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Ryan, Leaders Tout Health Plan to Mixed Reaction from Conservatives

By Erin Mershon, CQ Roll Call

June 22, 2016 -- Speaker Paul D. Ryan, R-Wis., and other top House Republicans on Wednesday portrayed their new alternative to the Affordable Care Act as a consensus plan, even as some conservatives and outside groups hesitated to embrace it.

Ryan, Majority Whip Steve Scalise, R-La., and the four committee chairmen with jurisdiction over health care unveiled earlier in the day a broad manifesto meant to represent the full caucus's views on how to replace the 2010 law as well as an overhaul of Medicare and Medicaid and a rewrite of other major health policies.

Little in the plan is new. The sweeping document revives nearly every major health policy change Republicans have proposed in recent decades. But it is the first plan, as GOP leaders emphasized, that has earned the backing of all the House Republican leaders who would need to sign off on a full replacement package, should a Republican win the White House.

"We've promised to repeal and replace Obamacare and make health care actually affordable. Well, here it is. A real plan, in black and white, right here. We are officially putting it on the table," Ryan said at an event at the American Enterprise Institute. Staff estimated 400 people attended.

The plan has not yet earned the support of Republican frontrunner Donald Trump. Ways and Means Chairman Kevin Brady, R-Texas, and Budget Chairman Tom Price, R-Ga., said the presumed GOP presidential nominee's advisers had been briefed on its contents, but that they had not spoken to Trump about it.

"I know he's committed to repealing Obamacare and I know he wants much more affordable health care for Americans, so I'm hopeful," Brady told reporters after the event.

"I have all the confidence in the world that the plan he will endorse and the plan he will embrace is more consistent with this plan than it will be with Hillary Clinton's plan," Price told reporters.

Lukewarm Reception

It's not clear if the plan will get backing from the entire Republican conference, either. The conservative House Freedom Caucus, which in the past has rejected some efforts to replace the law as insufficient, has so far withheld its endorsement. The influential conservative group Heritage Action stopped short of endorsing the plan in a Wednesday statement, voicing concerns that the blueprint might rely too heavily on regulations that resemble those in the 2010 law, and taking issue with the lack of details about funding.

"Heritage Action looks forward to working with House Republicans to continue the conversation on conservative health reforms that promote opportunity for all and favoritism to none," the group said.

One Freedom Caucus member, Rep. John Fleming, R-La., a physician, has offered his support for the package in the past. The Republican Study Committee also praised the blueprint Wednesday.

Democrats were quick to denounce the proposal, saying it would walk back the 2010 law's consumer protections and gains that have been made improving Americans' access to care.

"The proposal they put forward today includes some more details, but the details they put forward today are wildly unpopular, which is why I suspect they will not receive a vote on the floor of the House of Representatives," said White House spokesman Josh Earnest.

Employers groups were quick to express concern with provisions related to capping the tax deduction for businesses that provide health care to their employees. Insurers, whose industry would see the largest changes from a repeal of the 2010 law, withheld any substantive reaction.

"We stand ready to work with both parties on market-based solutions that improve access and affordability for consumers," said Marilyn Tavenner, president of America's Health Insurance Plans, the industry's main lobbying arm, in a statement.

Republicans took issue with criticisms that the proposal lacked important details and did not include fresh ideas.

"We're attacking this in a fiscally responsible way, and when you eliminate all those taxes and all the mandates that drive up costs and you unlock that tax break for health care, this is very achievable, and frankly, should have been the way it was done originally," Brady said.

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