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NATION Thursday, May 4, 2017 East Oregonian Page 7A House to vote on health care bill Thursday Associated Press WASHINGTON — The House will vote Thursday on GOP legislation to repeal and replace Barack Obama’s Affordable Care Act, as Republicans finally aim to deliver on seven years of campaign promises that helped them gain control of Congress and the White House. But the move announced late Wednesday by GOP leaders also carries extreme political risk, as House Republicans prepare to endorse a bill that boots millions off the insurance rolls and may not even survive the Senate. “We will pass this bill,” House Majority Leader Kevin McCarthy, R-Calif., confidently predicted after a day of wrangling votes and personal arm-twisting by President Donald Trump. Pressed by reporters as he exited a meeting in Speaker Paul Ryan’s office, McCarthy protested: “We’re gonna pass it! We’re gonna pass it! Let’s be optimistic about life!” After an earlier defeat when Republican leaders were forced to pull the bill for lack of votes, the decision to move forward indicated confidence on the part of GOP leaders. Failure would be catastrophic. But a successful outcome would AP Photo/Susan Walsh Rep. Fred Upton, R-Mich., left, speaks to reporters outside the White House in Washington, Wednesday, following a meeting with President Donald Trump on health care reform. Rep. Greg Walden, R-Ore. is at right. make good on the GOP’s No. 1 goal of undoing Obama’s signature legislative achieve- ment, and provide a long- sought win for Trump, who has been in office more than 100 days without a signifi- cant congressional victory save Senate confirmation of a Supreme Court justice. The White House had aggressively pushed House leaders to act, and Trump got heavily involved in recent days, working the phones and personally agreeing to changes earlier Wednesday that brought two pivotal Republicans back on board. Reps. Fred Upton of Michigan and Billy Long of Missouri emerged from a White House meeting with Trump saying they could now support the bill, thanks to the addition of $8 billion over five years to help people with pre-existing conditions. “‘We need you, we need you, we need you,’” Long described as the message from a president eager for a victory. Democrats stood firmly united against the health bill. But they generally applauded a separate $1 trillion-plus spending measure to keep the government running, which passed the House on a bipartisan vote of 309-118 earlier Wednesday. The latest iteration of the GOP health care bill would let states escape a require- ment under Obama’s law that insurers charge healthy and seriously ill customers the same rates. Overall, the legislation would cut the Medicaid program for the poor, eliminate fines for people who don’t buy insurance and provide generally skimpier subsidies. The American Medical Association, AARP and other consumer and medical groups are opposed. The AMA issued a statement saying the changes sought by Upton and Long “tinker at the edges without remedying the fundamental failing of the bill — that millions of Americans will lose their health insurance as a direct result.” If the GOP bill became law, congressional analysts estimate that 24 million more Americans would be uninsured by 2026, including 14 million by next year. When the health bill does come to a vote Thursday it will be without an updated analysis from the nonpartisan Congressional Budget Office about its cost and affect, a point Democrats complained about bitterly. “Forcing a vote without a CBO score shows that Republicans are terrified of the public learning the full consequences of their plan,” said House Minority Leader Nancy Pelosi, D-Calif. “But tomorrow, House Republi- cans are going to tattoo this moral monstrosity to their foreheads, and the Amer- ican people will hold them accountable.” Even with Upton and Long in the “yes” column, GOP leaders had spent the day hunting for votes among wary moderates. More than a dozen opponents — including Kentucky’s Tom Massie, New Jersey’s Chris Smith and Leonard Lance and Pennsylvania’s Patrick Meehan — said they were still no despite the changes. GOP leaders can lose only 22 from their ranks and still pass the bill, and an Associated Press tally found 19 opposed. That suggests that Thursday’s margin could be razor-thin, much like when “Obamacare” itself cleared the House in 2010 on a party- line vote of 219-212. The GOP has been trying ever since to repeal the law even as around 20 million Amer- icans gained coverage under it. On Thursday Republicans might succeed for the first time in passing a repeal bill that may have a chance of getting signed into law. As they have throughout the debate, Republicans argued that Obama’s health law is collapsing under its own weight, and they must intervene to save it. They argue that their plan will provide consumers with lower premiums and more choices, removing the unpopular mandates that require most Americans to carry insurance or face fines. Several Republican lawmakers pointed to news out of Iowa this week that the last carrier of individual health insurance policies in most of the state might stop offering them to residents. “That’s why we have to make sure this passes, to save those people from Obamacare that continues to collapse,” McCarthy said. Separately, on the spending bill to keep the government running, Trump and GOP leaders hailed it as a victory, citing increases in money for the military. The $1.1 trillion spending bill was the bipartisan result of weeks of negotiations in which top Democrats like Pelosi successfully blocked Trump’s most controversial proposals, including a down payment on his oft-promised Mexico border wall, cuts to popular domestic programs, and new punishments for so-called sanctuary cities. Now that it’s passed the House, the mammoth, 1,665-page measure to fund the government through September heads to the Senate, which is also expected to approve it. Despite his complaints, Trump has prom- ised to sign it. BRIEFLY Trump on Mideast peace: ‘We will get it done’ AP Photo/Cliff Owen House Speaker Paul Ryan of Wis., accompanied by Rep. Cathy McMorris Rodgers, R-Wash., speaks to re- porters Tuesday on Capitol Hill in Washington. A gov- ernment-wide spending bill that President Donald Trump seemed to criticize Tuesday morning but now calls “a clear win for the American people” is headed for a House vote on Wednesday. House passes $1.1 trillion spending