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Alice Ollstein

Alice Ollstein is a reporter at Talking Points Memo, covering national politics. She graduated from Oberlin College in 2010 and has been reporting in DC ever since, covering the Supreme Court, Congress and national elections for TV, radio, print, and online outlets. Her work has aired on Free Speech Radio News, All Things Considered, Channel News Asia, and Telesur, and her writing has been published by The Atlantic, La Opinión, and The Hill Rag. She was elected in 2016 as an at-large board member of the DC Chapter of the Society of Professional Journalists. Alice grew up in Santa Monica, California and began working for local newspapers in her early teens.

Articles by Alice

It all came down to California.

With House Majority Leader Kevin McCarthy (R-CA) furiously whipping wobbling Republican members, the bill to repeal the Affordable Care Act passed the House by just two votes Thursday afternoon.

Right up until the final hours before the vote, a number of California Republicans remained publicly undecided. Yet by the time the gavel came down, enough fell in line and voted with the majority of their party to nudge the bill over the finish line.

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The moment the vote scoreboard on the wall of the House chamber showed Republicans had cleared 216 votes on their bill to repeal the Affordable Care Act, GOP lawmakers broke into loud cheers. Some pumped their arms in the air, while others clapped in a more subdued fashion.

Rep. Tom MacArthur (R-NJ), however, warned his colleagues against excessive jubilation. MacArthur, a co-chairman of the moderate Tuesday Morning group, negotiated a key amendment to the bill that won over critical votes from the House Freedom Caucus.

“I don’t think it’s a day for spiking the football,” he said, shortly after the vote. “This is an important bill. And I’m glad we did it, but I recognize there are a lot of Americans who have concerns. We have a lot of work to do helping people understand what this really does. They have been subject to a lot of fear-mongering.”

MacArthur then left to join 200-plus other lawmakers boarding buses to the White House to celebrate the bill’s passage with President Donald Trump. Protesters chanted, “Shame!” at the Republicans as they filed onto the buses, and Democratic lawmakers sang at them, “Na Na Hey Hey Kiss Him Goodbye.”

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Just a few hours before a scheduled vote on a bill to repeal the Affordable Care Act, the House voted 429-0 to strip out a provision in that legislation that would have exempted members of Congress and their staffers from some of the most radical changes to health care law.

“We firmly believe members of Congress should live by the same rules as everyone else. Period,” Rep. Michael Burgess (R-TX) said Thursday on the House floor. “It’s only right. It’s only proper.”

Journalists in late April noticed and highlighted technical language in the American Health Care Act that shielded members of Congress from waivers of Obamacare’s protections on age rating, essential health benefits and community rating—meaning that they would retain those protections even if their constituents lost them.

“They planned to exempt themselves from Trumpcare until they got caught,” Rep. Jan Schakowsky (D-IL) accused Republicans from the House floor.

Some Republican lawmakers told TPM last week that they were not aware of the carve-out provision. Others tried to argue—incorrectly—that they would not be carved out because they are part of Washington D.C.’s marketplace, and that since D.C. is not a state the provision doesn’t apply. GOP leadership then argued that the carve-out was in the bill in order to comply with the Senate’s reconciliation rules and receive a fast-track, party-line vote, but Senate aides disputed this.

After voting to strip out the exemption language, House Republicans said they were ready to vote on the health care bill itself, saying they were pleased it would apply to themselves as well as the rest of the country.

“Most Americans know that what’s good for the goose is good for the gander,” Rep. Pete Olsen (R-TX) said.

 

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With a vote on the GOP bill to repeal the Affordable Care Act just hours away, the last remaining holdouts in the Republican conference are feeling the heat. Rep. Carlos Curbelo (R-FL), who as of Wednesday was undecided and hadn’t seen the final text of the bill, told TPM Thursday morning that he is feeling much better about the bill.

“Some of my concerns have been addressed, but there are others,” he said, walking out of a closed-door meeting in the Capitol basement.

Curbelo said he was largely convinced by Rep. Fred Upton (R-MI), who rolled out a new amendment yesterday that allocates an additional $8 billion dollars over five years for states that opt out of cost protections for people with pre-existing conditions.

“No matter where someone ends up in the health care states, even if they are in one of these opt-out states and they haven’t kept continuous coverage, there’s going to be support for him. That’s what the Upton amendment kind of cures. That was important for me,” he said.

Moderates like Curbelo remain uncomfortable with many aspects of the underlying bill—including cuts to Medicaid on the magnitude of hundreds of billions of dollars.

