Trumpcare Appears Defeated, But LGBT Opponents Remain Wary

BY CHRIS JOHNSON, WASHINGTON BLADE

After Republican support crumbled for Trumpcare, LGBT advocacy groups that sought to preserve the Affordable Care Act are quietly confident it will remain in place — although they say they're keeping a watchful eye.
Late Monday night, two Republicans — Sens. Mike Lee (R-Utah) and Jerry Moran (R-Kansas) — announced they'd vote "no" on the latest version of the Better Care Reconciliation Act proposed by Senate Majority Leader Mitch McConnell (R-Ky.). With Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.) already opposed to the bill, the defections of Lee and Moran assured defeat of the bill if it came to the floor.
David Stacy, government affairs director for the Human Rights Campaign, said despite the apparent failure of Trumpcare, now is not the time to rest.
"While we're glad to see the Trump/McConnell plan to strip health care from millions of Americans has failed up until this point, by no means are we claiming complete victory," Stacy said. "The ACA provides unprecedented access to health care for LGBTQ people and we simply cannot afford for this access to be taken away. HRC will continue to engage our millions of members across the country and keep the pressure on Congress to reject any proposals to dismantle our health care system."
LGBT groups like the Human Rights Campaign oppose Trump's effort to repeal and replace the ACA on the basis that many LGBT people gained insurance as a result of President Obama's signature legislative achievement and because the measure would deny Medicaid reimbursements to Planned Parenthood, which touts its health services for LGBT people.
McConnell has pledged to bring to the floor legislation in the coming days that would repeal Obamacare without offering any replacement — a move that in addition to eliminating health care for millions of people would explode the deficit.
Even though the same bill passed the chamber in 2015, it's unlikely to pass this time around without assurance of a presidential veto. Key Republicans — Sens. Lisa Murkowski (R-Alaska) and Shelly Moore Capito (R-W.Va.) — have said they'd vote "no." Collins voted "no" in 2015 and said she'd do so again.
Mara Keisling, executive director of the National Center for Transgender Equality, nonetheless cautioned "cynical efforts to hurt Americans for political purposes" may still be on the way despite projections Trumpcare is dead.
"We are not confident that efforts to defund Planned Parenthood are dead," Keisling said. "We are not confident that efforts to take healthcare away from trans service members and veterans are dead. We will continue to fight side-by-side with so many allies to make sure our healthcare system is improved and not dismantled and made accessible only to the wealthy. We are extremely confident that our side will fight harder and with solidarity to protect people's lives than the powers that be will fight to hurt us."
After the loss of GOP support for the Better Care Reconciliation Act, President Trump took to Twitter to lambast lawmakers, blaming the failure on "all of the Democrats and a few Republicans."
"Most Republicans were loyal, terrific & worked really hard," Trump tweeted. "We will return!"
The White House has maintained Trump made phone calls to lawmakers and met with them to encourage their support for the Senate health care bill. On Wednesday, Trump was set to hold a working lunch at the White House State Dining Room with Republican members of Congress to discuss health care.
Nonetheless, the general perception is Trump has been disengaged from efforts to repeal Obamacare — a signature promise during Trump's presidential campaign. On Monday, the same day GOP support for Trumpcare crumbled, Trump posed for a photo-op in the cab of a firetruck parked on the White House lawn for "Made in America" week.
White House Deputy Principal Press Secretary Sarah Huckabee Sanders blamed Democrats on Tuesday for the failure of Trumpcare, even though they're in the minority in Congress and weren't responsible for GOP withdrawal from the bill.
"They're responsible for passing Obamacare," Sanders said. "They're responsible for creating the mess that we're in. They're responsible for being unwilling to work with Republicans in any capacity to help fix a system that they know is completely flawed and have publicly said so. I think that it's pretty clear, and I think the responsibility lies on their shoulders."
Gregory Angelo, president of Log Cabin Republicans, said contrary to expectations that Trumpcare is dead, he wouldn't rule out Republican efforts to reform health care law.
"I don't think we've heard the last from the GOP on healthcare," Angelo said. "Whether it's repeal, replace, reform, or some combination thereof, the continuing collapse of Obamacare, spikes in premiums and insurer exits from exchanges will necessitate that Republicans act sooner or later."
Trump himself may take unilateral action. On Tuesday, he told reporters "we're probably in that position where we'll let Obamacare fail" in the aftermath of crumbling support for the bill.
"We're not going to own it. I'm not going to own it," Trump said. "I can tell you the Republicans are not going to own it. We'll let Obamacare fail and then the Democrats are going to come to us and they are going to say 'how do we fix it, how do we fix it' or 'how do we come up with a new plan?'"
Trump's position for some time has been that Obamacare is a dead program, but his remarks raise questions about whether the Trump administration would seek to administratively undermine the Affordable Care Act, such as by denying subsidies to health care recipients who qualify for them.
At the White House, Sanders wouldn't commit the president to support the subsidies and the executive sustenance required under the Affordable Care Act.
"As has been the case since we got here, we'll continue to keep you posted as decisions and changes are made, or if they're not," Sanders said.
Meanwhile, bipartisan talks on health care are happening. Sen. Tom Carper (D-Del.) told the Daily Beast a bipartisan group of senators spoke Tuesday night about possible fixes to Obamacare that don't involve repealing the law.
"Democrats, Republicans, and I think one independent slipped in as well," Carper was quoted as saying. "I'm more encouraged at this point than I've been in quite some while that we might somehow be able to find a road, a path together."
A major criticism from LGBT groups — as well as HIV/AIDS advocacy groups — was the inclusion in GOP plans to replace Obamacare of a provision to undo the Medicaid expansion under the Affordable Care Act. That rose the income level to qualify for care under that program to 133 percent of the poverty level — provided the states agreed to it.
An estimated 40 percent of people with HIV — a disease that still disproportionately affects LGBT people — received coverage under Medicaid.
Carl Schmid, deputy executive director of AIDS Action, said he expects Obamacare to remain the law and is "greatly relieved," but nonetheless noted the need for change of the health care system.
"There is much that the administration can do through regulation to alter health care — private insurance plans and Medicaid — and [we] expect them to do that, actually they have started to make changes as well," Schmid said. "As they make changes, we want to make sure they do not restrict access and benefits and loosen important patient protections. Legislative fixes are still needed, premiums and patient cost-sharing are too high, and we hope that they can happen on a bi-partisan basis."