Republicans are wrestling with the difficult task of how to repeal and replace ObamaCare.
The party remains divided on many central questions: How long should repeal take? Should the Medicaid expansion be abolished? And should some of the taxes in ObamaCare be kept to help pay for a new coverage option?
As President Trump, Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.) seek to build consensus on the path forward, here are 10 of the biggest players to watch.
Sen. Lamar Alexander (R-Tenn.)
Alexander is helping to lead the Senate’s ObamaCare efforts as chairman of the Senate Health Committee. Adopting a pragmatic tone, Alexander has touted the “repair” of ObamaCare rather than repeal and called for targeted actions to make the individual market more stable.
“We can repair the individual market, which is a good place to start,” Alexander said at a hearing he held earlier this month.
Alexander has expressed hope about working with Democrats on the issue, but the polarized politics of ObamaCare could make that all but impossible. Still, Alexander recently cited a letter from Sen. Tim Kaine (D-Va.) offering to work on improvements to the law.
Rep. Mark Meadows (R-N.C.)
Meadows is among those calling for a speedy repeal of ObamaCare; as chairman of the conservative House Freedom Caucus, his voice carries weight.
Conservatives are growing impatient with the pace of repeal and replace efforts. Meadows, along with his predecessor as Freedom Caucus chairman, Rep. Jim Jordan (R-Ohio), recently released a statement calling on Republican leaders to bring a repeal bill to a vote quickly.
They also warned the repeal legislation should not be watered down from what passed the House in 2015.
“There’s no reason we should put anything less on President Trump’s desk than we put on President Obama’s now that we know it will be signed into law,” Meadows and Jordan said.
Secretary of Health and Human Services Tom Price
Price is taking the helm of the administration’s healthcare efforts after a drawn-out confirmation battle.
One of the first actions his department appears ready to take is finishing a regulation on ObamaCare “market stabilization.” That regulation is likely to include several tweaks that would help insurance companies, including a crackdown on people gaming the system through extra signup periods.
The rule could help prevent insurers from bailing out of the ObamaCare market, buying time for the replacement effort.
Beyond that, Price could take actions to change central aspects of the law, like weakening enforcement of the mandate for people to get coverage. Trump has also indicated he could help shape a replacement plan, saying last month that his administration would release a plan after Price’s confirmation.
Sen. Dean Heller (R-Nev.)
Two big reasons to watch Heller: He is one of the few Democratic targets in the 2018 elections, and he comes from a state that accepted ObamaCare’s expansion of Medicaid, the insurance program for the poor.
Republican senators from states that accepted the Medicaid expansion are grappling with whether to try to salvage it under repeal. They met last week to start discussing their options.
During Price’s confirmation hearing, Heller expressed his worries about people losing coverage if the Medicaid expansion is repealed. Under the expansion, coverage is available to adults who earn up to 138 percent of the federal poverty level.
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