bill, sends to Senate WASHINGTON (AP) — The House easily passed a $1.1 trillion governmentwide spending bill on Wednesday, awarding wins to both Democrats and Republicans while putting off until later this year fights over President Donald Trump’s promised border wall with Mexico and massive military buildup. The 309-118 vote sends the bill to the Senate in time for them to act to avert a government shutdown at midnight Friday. The White House has said Trump would sign the measure, which is the first major legislation to pass in Trump’s short, turbulent presidency. House Speaker Paul Ryan praised the measure as bipar- tisan, and said the biggest gain for conservatives came as Democrats dropped long- standing demands to match Pentagon increases with equal hikes for nondefense programs. “No longer will the needs of our military be held hostage by the demands for more domestic spending,” Ryan said. “In my mind, that is what’s most important here.” Democrats also backed the measure, which protects popular domestic programs such as education, medical research and grants to state and local governments from cuts sought by Trump — while dropping a host of GOP agenda items found in earlier versions. “It’s imperative to note what this bill does not contain,” said Rep. Nita Lowey of New York, lead negotiator for Democrats. “Not one cent for President Trump’s border wall and no poison pill riders that would have prevented so-called sanctuary cities from receiving federal grants, defunded Planned Parenthood, undermined the Affordable Care Act.” The bill is the product of weeks of Capitol Hill negotiations in which top Democrats like House Minority Leader Nancy Pelosi successfully blocked Trump’s most provocative proposals — especially the Mexico wall and cuts to popular domestic programs like community develop- ment grants. The White House won $15 billion in emergency funding to jumpstart Trump’s promise to rebuild the military and an extra $1.5 billion for border security — each short of Trump demands — leading the president on Tuesday to boast, “this is what winning looks like.” The opinions of top party leaders were not shared by everyone in the rank and file, some of whom feel that GOP negotiators too easily gave up on conservative priori- ties, such as cutting funds for Planned Parenthood and punishing “sanctuary” cities that fail to cooperate with immigration authorities. “I don’t think it was nego- tiated very well, and I’ll just leave it at that,” said Rep. Jeff Duncan, R-S.C. The long-overdue bill buys just five months of funding while Trump and his allies battle with congressional Democrats over spending cuts and funding for the wall, which Trump repeatedly promised during the campaign would be financed by Mexico. Mexican officials have rejected that notion. The measure is the product of a bipartisan culture among Congress’ appropriators, with money for foreign aid, grants to state and local governments and protection for the Environmental Protection Agency from cuts sought by tea party Republicans. The measure provides $2 billion in disaster aid money, $407 million to combat Western wildfires, additional grants for transit projects and a $2 billion increase for medical research at the National Institutes of Health. WASHINGTON (AP) — Despite bleak prospects for success, President Donald Trump promised on Wednesday “to do whatever is necessary” to forge an Israeli- Palestinian peace deal. At a White House meeting with Palestinian leader Mahmoud Abbas, Trump pledged to reinvigorate the stalled Mideast peace process that has bedeviled his predecessors and said he would serve as “a mediator, an arbitrator or a facilitator” between the two sides. “We will get it done,” Trump confidently told Abbas. “I’m committed to working with Israel and the Palestinians to reach an agreement,” Trump said. “But any agreement cannot be imposed by the United States or by any other nation. The Palestinians and Israelis must work together to reach an agreement that allows both peoples to live, worship, and thrive and prosper in peace.” The source of Trump’s optimism was not immediately apparent. He offered no details about his effort or how it would be any different from attempts over the past two decades during which former Presidents Bill Clinton, George W. Bush and Barack Obama all tried and failed. Palestinian officials said after the meeting that Trump had not raised any specific proposals to restart negotiations. Asked what distinguishes Trump’s plans from previous attempts, White House spokesman Sean Spicer said merely: “The man is different.” The peace process has been stalled since 2014, and there have been no serious attempts to restart negotiations. Like previous U.S. leaders, Trump faces numerous obstacles in the long-shot bid. They include the contours of a potential Palestinian state, Jerusalem’s status and the question of Palestinian refugees. Complicating it all are the vehement Palestinian criticisms of Israeli settlement construction and Israeli complaints that Palestinians are inciting violence. Tillerson calls for balancing U.S. security interests, values WASHINGTON (AP) — Translating “America First” into diplomatic policy, Secretary of State Rex Tillerson on Wednesday declared the United States can’t always afford to condition its foreign relationships and national security efforts on countries adopting U.S. values like human rights. He spoke to a State Department eager for answers about changing priorities and a sweeping, impending overhaul. Tillerson did not provide employees any details about the 2,300 jobs he plans to eliminate or how his proposed cut of roughly a quarter of the State Department budget might affect operations. Acknowledging widespread unease about the forthcoming changes, he pledged that diplomats would emerge from the agency’s changes with “a much more satisfying, fulfilling career.” Yet even as he left key administrative questions unanswered, Tillerson offered the most extensive presentation to date of what President Donald Trump’s “America First” mantra, adopted during the campaign and carried into the White House, means for America’s relations around the world. Over the last two decades, he said, Washington had “lost track” of whether post-Cold War alliances were still serving U.S. interests. The former Exxon Mobil CEO distinguished between U.S. “values,” which he described as enduring, and “policies,” which Tillerson said must adapt to the times. 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