Trump sides with House leaders on health bill

WASHINGTON - The White House and Republican House leaders came together Friday behind the plan now moving through Congress to overhaul the Affordable Care Act, including a provision criticized by conservatives pressing for a more aggressive attack on the law.

After President Donald Trump met at the White House with key House committee chairmen, his chief spokesman said the president supports the bill's timeline for phasing out the expansion of Medicaid, which some on the right would like to accelerate. House leaders dismissed the idea of speeding up the phaseout, as they have for several days.

'Right now, the date that's in the bill is what the president supports,” White House press secretary Sean Spicer said, adding, 'It's not a question of negotiation.”

The American Health Care Act, as the GOP proposal is named, would phase out the Medicaid expansion by 2020. But conservatives want it to end next year.

Thirty-one states - including Iowa - and the District of Columbia accepted the Affordable Care Act's Medicaid expansion, which obligated the federal government to cover 90 percent of the program's expenses.

Some 150,000 Iowans have obtained coverage because of the expansion.

The House GOP proposal instead would administer Medicaid by giving a fixed per capita amount of funding to states, rather than covering a percentage of all health care expenses incurred by enrollees.

The plan also would replace concurrent federal insurance subsidies under Obamacare with after-the-fact age- and income-based tax credits.

Spicer's comments indicate Trump has taken the side of GOP leaders in their battle with House conservatives, who have been pressing for a more dramatic rollback of Obamacare for weeks and insist that the pending legislation cannot pass the House without significant changes.

The development also suggested that Trump had reversed himself after meeting with House leaders Friday; earlier in the week, the president told conservative lawmakers and leaders of conservative groups that he was open to significant negotiations.

If so, Trump's stance gives House Speaker Paul Ryan, R-Wis., the measure's top booster, new momentum at the end of a difficult week of conflict between conservative members of Congress and GOP leaders.

The chairman of the House Freedom Caucus, the hard-right faction that contains the plan's most vocal critics, insisted Friday that Trump's position 'has not changed,” citing 'continued conversations” with White House budget director Mick Mulvaney.

'He's willing to get the very best of any deal, and he knows that there is a real willingness to negotiate in good faith to get a better bill,” Rep. Mark Meadows, R-N.C., said.

Both sides have been speaking to Trump, and each has hoped that he will help wear down the other, putting the president at the center of a fierce intraparty clash. Even now, the lack of clear guidance from Trump has left both sides jockeying to argue their case to him last.

Next week, the independent Congressional Budget Office is scheduled to release its estimates of the bill's cost and impact on insurance coverage, threatening to upend the debate anew.

The bill so far has passed two committees, but not the full House.

In a meeting with the committee chairs Friday, Trump expressed optimism. 'This is the time we're going to get it done,” he said.

The GOP leaders said afterward that they were willing to listen to different perspectives but warned against stalling.

In a Friday radio interview with conservative host Hugh Hewitt, Ryan warned that any deviation from the plan set in motion would be 'momentum killing.”

If the bill passes the House as is, it goes to the Senate, where even more skepticism over whether it does enough to unravel Obamacare awaits.