadmap. Georgia Rep.
“Obamacare-lite.” Tom Price, Trump’s nomi-
They’d strip out some of nee for Health and Hu-
the ACA’s taxes and re- man Services, is a budget
quirements. The unpopular hawk. Vice President-elect
“individual mandate” to Mike Pence has been in
carry health insurance or the same orbit throughout
risk fines could be replaced his career. The problem
with other persuasion short for budget hawks is that
of a government dictate. the 2016 political cam-
Rules on insurers would paign did not give them a
be loosened. But popular mandate. Issues like Medi-
provisions such as protect- care and Medicaid were
ing those with pre-existing scarcely discussed. Trump
health conditions would said he wouldn’t cut Medi-
be retained in some form, care, and sent conflicting
as well as financial assis- signals on Medicaid.
tance for low- and mod- Many Democrats can’t
erate-income people. The wait for Republicans to
requirement that health follow the call of the bud-
plans cover adult children get hawks. Betting that
until age 26 would be fairly will backfire, House Demo-
easy to preserve, since em- cratic Leader Nancy Pelosi
ployers have accommo- is rallying her lawmakers
dated it. against “attacks on the
A rebranded version of ACA and Medicare.”
Obama’s law may well THE RIP-IT-UP SOCIETY
cover fewer people. But The most conservative
its GOP advocates be- lawmakers want to “pull
lieve most Americans will Obamacare up by the
find their goal of “univer- roots as if it never existed,”
sal access” politically ac- says Republican political
ceptable when measured consultant Frank Luntz.
against the Democratic That sentiment is embod-
ideal of “universal cover- ied by the 40 or so mem-
age” underwritten by gov- bers of the House Freedom
ernment. Many GOP allies Caucus, and it’s probably
in the business community broadly shared among
favor revising the ACA. conservatives.q