House GOP tweaking health bill
Before recess, panel approves provision for ‘ high- risk’ pools
WASHINGTON — House Republican leaders on Thursday were planning to modify their stalled health care bill after Vice President Mike Pence pressured them to show progress toward passing the bill before lawmakers leave for a two- week recess.
An amendment to the bill that would provide for “highrisk pools” — a mechanism to subsidize pricier insurance coverage for the seriously ill — was considered at a Rules Committee meeting Thursday. But while leaders said the tweak showed momentum for the legislation, it appeared that larger divisions over the bill’s content have yet to be bridged.
On Thursday morning, House Speaker Paul Ryan, R- Wis., invited more than 20 fellow Republicans to his weekly news conference to unveil the new amendment in what appeared to be an effort to show progress toward an accord.
“This brings us closer to the final agreement that we all want to achieve,” Ryan said, later adding that it was “a step in the right direction.”
The amendment that the Rules Committee approved Thursday afternoon on a partyline vote would set up a federal insurance pool for those with serious and expensive medical conditions such as cancer, congestive heart failure and AIDS. The fund is intended to subsidize coverage for patients with those serious preexisting conditions to lower premiums for healthier patients.
Committee Chairman Kevin Brady, R- Texas, said the amendment, sponsored by conservative Reps. Gary Palmer, R- Ala., and David Schweikert, R- Ariz., demonstrates “another example of House Republicans’ unwavering commitment to repeal and replace Obamacare [ President Barack Obama’s Patient Protection and Affordable Care Act] and provide immediate relief to those trapped in this failing law.”
Pence made his request to Ryan and Majority Leader Kevin McCarthy, R- Calif., during a Wednesday evening visit to the White House, according to several people briefed on the meeting. These people asked for anonymity in order to discuss private conversations.
According to a senior White House official not authorized to speak publicly, Pence conveyed in the intense discussion that the president wanted the House to move immediately on health care in order to keep the effort to repeal the 2010 Affordable Care Act alive. President Donald Trump needs to score a short- term win on the issue, the vice president emphasized, since otherwise lawmakers may retreat.
A House aide said Pence and other White House officials painted a “dire” political picture of what would happen if Republicans fail to act on health care. Ryan also met briefly with Trump, the aide said.
But GOP leaders have yet to demonstrate that this amendment alone will resolve the differences between moderates and conservatives that scuttled their initial health care proposal late last month.
Rep. Raul Labrador, R- Idaho, one of the conservative House Freedom Caucus’ most outspoken members, called it a “good” amendment but said he’s “not yet” ready to sign on to the underlying measure.
“They’re moving in the right direction,” he said. “We’re still working on it.”
Rep. Tom MacArthur, R- N. J., a co- chairman of the moderate Tuesday Group and a key player in the intraparty negotiations, praised the idea behind the amendment and said it simply reflected lawmakers’ ongoing policy work. Still, he would not say if he backs the measure, which provides $ 15 billion in federal subsidies for those in the high- risk pool.
“Nobody was grasping for an idea to go home with,” MacArthur told reporters. “The reality is we’re still needing to find an ultimate conclusion before we can vote on this bill, and we’re not there yet obviously.”
McCarthy and Majority Whip Steve Scalise, R- La., said talks would continue through the recess and did not rule out possibly returning lawmakers to Washington early if a compromise comes together.
Huge roadblocks remain in the way of such a deal. At a Politico event Thursday morning, Rep. Mark Meadows, R- N. C., the chairman of the Freedom Caucus, laid out a path to get “the majority if not the entire Freedom Caucus” to vote for the bill — by extending the ability for states to apply for waivers to key Affordable Care Act insurance mandates. But there appears to be little appetite for doing that elsewhere in the House GOP.
Rep. Patrick McHenry, R- N. C., said Wednesday that rolling back those mandates — intended to protect insurance access for people with pre- existing medical conditions — would be a nonstarter: “It goes counter to the president’s promises. It goes counter to the promises of more than 200 members of the House.”
High- risk pools, such as the amendment proposes, have long been a staple of conservative health care overhaul plans, allowing insurers to rope off patients with exponentially higher costs from the rest of the population they insure. To fund the high- risk pools under their bill, House Republicans have proposed providing states more than $ 100 billion in federal “stabilization” funds.
But some high- risk pools operating before passage of the Affordable Care Act were not financially viable, and Avalere Health President Dan Mendelson warned the same thing could happen again, given this group’s extremely high medical expenses.
“The amount that they’ve allocated seems really big,” Mendelson said, referring to House leaders, “until you realize these are the train wrecks.”
The 2010 law created a temporary high- risk pool, called the Pre- Existing Condition Insurance Plan, which operated from mid- 2010 until Dec. 31, 2013, and received $ 5 billion to help cover consumers’ costs.