WASHINGTON – President Donald Trump can’t solely blame Colorado for the failure of Republicans on Friday to pass — or even try to pass — an overhaul of the Affordable Care Act.
But the state’s reaction to the bill is indicative of why the proposal collapsed one day after Trump threatened lawmakers with a do-or-die ultimatum to either pass it or live with the current health care law, better known as Obamacare.
Only one of Colorado’s four House Republicans was on-the-record supporting the bill and even that lawmaker, U.S. Rep. Mike Coffman of Aurora, said he needed a Thursday trip to the White House to cement his support.
“I was not a hard yes,” Coffman said.
The other three — U.S. Reps. Ken Buck, Doug Lamborn and Scott Tipton — all said they were uncertain of their vote in the frantic hours leading up to House Speaker Paul Ryan’s decision to pull the bill from consideration.
“Right now Obamacare stays in place. That’s bad for the American people and it doesn’t leave Republicans an immediate opportunity to carry out their pledge to repeal and replace Obamacare,” said Lamborn, R-Colorado Springs. “We need to regroup and very soon find a way to do that.”
He placed the blame with a group of hard-line Republicans who would not accept anything less than a full repeal of the Affordable Care Act — a sticking point that managed to sink Republican efforts in the House even though the GOP controls the lower chamber.
“There are some members of the caucus and some outside groups who believe the first step needs to be a complete repeal,” he said. “That is a legislative impossibility.”
Hard-line Republicans, however, weren’t the only obstacle facing Trump and Ryan.
For weeks, the ever-shifting proposal faced criticism from liberals — and even moderate Republicans — for its approach to health care, notably its aim to curtail an expansion of Medicaid that was made possible under the former President Barack Obama’s 2010 health care law.
In Colorado, that expansion has added an estimated 407,000 residents to the Medicaid rolls and played a key part in reducing the state’s rate of uninsured residents — from nearly 15.8 percent in 2011 to 6.7 percent in 2015, according to the Colorado Health Institute.
The added coverage is a key reason why Colorado hospitals have seen a sharp drop in “uncompensated care” for the insured; from $2.3 billion in 2009 to $1.1 billion in 2015.
But conservative lawmakers see the expansion of Medicaid as a worrisome growth of government bureaucracy and have sought to either amend or eliminate the program’s growth.
Both Tipton and Coffman have voiced support for the idea of linking Medicaid coverage to employment. “It’s for able-bodied adults without dependents and so yeah they ought to work,” Coffman said.
Asked about his thoughts on Ryan’s decision to cancel a vote on the bill, the Aurora Republican said it made sense given its likely defeat.
“If they don’t have the votes, they don’t have the votes. (You) might as well pull it,” he said. “Obviously, (it is) very disappointing.”
He added: “You have to have a starting point somewhere for health care reform and you can negotiate from there but they were not really able to reach that starting point where there was enough support on the Republican side to get something done.”
Even so, he pushed back against the idea that GOP efforts to repeal and replace the Affordable Care Act were over. “The president said that and the speaker said that (but) we have an obligation to make changes,” Coffman said.
The drama of Friday’s non-vote, however, could make Republicans a little gun-shy. It’s rare for congressional leaders to plan a vote when the outcome is not pre-determined and the genuine suspense turned Capitol Hill into a buzz of activity with lawmakers, reporters and activists rushing around for information.
On the morning of the vote, even Buck — a member of the influential Committee on Rules — was circumspect.
“I’m going to vote after I hear the debate,” said Buck, adding that he didn’t take a single meeting with Trump or Vice President Mike Pence prior to the scheduled vote. “I’m not going to have my arm twisted by anybody.”
One reason Republicans needed a united front in trying to pass its health care bill was because House Democrats — including Colorado’s Diana DeGette, Ed Perlmutter and Jared Polis — were universally opposed to the legislation.
On Friday, DeGette joined her colleagues in debating the bill on the floor of the House.
“This bad bill would rip health insurance away from millions of people — 24 million over ten years, and 14 million next year alone,” she said. “Democrats believe we can and should work together to improve the ACA, not to vote on a misguided bill that would gut it.”