Yet many, including Curbelo, have told TPM they are pinning their hopes on the Senate to sand down the legislation’s harshest edges. He says he is already working with his fellow Floridian Sen. Marco Rubio and other Senate offices on amendments to increase tax credits for low-income people who are nearing the age of retirement.

“I want as much of a guarantee as I can get from Senate offices that that is a major priority and that it’s going to get done,” he said.

Curbelo did not seem aware of a little-noticed provision in the bill that allows for the return of annual and lifetime limits on health care in employer-sponsored plans.

“The [Energy and Commerce] committee has argued that that wouldn’t be the case, but I need to get more information on that,” he said.

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After eight years of railing against the Affordable Care Act, dozens of toothless repeal votes, and weeks of struggling to put together a viable alternative despite controlling every lever of government, Republicans in Congress said Wednesday that they have finally secured the votes needed to pass their own health care overhaul.

A vote is scheduled for tk.

LEADERSHIP QUOTE

The final bill text has not been released to the public or to lawmakers, and there has been no independent analysis of the cost or impact on health coverage. Yet the House will forge ahead with a vote this week.

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After eight years of railing against the Affordable Care Act, dozens of symbolic repeal votes, and weeks of struggling to put together a viable alternative despite controlling every lever of government, Republican House leaders said late Wednesday afternoon that they have finally secured the votes needed to pass their own health care overhaul. It is expected to be a nail-biter of a vote, and last-minute defections are possible.

House Majority Leader Kevin McCarthy came out of a closed door leadership meeting around 7 p.m. Wednesday night to announce that they had locked up the votes to pass the bill and would bring it to the floor on Thursday.

“I think we have enough votes,” he told reporters. “It’s a good bill. As you know, we already debated a large portion of this. We’re going to pass it.”

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Tierney Sneed contributed reporting.

Even as rumors of a House vote as early as Thursday to repeal the Affordable Care Act rippled around the Capitol Wednesday afternoon, lawmakers told TPM they have not yet seen the final text of the bill, will not wait for the Congressional Budget Office to analyze it, and do not know if there are enough Republican supporters to ensure its passage.

It’s become a near-weekly ritual for the White House to demand a vote on the ever-evolving American Health Care Act only to see momentum fizzle out and negotiations move behind closed doors. But this time, Republican lawmakers swear they are within just a few votes of sealing the deal.

“I’m told that all systems are go,” Rep. Mark Sanford (R-SC) told reporters. “My suspicion is that the vote will come tomorrow.”

Some lawmakers wondered aloud if the vote would happen Thursday or Friday, while others floated the possibility it could move late Wednesday night.

“I don’t know. I wish I knew. I wish I had news for you,” said Rep. Brett Guthrie (R-KY).

Many lawmakers reported that President Donald Trump has been pushing hard for a vote as soon as possible, phoning individual members, summoning dissenters to the White House, and winning over holdouts with personal pleas.

Rep. Bill Flores (R-TX) told reporters Wednesday that when it came to health care negotiations, Trump has “been all over this like a dog on a bone.”

Yet negotiating with a president who has no political experience and little knowledge of health care policy hasn’t been easy.

“This president has more philosophic dexterity than most presidents I’ve dealt with in the past,” Sanford said with a smile on Wednesday. “That makes it a little different. Typically there’s a fixed starting point and a fixed ending point.”

Thanks to that “dexterity,” Sanford and the rest of the Freedom Caucus extracted major concessions from Trump and Republican leadership over the past few weeks, including provisions that will allow states to waive Obamacare’s rules that ensure essential benefits are covered by all health care policies and that protect people with pre-existing conditions from being priced out of the market.

That left moderate Republicans, who fear those amendments will severely hurt their constituents, in the hot seat.

House GOP Leadership unveiled a new amendment late Tuesday night to try to win back their support—a provision that would allocate an additional $8 billion dollars over five years for states that waive cost protections for people with pre-existing conditions.

“You know, based on the past it seemed like an appropriate amount,” Rep. Greg Walden (R-OR), chair of the Energy and Commerce Committee, explained. “It’s like, what do we think the right amount will be? This seemed to be the logical amount.”

Walden added that the money won’t need to be spread over several states, because: “If you go way back, there weren’t that many states that created their own high risk pools anyway,” he argued. In fact, prior to the Affordable Care Act, 35 states did so.

Even the author of the amendment, Rep. Fred Upton (R-MI), seemed to struggle when pressed on how exactly the policy would work.

“What it in essence does is it takes $8 billion dollars—in essence, new money, for 5 years,” he said, “and it’s provided to the risk pools to those states that have sought successfully a waiver to deal with their future.” Upton added that this money would help “buy down” the premiums of people in those high-risk pools.

