As Republicans grapple with the prospect of another shutdown and potential government shutdown, House Speaker Paul Ryan has suggested that the party could pass a new healthcare bill based on what it learned from the failed Obamacare replacement.
Ryan, the House Budget Committee chairman, has floated the idea that Republicans could pass the American Health Care Act (AHCA), which would allow states to opt out of the Affordable Care Act’s requirement that all Americans have health insurance or face a penalty.
The AHCA was a failed attempt to create a health care law that was much more popular than the ACA and the Republican-led House passed it with just 48 votes in May.
While Ryan is pushing to make a health insurance replacement the cornerstone of the 2018 midterm elections, many GOP lawmakers have expressed reservations about the bill.
Ryan is pushing the AHCA as a means of repealing the ACA without having to enact a new law to replace it.
But the AHC’s primary goals are to give states the ability to opt in or out of Medicaid expansion, which has been the main focus of the Republican healthcare efforts.
Under the AHA, states could opt out from the expansion if they choose to.
But Ryan said the AHAs proposal could allow states that have not expanded Medicaid to opt into the program.
“If the governor of New York is willing to go and negotiate, let’s make it a very, very simple proposition that New York will not expand Medicaid,” Ryan said in an interview with CNN’s Dana Bash on Tuesday.
“Then he can go and sign up people, get a permit to do it and then we’ll be able to say to people in New York, you know, OK, we can get the expansion.”
“It’s going to be a very simple solution,” Ryan continued.
“We’re going to put a very specific provision into the bill that says, in New Jersey, the Medicaid expansion will continue, and we’re going.
If you live in New Mexico or Arizona or Illinois, if you’re a New Yorker and you’re willing to get a prescription drug, and you live there, and the prescription drug is cheaper than the drug you get elsewhere, then we will not require you to go out and get the drug.”
Republican senators are also skeptical of Ryan’s plan, which they said would be “unworkable” for the federal government.
“We’re not looking at this as, well, we want to do the same thing, we’re not going to take a new bill,” Sen. Tom Cotton (R-Ark.), who is a member of the Senate Budget Committee, told reporters on Tuesday, after Ryan said he was “not going to negotiate.”
“We are going to pass our bill, but we’re also going to look at the Medicaid and the cost of it and see what we can do to help people afford it,” he added.
“So we are going, for the sake of our country, we are not going.”
Senate Majority Leader Mitch McConnell said in a statement Tuesday that Republicans were “confident that the American people will understand that a healthcare system is better when it is fixed, not when it changes.”
Republicans are hoping that a new plan that is much more favorable to states will help convince them to join the Obamacare exchanges and offer tax credits to people buying insurance across state lines.
However, there are also concerns about the potential that the AHAC will increase premiums for the average middle-class family in the state that signed up for the exchanges.
Republicans have also said they will not allow the AHACA to become law if it doesn’t include the defunding of Planned Parenthood, and they are also considering legislation that would defund Planned Parenthood.
Ryan said on Tuesday that the bill would not include the funding for Planned Parenthood but it would include funding to fund the Planned Parenthood for Women Health Program, which provides birth control, STD testing, and cancer screenings for low-income women.
The bill is expected to be introduced in the House of Representatives on Wednesday, according to CNN.