A House GOP aide involved in ongoing discussions told CNN that the strategy is being referred to as “Reconciliation Plus.” It refers to a budget reconciliation bill that would repeal Obamacare, plus additional measures that lawmakers can tack on in order to simultaneously “replace” what they roll back.
There are several replacement measures that top Republicans are currently considering involving the expansion of Health Savings Accounts, changes to Medicaid, tax credits and high-risk pools, according to two senior congressional GOP aides. The discussions are ongoing and still in flux, but these conversations reflect the GOP’s determination to act on repeal and replace at the same time.
Republican lawmakers are exploring both block grants and per-capital caps structures for Medicaid, per the two aides. They are also looking at adjusting the tax credits by age — an idea that House Speaker Paul Ryan included in his “A Better Way” plan — as well as by family size, according to a senior congressional aide.
And GOP leaders are also still looking to confirm that the strategy they are exploring of including Obamacare replacement measures in the repeal bill will pass the Parliamentarian test. They are particularly concerned about the “Byrd Rule,” which deals with the budget reconciliation process and lays out strict rules on what can be included in a reconciliation bill.
The House passed a reconciliation bill in 2015 that would repeal Obamacare, but this would mark the first time that Republicans are attempting to also attach replacement measures to that vehicle.
And it’s unclear whether this strategy will appease everyone in the GOP conference.
Some conservative Republicans have started to complain that Obamacare repeal has become too complicated and drawn-out, and are advocating that GOP leaders quickly take a vote on a budget reconciliation bill from 2015 that repealed Obamacare (it was vetoed by President Barack Obama).
Rep. Mark Meadows, the chairman of the conservative House Freedom Caucus, told CNN that the party needs to move much faster on repeal.
“I don’t know that there’s any new revelations that are going to come up by waiting 60 to 90 more days,” Meadows said. “We’re making the whole idea of repeal and replacement far more complex and laborious than it needs to be and I think it’s time that we just make some decisions and move forward with (the repeal bill).”
But Republican leaders believe that it’s important to include as many replacement measures as possible in the repeal bill because the budget reconciliation legislation only requires a simple majority of senators to be approved. Republicans are not hopeful that they will get help from Democratic colleagues on reforming Obamacare.
“Why limit ourselves when we actually are able to do more? It only takes 51 votes in the Senate to do that so strategically. It makes more sense to do as much as we can in reconciliation,” the House GOP aide said.
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