Many Kansas and Missouri Republicans are unsure about GOP health insurance measure | McClatchy Washington Bureau

The Republicans’ Obamacare replacement bill is a tough sell so far for many Kansas and Missouri Republican congressmen and senators.

With Democrats expected to oppose the rewrite of the 2010 Affordable Care Act, Republicans in the House of Representatives have a small margin for error. They can afford to lose only about 20 votes for the bill to pass.

GOP Reps. Kevin Yoder of Kansas and Vicky Hartzler and Sam Graves of Missouri and Kansas Sens. Pat Roberts and Jerry Moran are not voicing support, at least not yet. They haven’t specified their concerns, saying they want more time to scrutinize the complex legislation.

Republican supporters include Rep. Lynn Jenkins of Kansas and Sen. Roy Blunt of Missouri.

Ninety-seven of Missouri’s 114 counties offer only one insurance option on the Obamacare exchange, said Blunt, a member of the Senate Republican leadership team. Many companies may not offer any options next year if Congress does not act, he said.

“Something has to be done to restore patient-centered choices,” he said.

More than 257,000 people are enrolled in Obamacare in Missouri and about 86,000 in Kansas.

The House Republicans’ American Health Care Act would scrap Obamacare’s income-based subsidies in favor of tax credits based on age, with the biggest credits going to older people.

The tax credit proposal would provide substantially less assistance for lower- and moderate-income older adults, by as much as $5,900 for an individual, according to an analysis released Friday by the AARP Public Policy Institute.

The legislation would end the requirement that most Americans buy health insurance and the mandate that required large companies to provide affordable health plans to their employees or pay penalties.

Moran and Roberts were noncommittal about the Republican plan.

“I’m eager to review the legislation passed by the House and will be working to ensure it provides real, substantive improvements to our health care system,” Moran said in a statement

Roberts applauded House committees for moving the bill forward on Thursday, but didn’t say he would support it himself.

“I look forward to fully reviewing the final version that passes the House and working in the (Senate) committees to strengthen our health care system for patients and providers while protecting our scarce taxpayer dollars,” Roberts said.

In the House, Yoder is uncommitted for now but saw the Republican plan as “a good starting point.” He said he was “approaching this with an open mind and seeking feedback to make sure we arrive at a final product that achieves our goals of lowering the cost of care, putting patients back in control, and offering more options to let you choose the plan that’s best for you and your family.”

Hartzler, too, remains uncommitted. Her spokesman, Kyle Buckles, said the Missouri Republican would wait for an analysis from the nonpartisan Congressional Budget Office estimating the bill’s costs. She also wants to see what changes are made to the bill before it comes to the House floor for a vote.

Among her concerns are the potential costs “that will still be shouldered by the taxpayers, and I would like to make sure that Missouri won’t be negatively impacted because it didn’t choose to expand Medicaid,” she said.

Medicaid is the joint federal-state health insurance program for lower-income and some disabled people.

Missouri’s Graves also isn’t ready to commit to the bill, saying “This is one step out of many, and we have a long ways to go.”

Kansas’ Jenkins voted in favor of advancing the bill out of the House Ways and Means Committee on Thursday.

The legislation includes provisions Jenkins wrote that will allow plan participants to use the funds in their health savings accounts and flexible spending accounts to purchase over-the-counter medications.

As the bill makes its way to the House floor, Jenkins said, she welcomes “any and all feedback from folks in Kansas so that their voices are heard in Congress.”

Democratic lawmakers stand adamantly opposed to the Republicans’ proposal.

The bill “ends access to health care as we know it,” said Missouri Democratic Rep. Emanuel Cleaver.

“This isn’t replacement, this is an elimination — snatching health care away from millions of Americans,” the former Kansas City, Mo., mayor said in a statement. “This plan would cut Medicaid and force older Americans to pay more out of pocket. The only people who will benefit from this plan are the big insurance companies and the wealthy with extreme tax breaks.”

Sen. Claire McCaskill, a Missouri Democrat who is running for re-election in 2018 in a state President Donald Trump won, took to Twitter to raise concerns about the GOP’s American Health Care Act, which she termed “Trumpcare.”

She said the bill would hurt older, rural Missourians who had voted for Trump.