Con­ser­va­tives en­dorse re­vised health care plan

Some cen­trists still wary

The Washington Times Daily - - FRONT PAGE - BY TOM HOW­ELL JR.

The hard-line con­ser­va­tives who helped sink Repub­li­cans’ first Oba­macare re­peal at­tempt re­versed course Wednesday and of­fi­cially en­dorsed the lat­est plan de­signed to slash costs for healthy Amer­i­cans, giv­ing con­gres­sional lead­ers a crit­i­cal boost as they seek a do-over.

The House Free­dom Cau­cus’ sup­port will heap pres­sure on Repub­li­can cen­trists, who also re­sisted the first go-around last month but who will now be called upon to get the re­peal bill over the fin­ish line.

“While the re­vised ver­sion still does not fully re­peal Oba­macare, we are pre­pared to sup­port it to keep our prom­ise to the Amer­i­can peo­ple to lower health care costs,” the Free­dom Cau­cus said in a state­ment.

The en­dorse­ment is the di­rect re­sult of a pro­posal bro­kered by Free­dom Cau­cus Chair­man Mark Meadows of North Carolina and Rep. Thomas MacArthur, a cen­trist from New

Jersey. It would al­low states to opt out of parts of Oba­macare re­quir­ing in­sur­ers to cover “es­sen­tial” ben­e­fits such as ma­ter­nity and men­tal health care or pre­scrip­tion drugs.

States also can waive rules re­quir­ing in­sur­ers to charge healthy con­sumers the same amount as sicker con­sumers, so long as states set up risk pools to sub­si­dize those priced out of the mar­ket be­cause in­sur­ers can­not deny peo­ple with pre-ex­ist­ing med­i­cal con­di­tions.

The deal won im­me­di­ate praise from some of the con­ser­va­tive pres­sure groups that helped sink the re­peal bill in March.

But it faced im­me­di­ate crit­i­cism from Democrats, who said the lan­guage would give a spe­cial carve-out to mem­bers of Congress, al­low­ing them to keep their high-cov­er­age plans while let­ting states strip down cov­er­age for their res­i­dents.

Repub­li­can aides said they had to in­clude the ex­emp­tion to sat­isfy Se­nate rules be­cause of the com­pli­cated bud­get process Repub­li­cans are us­ing to pass their re­peal bill with­out fac­ing a Demo­cratic fil­i­buster.

“Con­gress­man MacArthur does not be­lieve mem­bers of Congress or their staff should re­ceive spe­cial treat­ment and is work­ing with House lead­er­ship to make ab­so­lutely clear that mem­bers of Congress and staff are sub­ject to the same rules, pro­vi­sions and pro­tec­tions as all other Amer­i­cans,” MacArthur spokes­woman Camille Gallo said.

Aides said Repub­li­cans would push for leg­is­la­tion that fixes the prob­lem along­side the re­peal-and-re­place bill.

“That side­car bill needs to be voted on 15 min­utes af­ter­ward or it’s all BS,” said Robert Laszewski, a health pol­icy con­sul­tant in Vir­ginia.

He said it would be out­ra­geous for mem­bers of Congress to en­sure their health care ben­e­fits are more ro­bust than ev­ery­one else’s.

Democrats said the con­gres­sional carve-out was just one prob­lem with the bill, which they said evis­cer­ated the pro­tec­tions writ­ten into Oba­macare.

“If House Repub­li­cans are afraid of TrumpCare for them­selves, they have no right to force it on hard­work­ing Amer­i­can fam­i­lies,” said House Mi­nor­ity Leader Nancy Pelosi, Cal­i­for­nia Demo­crat.

Democrats have been in lock­step opposition to the Repub­li­can ef­forts from the be­gin­ning, say­ing the so­lu­tion to Oba­macare’s prob­lems is an in­fu­sion of more govern­ment fund­ing and a larger fed­eral role in the health care mar­ket.

With­out Democrats, Repub­li­cans need to have near una­nim­ity. It was a lack of sup­port within the party that forced House lead­ers to pull their bill from the floor.

Now, those lead­ers are hope­ful that prob­lem has been re­solved.

“We think the MacArthur amend­ment is a great way to lower pre­mi­ums, give states more flex­i­bil­ity while pro­tect­ing peo­ple with pre-ex­ist­ing con­di­tions. Those are the three things we want to achieve,” said House Speaker Paul D. Ryan, Wis­con­sin Repub­li­can.

The Free­dom Cau­cus said at least 80 per­cent of its roughly 30 mem­bers sup­port the lat­est plan, which is enough to earn a cau­cus en­dorse­ment.

Mr. Ryan and other senior Repub­li­cans stopped short of say­ing they have the 216 votes needed to pass the bill.

The big­gest hur­dle now could be cen­trists. Mul­ti­ple mod­er­ates from the North­east — in­clud­ing Rep. Charles W. Dent, Penn­syl­va­nia Repub­li­can and an in­flu­en­tial mem­ber of the Tuesday Group — have said the changes don’t as­suage their con­cerns about the un­der­ly­ing bill. The Con­gres­sional Bud­get Of­fice es­ti­mates that the plan would re­sult in 24 mil­lion fewer peo­ple hold­ing cov­er­age a decade from now.

“Too many peo­ple have viewed health care re­form as a speed bump on the road to tax re­form,” Mr. Dent said.

Rep. Tom Cole, Ok­la­homa Repub­li­can, said hold­out mod­er­ates prob­a­bly num­bered in the “mid­teens.”

“You might be able to get there with­out them, but you want something that ev­ery­one can feel com­fort­able vot­ing for,” he said. “Lead­er­ship cer­tainly is not try­ing to deal any­body out of the game.”

The changes were ne­go­ti­ated in part by Vice Pres­i­dent Mike Pence, who shut­tled back and forth to Capi­tol Hill to find a way for­ward.

Rep. War­ren David­son, Ohio Repub­li­can and mem­ber of the Free­dom Cau­cus, said the MacArthur changes and an amend­ment by Rep. Gary J. Palmer, Alabama Repub­li­can, that freed up $15 bil­lion for high-risk pools brought him from “no” to “yes.”

Some con­ser­va­tives still aren’t sold. Rep. Wal­ter B. Jones, North Carolina Repub­li­can, said he ap­plauds Mr. MacArthur’s work but wants to see the fi­nal prod­uct around it.

“I think what’s he’s do­ing is yeo­man’s work and he’s do­ing a great job, and I think it does help the bill,” he said. “But un­til you see the whole bill, I just don’t know how you can say I like just one part of it.”


House Free­dom Cau­cus Chair­man Mark Meadows helped bro­ker the health care deal.

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