Republican House Speaker Paul Ryan’s decision today to halt the bill repealing key provisions of the Affordable Care Act has spared Maine’s GOP congressional members from having to take difficult votes that would have wide-ranging effects on their constituents.
The decision to abruptly pull the American Health Care Act after over four hours of debate came after Ryan realized he didn’t have enough GOP votes to pass it.
The vote was billed as Republicans’ first chance to fulfill a seven-year promise to get rid of the Affordable Care Act, and for President Donald Trump to make good on one of his leading campaign pledges. But the decision also means that Republicans on the fence won’t have to take a vote that many in the GOP worried could have electoral consequences, U.S. Rep. Bruce Poliquin of Maine’s 2nd District among them.
Initially, Poliquin said the bill "will bring much needed health insurance relief to the American People while keeping the promises made to them." This week he said it needed changes. Even as the debate unfolded Friday, Poliquin’s office said the congressman had not made up his mind. Poliquin's press office released a lengthy statement after the vote, but he gave no indication of how he would have voted had the vote not been canceled.
Republican U.S. Sen. Susan Collins was more outspoken about her opposition to the original bill, appearing on Meet the Press last weekend to highlight its deficiencies. Late amendments to the proposal were designed to win the support of moderates like her, but Collins told Maine Public Radio before the House debate that she needed more details.
Collins also says that President Trump’s ultimatum to Congress, to either pass the bill or live with the consequences of the ACA, did little to unite two disparate factions of the Republican caucus.
“A take it or leave it approach, I’ve never seen work very well in Washington,” she says.
Collins also highlighted elements of the bill that would make it difficult for any member of the Maine delegation to support. They include projections that premiums would soar for Mainers between age 50 and 64 who are living in rural areas.
“That’s the definition of the state of Maine,” she says.
That means Republicans like Collins and Poliquin were spared from voting on a proposal that could hurt key constituencies. First District Democratic U.S. Rep. Chellie Pingree and independent U.S. Sen. Angus King have repeatedly called the bill a bad deal for Maine.
In a statement, Pingree says the canceled vote was a huge win for Maine.
Gov. Paul LePage, an early critic of the bill, issued a statement Thursday urging Maine’s congressional delegation to support it after the bill was amended to include changes to Medicaid coverage for low-income Mainers.
LePage’s press office continued to defend the bill as the House of Representatives debated it Friday. At one point, the governor released a statement slamming opponents for making misleading assertions about the bill.
LePage’s support marked a sharp reversal from previous statements, but appear linked to amendments that were introduced Thursday.
The changes included ending the option of expanding Medicaid sooner than the original bill, allowing states to include work requirements for recipients and block grants that give states greater flexibility to draft regulations and eligibility.
The Medicaid changes were designed to appeal to hardliners in the GOP. Other provisions included eliminating requirements under the ACA that health insurance is comprehensive and include 10 specialty services, including maternity and mental health care.
The amended bill also accelerates the elimination of taxes that fund the seven-year-old ACA.
Other changes were designed to lure support from moderates. The changes included an additional $85 billion for subsidies designed to help low-income Americans purchase individual plans.
Those changes did little to change a projection by the nonpartisan Congressional Budget Office that the GOP bill could mean 24 million fewer Americans have health insurance over the next 10 years than if the ACA remained as is.
Additionally, the CBO’s revised score found that that updated version would have cost $186 billion more than the original GOP bill.
The GOP’s bill would have added $104.7 billion to the deficit through 2020, according to CBO.
The estimated cost of premiums was similar to the original bill. CBO projected the average premium for an individual plan would have jumped between 15 and 20 percent over two years.
Politically, Friday’s canceled vote is a major blow to the Trump administration and Ryan. The president backed the bill and repeatedly urged Republicans to support it. But Trump, who has billed himself as a master dealmaker, was unable to bring together the moderate and hardliner wings of the Republican caucus to support his first legislative initiative.
The canceled House vote could shift attention to the Senate where Collins has already submitted a bill that she hopes can garner bipartisan support. Amid the fallout Friday, Iowa Sen. Chuck Grassley tweeted that Collins' bill could get another look.
