There’s no time set for when the Republicans will try to advance a new proposal for repealing and replacing the Affordable Care Act to make amends for their failed effort in late March, although they appear to be gaining momentum.
The proposal, hammered out privately by White House officials, leaders of the arch-conservative House Freedom Caucus and centrist Republican Rep. Tom McArthur of New Jersey, would allow states to opt out of many of the Obamacare regulatory mandates. They could also seek waivers to free insurers from having to provide all 10 “essential health benefits” required under existing law, such as maternity care and mental health treatment.
While insurers would continue to be required to cover people with “pre-existing medical conditions,” they could charge those people higher premiums than others, provided their states set up government funded “high-risk pools” to help cover the premiums for older and sicker patients.
The 30-member Freedom Caucus announced on Wednesday that it would support the latest GOP healthcare plan, even though the bill falls short of their call for fully repealing Obamacare. “We look forward to working with our Senate colleagues to improve the bill,” the group said in a statement. “Our work will continue until we fully repeal Obamacare.”
Ryan told reporters, “We’re getting really close” to a compromise that would stand a reasonable chance of passing on the House floor, but dodged a question of when the bill might be brought up for a vote. “We’ll vote on it when we get the votes,” he said.
But one thing is certain: Members of Congress are working behind the scenes to protect their own interests and those of their families and many of their staffers in the event Obamacare replacement legislation ultimately emerges from the House.
House Republicans quietly inserted a provision in the latest version of their health care overhaul plan that exempts members and their staffs from the GOP effort to repeal or shred most of the Obamacare regulations and protections, including those guaranteeing Americans a broad array of medical services and restrictions on premium hikes for older and sicker people.
As first reported by Sarah Kliff of Vox, the provision added by McArthur at the behest of the leadership specifically would guarantee that members of Congress and personal staff members could keep all coverage benefits and protections under Obamacare, even if the states in which they live choose to seek waivers to eliminate many of them.
The 2010 Affordable Care Act required members of the House and Senate and many of their staffers to shift from the generous and taxpayer subsidized Federal Employees Health Benefit Program to the new Obamacare health care exchange in the District of Columbia. The rationale for that was that members of Congress should be willing to accept the same quality of health care mandated for tens of millions of Americans.
Yet from the very start of the program four years ago, members of Congress and their staffs have been given special treatment.
To assure that they continued to receive low-cost coverage, lawmakers and their staffs were defined as “small businesses” and entitled to subsidies of more than 70 percent as part of an obscure health insurance program for small employers. As part of this special carve out, all 535 members of the House and Senate and tens of thousands of staff members were provided with “gold level” Obamacare coverage, with taxpayers picking up nearly three-quarters of their costs.
Now, in the improbable event that Trump and the Republicans succeed in pushing their latest version of health care overhaul legislation through the House and the Senate, lawmakers and their aides would be immune to sharp cutbacks in coverage and protection if their home states decided to opt out of many of the mandates or coverage requirements.
As Trump fast approaches his 100th day in office, the White House and congressional Republicans have scrambled to find common ground on an Obamacare replacement bill after a previous effort collapsed in March that forced Ryan to pull the bill from the floor before a scheduled vote.
Reps. Mark Meadows (R-NC), Jim Jordan (R-OH) and Raul R, Labrador (R-ID), leaders of the Freedom Caucus who helped bring down the first bill, signaled on Tuesday that they were prepared to support the latest version, largely crafted by McArthur, one of the few centrists or moderates who has been willing to get behind a plan until now.
However, many House moderates who belong to the Tuesday Group continue to resist the efforts to dismantle Obamacare – an effort supported by only 37 percent of Americans according to a new Washington Post-ABC News poll. And the previous talk by Trump and others that the House might try to pass the latest version of the bill before the end of this week now seems unlikely at best, as Congress rushes to pass a spending bill to keep the government operating.
“It’s hard to understand the strategy of trying to gain support for a health care repeal bill that the majority of Americans already oppose by adding a provision to strip pre-existing condition protections, a provision which the overwhelming majority of Americans vehemently oppose,” Rep. John Yarmuth of Kentucky, the ranking Democrat on the House Budget Committee.
“But when the starting point for House Republicans is kicking 24 million people off their health insurance, cutting more than $800 billion from Medicaid, and pricing older Americans out of the insurance market, it’s clear this debate for them is about politics and ideology and not good health care policy.”