Ryan: Adding Work Requirement, Tax Credits to Health Care Bill

House Speaker Paul Ryan said he would “most likely” bring a health-care bill forward for a floor vote on Thursday, even as he seeks to increase tax credits to help older people buy insurance to tamp down concerns about moderate Republicans.

“We believe that we do need to add some additional assistance to people in those older cohorts,” Ryan said of the bill, known as the American Health Care Act, on “Fox News Sunday.” “That’s one of the things we’re looking at.”

Ryan defined the group as people in their 50s and 60s who typically face higher health care costs than those in their 20s or 30s. A Congressional Budget Office review of the bill released on March 13 suggested there would be increases in out-of-pocket costs, especially for older people.

The nonpartisan CBO estimated that 14 million Americans could lose their insurance next year under the Republican’s Obamacare-replacement plan, a dire picture for Republicans of the bill’s effects heading into the 2018 congressional elections.

At the same time, insurance premiums will continue to rise in the near term, especially for older Americans. As the bill now stands, older, poorer Americans will have far less help from Republican tax credits starting in 2020 than they get through Obamacare subsidies.

Older, Rural Americans

“We have to do something about the fact that the House bill disproportionately affects older, rural Americans,” Republican Senator Susan Collins of Maine said on NBC’s “Meet the Press” on Sunday.

Ryan didn’t say whether he had the 218 votes necessary to pass the bill, which would replace President Barack Obama’s signature Affordable Care Act, but he said he feels “very good about where we are.”

“We’re still having conversations with our members,” Ryan said. “We’re making fine-tuning improvements to the bill to reflect people’s concerns.”

Asked on Fox News Channel’s “Sunday Morning Futures” whether the bill would pass the House on Thursday, Republican Representative Cathy McMorris Rodgers of Washington said, “We’re definitely moving in the right direction” and “I am confident we will come together.”

Increased Competition

Ryan said that proposed changes to the health-care system that would occur outside of the bill also would lower payments. Health and Human Services Secretary Tom Price also said regulatory changes in particular could increase competition in markets.

“We’ve had insurers tell us not only will we stay in the market, we’ll get back in the market,” Price said Sunday on ABC’s “This Week.”

But Senator Tom Cotton of Arkansas, a Republican critic of the bill, said he didn’t believe the bill would lower premiums for working people.

“It’s fixable, but it’s going to take a lot of work,” Cotton said on CNN’s “State of the Union.” “We need to roll up our sleeves and focus on fixing those problems, rather than trying to rush to some arbitrary deadline.”