GOP leaders move to quell dissent as healthcare bill passes second House committee

A second House committee voted on Thursday to advance legislation to repeal and replace the Affordable Care Act as President Donald Trump and other Republican leaders worked to whip up support for the bill.

The House Energy and Commerce Committee’s vote followed the Ways and Means Committee’s vote to pass the bill earlier Thursday, both after hours of acrimonious debate. The bill now moves onto the House’s Budget Committee.

“Today, the House took a decisive step forward in fulfilling a promise to the American people that has been years in the making: Repealing and replacing Obamacare with affordable, patient-centered reforms,” full committee Chairman Greg Walden, R-Ore., said in an announcement.

Speaker Paul Ryan was similarly enthusiastic about the bill during his weekly press briefing, saying “this is the closest we will ever get to repealing and replacing Obamacare.”

He also noted, though, that the reconciliation measure, designed to avoid a filibuster in the Senate, is part of a three-part process Republicans are planning to overhaul healthcare. The other two components are administrative action from the Department of Health and Human Services, and additional legislation aimed at promoting competition in the health insurance markets, he said.

The Trump administration, press secretary Sean Spicer said during a Thursday press briefing, is hard at work to communicate that process to congressional leaders.

“There’s a lot of facets to getting this pushed through, and I think that one of the things we’ve been able to do quite effectively is talk to members especially in the House,” he said, “but the vice president has been very active in both chambers to communicate how this is a comprehensive strategy in three prongs to repel and replace [the ACA] with something more effective.”

President Donald Trump himself also has been striving to listen to the concerns of conservative House Freedom Caucus, according to the New York Times. Members of that caucus have pushed back against the bill, calling it “Obamacare lite.” Trump also recently met with representatives of the Heritage Foundation and Americans for Prosperity, the article noted.

“He wants people to have an input on this to makes sure we have the best possible bill that serves their needs, and that we don’t look back like we do with Obamacare and say, ‘I wish we had done this right,’” Spicer said of Trump.

Concern on the state level

Some GOP governors, though, continue to resist Congress’ effort to push through a bill—mainly out of concern for its proposed rollback of Medicaid expansion.

"We've said all along, 'Work with the governors,' that it should be a governor-led effort and for the Congress to rely on the governors," Nevada Gov. Brian Sandoval said Tuesday, according to the Associated Press. "Well, they came out with their own bill, which doesn't include anything that the governors have talked about."

RELATED: GOP governors plot to preserve Medicaid expansion

Perhaps seeking to quell such concerns, HHS Secretary Tom Price on Friday issued a statement that indicated the agency plans to use its regulatory authority to “create greater flexibility in the Medicaid program for states.”

This will include a review of existing waiver procedures in order to allow states innovate and test new ideas to improve access to care and health outcomes, Price said.

Trump’s pick to lead the Centers for Medicare & Medicaid Services, Seema Verma, is likely to lead the way in this effort once confirmed, as she was the architect of Indiana’s conservative twist on Medicaid expansion. Verma moved a step closer to confirmation Thursday after the Senate agreed to end debate over her nomination.