Congress completes first step to repealing health care law

WASHINGTON — The House is poised to back legislation that is the first — and by far the easiest — step toward gutting President Barack Obama's divisive health care law.

Friday's vote would clear the way for a subsequent repeal bill to advance in the Senate without the threat of a Democratic filibuster.

The legislation doesn't need to be signed by the president and wouldn't actually change a word of the hotly contested health care law. But its passage is crucial if Republicans controlling Congress are to keep their long-standing promise to scuttle the law, which has delivered health coverage to about 20 million people but is saddled with problems such as rapidly rising premiums and large co-payments.

Republicans on Friday lambasted the law and Democrats warned of harmful consequences of repealing it.

Rep. John Shimkus, R-Ill., said during debate that the public sent a clear message in the November election that the health care law should be repealed. "This is going to happen," he said. "And we know there's going to be a replacement."

Rep. Earl Blumenauer, R-Ore., scolded Republicans for constantly trying to repeal "Obamacare" but refusing "to work with us to fine-tune the legislation when we could move forward and build on this foundation."

The timetable for the upcoming, binding repeal measure is uncertain, but Republicans want to pass it as quickly as possible. The House legislation would let a repeal bill pass without having to clear the 60-vote filibuster hurdle in the Senate, where Republicans control 52 seats and Democrats are gearing up for an epic battle.

After pressure from both President-elect Donald Trump and rank-and-file lawmakers, House GOP leaders are now promising to advance legislation to repeal the health law and replace it with something else at the same time.

"We have a responsibility to step in and provide relief from this failing law," House Speaker Paul Ryan told journalists on Thursday. "And we have to do it all at the same time so that everybody sees what we're trying to do."

Trump is promising the public he will sign legislation to repeal and replace the law soon. Republican leaders are trying to deliver, but it seems as if Trump may be overpromising, given the enormity of the task and the political stakes involved.

Top Republicans such as Senate Majority Leader Mitch McConnell, R-Ky., aren't setting a timetable but promises that the early repeal bill would "begin to make important progress" and that the replacement measure will come in "manageable pieces, with step-by-step reforms."

The Senate approved the preliminary repeal measure early Thursday morning on a near party-line 51-48 vote, and Trump spurred on House Republicans. "The 'Unaffordable' Care Act will soon be history!" Trump tweeted.

The controversial law has provided health care subsidies and Medicaid coverage for millions who don't get insurance at work. It has required insurers to cover certain services like family planning and people who are already ill, and has curbed rates that the sick and elderly can be charged.

GOP leaders hope to use their first bill to void and rewrite as much of Obama's law as they can, but so far they've provided little detail.

Republicans want to end the fines that enforce requirements that many individuals buy coverage and that larger companies provide it to workers — mandates that experts say were needed to stabilize insurers' rates. They also want to erase the taxes the law imposed on higher-income people and the health care industry, eliminate its subsidies that help people buy policies and pare back its Medicaid expansion.

But they face internal disagreements over policy, such as how to pay for their new statute and how to protect consumers and insurers during what may be a two- or three-year phase-out of Obama's overhaul.

Associated Press