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GOP plans House vote on health bill
$8 billion deal on pre-existing conditions caps push to repeal, replace Obamacare
WASHINGTON — House Republican leaders said Wednesday that they plan to bring their plan to revise key parts of the Affordable Care Act to a vote Thursday, capping weeks of fits and starts in their attempt to fulfill a signature campaign promise.
The flagging Republican effort to reshape the nation’s health care system picked up steam Wednesday, as GOP leaders tried to address concerns about people with pre-existing medical conditions.
But independent analysts remained skeptical that the proposal would fully address the needs of at-risk patients who receive coverage guarantees under the Affordable Care Act, underscoring the controversial nature of the GOP effort.
Several lawmakers said they would hold a vote this week only if they felt certain it could pass — meaning they now believe they have the votes.
House Majority Leader Kevin McCarthy, R-Calif., guaranteed victory. “Do we have the votes? Yes. Will we pass it? Yes,” he said.
There’s no guarantee that the bill, if passed by the House, will become law. First the Senate must work its will, and the House legislation has generated significant opposition in the upper chamber.
Rep. Fred Upton, RMich., put the finishing touches on his proposal to provide more assistance — $8 billion over five years — to people with pre-existing medical conditions Wednesday. Those people are at risk of losing protections under the GOP plan, which seeks to repeal and replace parts of the ACA, also known as Obamacare.
Just a day earlier, Upton said he could not support the GOP plan because of pre-existing conditions. But he sounded an optimistic note after sketching out his fix Wednesday and meeting with President Donald Trump at the White House.
Long said Trump called him Tuesday afternoon. The two had a “good give and take,” he said and Trump grew “a little angry” when he said he could not support the bill. But eventually, he said, they came to an agreement on his amendment.
Rep. Billy Long, R-Mo., who like Upton was against the bill earlier this week because of pre-existing conditions, was also in the White House meeting. Now supportive of the bill, he cautioned: “There’s still work to be done on the votes, I believe.”
A Washington Post analysis showed 20 House Republicans either opposed to or leaning against the bill late Wednesday, and 36 more either undecided or unclear in their positions. If no Democrats support the bill, House Republicans can lose no more than 22 GOP votes to pass their bill.
Upton’s amendment was not met with resistance by the House Freedom Caucus, a key bloc of conservatives whose opposition to an earlier version of the health care bill led GOP leaders to yank the measure.
Under the GOP plan, states could opt out of parts of the ACA, meaning that people with pre-existing conditions could be denied coverage or charged more. Such states would have to set up high-risk pools to absorb some of the costs.
Upton’s amendment would help some patients with expensive conditions such as cancer or diabetes pay premiums and out-ofpocket costs.
But some experts doubted that $8 billion was enough to address those costs.
According to an analysis from the Kaiser Family Foundation, the temporary high-risk pool created by the ACA covered 100,000 people; the government paid $2 billion in subsidies to that pool in one year.
Far more people with preexisting conditions are likely to lose health coverage under the GOP health care plan — some estimate around 5 million — and depending on how many states apply for the funds, $1.6 billion a year could be spread thin.
“For subsidies to cover 68 percent of enrollees’ premium costs, as ACA tax credits do now in the individual market exchanges, the government would have to put up $32.7 billion annually,” wrote Emily Gee, a health economist at the progressive Center for American Progress, in an analysis of the Republican plan. “Even after applying that subsidy, high-cost consumers would still owe $10,000 annually toward premiums.”
After meeting with Trump, Upton said his amendment would “more than cover those who might be impacted.”