US President Donald Trump was facing a revolt on Tuesday by the conservative Republican Party, dissatisfied with the scope of its health reform bill, which it considers too “lukewarm”.
Several lawmakers accuse the proposal of betraying the conservative dogma of fiscal rigidity by maintaining current law subsidies under the guise of tax rebates for those who buy health insurance.
“This is an Obamacare light, and it will not be approved. Conservatives are not going to support that, “the ultraconservative senator and former presidential hopeful Rand Paul said Tuesday.
Trump, meanwhile, held meetings with about twenty Republican lawmakers, including the Senate chief of staff, and in front of the press’s microphones said he was “proud to support the reform bill.”
Health Secretary Tom Price said the presentation of the project is just “the beginning of the process” and that there would be intense negotiations ahead.
The attempt to reform the US health care system, seven years after the landmark law passed by Barack Obama, will have its first test on Wednesday when two House committees discuss and possibly amend the proposal.
Democratic lawmakers are expected to vote against it and Republicans must ensure strong internal unity to advance the bill, especially in the Senate where they have a narrow majority of 52-48.
Speaker of the House of Representatives, Paul Ryan, who has led the project, tried to minimize divisions within the partisan ranks.
“We’ll have 218 when this goes to the plenary, I can guarantee this,” Ryan said, referring to the majority of votes needed to pass laws in the 435-seat chamber.
In the United States, one of the few countries that lacks a universal and free health care system, health coverage is fundamentally a private market.
About half of Americans have private coverage through their employer, according to the Kaiser Family Foundation and only a third have access to a public system, which is reserved for the poorest citizens (the Medicaid program) and people over 65 years (Medicare).
The rest of the population is without medical coverage. The latter must pay exorbitant prices when they need medical attention and according to studies of May last year, totaled no less than 29 million people.
In 2010, then-President Barack Obama supported by the Democratic Party negotiated and passed a major reform of the health insurance system to reduce the number of people without medical coverage, estimated at 16% of the population.
The law (which was quickly ironically renamed by its critics “Obamacare”) modified the maximum income limits to allow more people to benefit from the Medicaid system and established financial aids such as tax cuts for people who adopted a private plan.
To facilitate the process, the government created a single market for bids whereby those interested could purchase those private plans at a reduced price. In contrast, the law imposed fines on people without coverage of a health plan.
Obama’s reform is credited with reducing the rate of uninsured people to less than 9 percent by 2016, but Republicans, for whom any idea of a universal health system smells of “socialism,” came to criticize the Obamacare for the cost to the State and the increase of the monthly payments of the insurers.
Still, the bill now submitted by Republicans kept two core provisions of Obamacare: that youths could be included in their parents’ health programs until the age of 26 and that health insurers can not refuse coverage of preexisting diseases.
The new legislation called for rejection from outside Congress on Tuesday: the neoliberal platform Club for Growth called it an “overheated substitute for a state health system.”
Vice President Mike Pence said the proposal was “open for improvement” in Congress.
The bill also faces opposition from moderate groups, including Republican governors who fear that the elimination of the Medicaid expansion will leave thousands of residents uninsured.