Voter pressure, intraparty discord hobble GOP's effort to overhaul healthcare policy

Capitol Building on Capitol Hill
GOP leaders face increasing questions from within their own party about the direction of an ACA replacement.

Republican leaders are struggling to surmount steep obstacles in their effort to repeal and replace the Affordable Care Act as they face increasing concerns even within their own party about what a new healthcare plan should look like.

On Monday night, two prominent House Republicans, Rep. Mark Meadows and Rep. Mark Walker, both of North Carolina, revealed they would vote against a recently leaked draft bill crafted by GOP leaders, CNN reported. Both Meadows, chairman of the House Freedom Caucus, and Walker, chairman of the Republican Committee, see tax credits included in the draft function as an “entitlement program."

"What is conservative about a new entitlement program and a new tax increase?" Meadows asked. "A new Republican president signs a new entitlement and a new tax increase as his first major piece of legislation? I don't know how you support that—do you?"

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Intraparty dissenters have taken issue with other elements of the repeal plan, the Associated Press reported. Sen. Lisa Murkowski, R-Alaska, has said she would not support a plan that would cut funding to Planned Parenthood or roll back states’ Medicaid expansion, two key elements in a likely Republican plan.

GOP legislators have also faced mounting pressure from their constituents, as recent town halls turned contentious in the face of concerns about ACA replacement strategies. Voters are especially concerned about proposals that would shift additional costs to the consumers, such as those emphasizing “catastrophic” health plans that typically have higher deductibles, or pushing for co-pays and premiums for people enrolled in Medicaid, the Los Angeles Times reported.

Even President Donald Trump has publicly noted that this process has been more fraught than expected, saying during a Monday press briefing that “nobody knew that healthcare could be so complicated."

Facing growing concerns from within the party, GOP leaders are looking at a new possible strategy: Challenging potential defectors by pushing through a repeal bill with the assumption that their peers would not take the risk of blocking it.

Former House Speaker John Boehner threw further doubt on Republicans' efforts, saying last week that the likelihood of a full repeal and replacement of the ACA is unlikely. Sen. Chuck Schumer, D-N.Y., recently echoed those comments, saying “odds are high” that the law will remain in place, The Washington Post reported.