But when asked if amendment could actually incentivize states to waive protections for people with pre-existing conditions, since those who maintain them can’t receive the money, several lawmakers appeared unsure.

“That’s a good question,” Rep. Carlos Curbelo (R-FL) responded. “The amendment hasn’t been filed yet. I want to see it once it gets filed.”

“I haven’t seen the language, so I don’t know that it really does that,” Rep. Bill Flores (R-TX) told TPM. “I’ve only heard about what’s in it.”

Flores added that he wasn’t troubled that the House was barreling towards a vote without waiting for an analysis from the Congressional Budget Office on how it would impact the federal deficit and how many people could lose their health insurance if it passes.

“I can take the numbers we had before and add from there,” he said.

The Congressional Budget Office reported in March that the original GOP health care bill would reduce the deficit by more than $300 billion over a decade. Lawmakers have made several major changes to the bill since then—allocating tens of billions of dollars for high-risk pools and allowing states to sell insurance that doesn’t cover essential health benefits—but are not seeking an updated score.

Lawmakers shrugged off concerns that the additional funding for high-risk pools in the new amendment would expire after just five years.

“I think you’ll see that pre-existing condition premiums, for the most part, come down, not up,”Rep. Mark Meadows (R-NC) told TPM. “If you look at the Maine model, they actually came down.”

Maine’s high-risk pool system—however—was much more subsidized than what Republicans are proposing, and premiums still sharply increased for many older patients and small business employees.

“I think what you’ll see a real effort to make sure people with pre-existing conditions are taken care of,” Meadows asserted.

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As the White House and GOP leaders scramble to win back several prominent defectors from their bill to repeal the Affordable Care Act, Senate Minority Leader Chuck Schumer (D-NY) took to the Senate floor Wednesday morning to warn wavering House members not to stake their reputations on a bill unlikely to ever to reach the President’s desk.

“Even if the new version of Trumpcare passes the House—we hope it doesn’t—its chances for survival in the Senate are small,” he said. “So to my moderate Republican colleagues in the House, I ask, why would you risk a yes vote for a bill that is devastating to your constituents and has virtually a minuscule chance, probably no chance of becoming law?”

Schumer also criticized both the policy and process behind the American Health Care Act, which he repeatedly branded “Trumpcare,” saying a new amendment drafted Tuesday night will do little to solve the basic problems at the heart of the legislation.

“The significant changes House Republicans are proposing to the bill would still cause premiums and deductibles to rise, would still jack up the costs on low-income and older Americans, and most importantly, it doesn’t change a thing about the 24 million fewer Americans who would get health care,” Schumer said. “Second, it’s unwise, irresponsible to rush through a brand-new bill without a new [Congressional Budget Office] score, without committee hearings, without any debate on the floor of the House.”

Schumer noted that without an analysis from the non-partisan CBO, which calculates the impact of legislation on the federal deficit, it is far from certain that the bill can pass the Senate on a simple majority vote under the reconciliation rules. The CBO reported in March that the original GOP health care bill would reduce the deficit by more than $300 billion dollars over a decade. But lawmakers have made several major changes to the bill since then, and are not seeking an updated score.

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President Donald Trump and GOP leaders are asserting that their bill to repeal the Affordable Care Act will protect people with pre-existing conditions—despite fact that the current bill allows states to waive the protections, giving insurers a green light to jack up the rates of those with a chronic illness or disability.

Other rank-and-file lawmakers have been more blunt.

“People can go to the state that they want to live in,” Rep. Robert Pittenger (R-NC) told reporters Tuesday morning when asked if people with pre-existing conditions could be charged much more under the American Health Care Act.

“States have all kinds of different policies and there are disparities among states for many things: driving restrictions, alcohol, whatever,” he continued. “We’re putting choices back in the hands of the states. That’s what Jeffersonian democracy provides for.”

Pittenger acknowledged that under an amendment to the bill rolled out in April to win over the support of hardline conservatives, states can apply for waivers to Obamacare’s community rating rule, which limits how much insurance companies can charge people with pre-existing conditions. With no limit set in the bill for what insurers could charge, many patient advocacy groups say they’re afraid millions of people could be priced out of health insurance entirely.

Under the GOP’s amended bill, states could also seek waivers to Obamacare’s essential health benefits rule, allowing insurers to sell bare bones plans that don’t cover things like prescription medicine, emergency room visits, or maternity care.

“This is federalism,” Pittenger said. “This brings the choices back to the American people and back to the states.”

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