Freedom Caucus Endorses Obamacare Repeal Compromise
President Donald Trump inched closer to his elusive goal of transforming the health care system Wednesday as hard-line House conservatives — once the chief opponents of the GOP plan — embraced a new proposal to replace Obamacare.
Senior House Republican sources said they still didn’t have the votes for passage Wednesday evening. But GOP leaders felt bullish enough about their progress that they began considering a vote as early as this week. Nothing is scheduled. However, Republicans on Wednesday — through an obscure House rule for another piece of legislation — gave themselves same-day authority to fast-track any bill at the last minute, through Saturday.
“It’s only a matter of time now,” Rep. Patrick McHenry (R-N.C.), the House’s chief deputy whip, declared after the House’s arch-conservative Freedom Caucus endorsed the measure.
Yet even as the backing of the conservative group provided an undeniable burst of momentum to Trump and the GOP leadership, a band of moderate House Republicans remained deeply skeptical. Insiders say the changes to the bill have hardened the positions of some moderate and traditional Republican opponents of the bill. And even if the House passes the bill, the Senate remains an enormous hurdle.
But moderates present the most immediate threat to the White House’s sudden progress. Rep. Mike Coffman (R-Colo.), who backed an earlier version of the proposal, said he’s now undecided. Rep. Barbara Comstock (R-Va.), who opposed the initial version, said she needs “basic information” about the conservative-backed changes before she takes a position.
And Rep. Charlie Dent (R-Pa.), co-chair of the moderate, 50-member Tuesday Group, said he hasn’t detected any reversals among the opponents of the health care bill — in fact, he said, their ranks may grow.
“The question now is how many people does it take from yes to no,” he said.
Others Tuesday Group members, including Reps. Adam Kinzinger (R-Ill.) and John Katko (R-N.Y.), wouldn’t comment on the measure, an amendment to the Affordable Care Act.
That resistance could threaten the White House’s desire for a quick vote on the new plan. It also tempered the exuberance of some backers of the House health care plan, known as the American Health Care Act, after the Freedom Caucus endorsement.
The group of three dozen conservatives said in an early Wednesday statement that an agreement negotiated by caucus Chairman Mark Meadows (R-N.C.) and centrist Tuesday Group co-Chairman Tom MacArthur (R-N.J.) assuaged their previous concerns about the bill. The White House has been pressing Republicans to broker a compromise.
“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 healthcare costs,” the statement said. “We look forward to working with our Senate colleagues to improve the bill.”
Asked whether his proposal would get the bill across the finish line, MacArthur said the primary goal had to be ensuring the bill’s previous supporters remained in the fold.
“I think we now need to make sure we hold the people that were ‘yes’ before,” he said. “And if we do, I’m cautiously optimistic we can get this done.”
Though he is a Tuesday Group co-chairman, MacArthur said he didn’t consider that role to be the driver behind his effort. “I don’t think about one caucus or another,” he said.
The new health care language allows states to opt out of central Obamacare protections for consumers — as long as the states offer an alternative proposal that lowers premiums, increases the ranks of insured people or stokes greater competition among health insurance companies. States would also be required to set up “risk pools” that help provide coverage for people with pre-existing conditions.
The plan would prohibit insurers from charging women higher premiums than men and retains Obamacare’s guarantee of “access” to coverage for people with pre-existing conditions. But it would also allow states to waive Obamacare’s prohibition on charging sick people higher premiums if they have a gap in coverage. States could also pull back from Obamacare’s set of minimum insurance benefits.
Centrists are wary of supporting any measure that could be construed as stepping away from a pledge to protect constituents with pre-existing conditions. Dent said he was surprised that an amendment negotiated by MacArthur — a Tuesday Group leader — would include the kind of policy changes that ultimately won the support of the Freedom Caucus. He described it as “face-saving and blame-shifting” by conservatives who were blamed for the failure of earlier versions of the AHCA.
As top conservative groups and lawmakers declared their support for the revised measure, however, a new problem arose that could slow progress. A provision in the proposal appeared to exempt members of Congress and their aides from weakened regulations that states would be allowed to adopt.
Democrats seized on the language, arguing that Republicans were trying to shield themselves from their own legislation. The Democratic Congressional Campaign Committee even planned a rapid-fire digital ad campaign highlighting the provision as Republicans were grappling with the details.
“It should be no surprise that TrumpCare has gotten so terrible that Republicans have resorted to exempting themselves and their families from the pain it inflicts,” said Drew Hammill, spokesman for House Democratic leader Nancy Pelosi. “Speaker Ryan and congressional Republicans promised that Americans with pre-existing conditions would be protected, but it turns out they were only talking about themselves.”
Multiple GOP lawmakers and staff members acknowledged that the language could create an appearance problem. But they all expressed confidence that the matter would be resolved, either through another bill or by changing the text.
Still, several Freedom Caucus members who suggested they might support the bill after the White House gave conservatives additional concessions said they want to see the issue fixed first.
“There is a thing that’s missing, which is the congressional component, which makes sure that Congress isn’t exempt,” said Freedom Caucus member Scott Perry (R-Pa.), when asked whether he plans to back the bill.
Another caucus member, Rep. Warren Davidson (R-Ohio), said the caucus discussed the problem at a meeting Wednesday morning. While he supports the new repeal framework, Davidson said, “I want to make sure Congress doesn’t get special treatment.”
The proposal unveiled late Tuesday by Meadows and MacArthur — cheered on by the Trump administration and, especially, Vice President Mike Pence — has been billed as the compromise that could corral skittish Republicans reluctant to support earlier versions of the proposal. And on Wednesday, before the Freedom Caucus took an official position, several conservatives who had withheld their support from earlier proposals indicated they were ready to sign on.
“If the amendment goes in, I’m for it,” said Rep. Jim Jordan, vice chair of the Freedom Caucus, who noted that the bill is not a “full repeal of Obamacare.”
Conservative advocacy groups that once knocked the GOP health care plan as an insufficient repeal of Obamacare began lining up behind the new plan.
“While we’re still short of full repeal, this latest agreement would give states the chance to opt out of some of Obamacare’s costliest regulations, opening the way to greater choice and lower insurance premiums,” Club for Growth President David McIntire said in a statement. FreedomWorks, another conservative group, also endorsed the revised proposal.
The revised plan was unveiled as the House was also juggling an imminent government shutdown deadline and the outline of a tax plan that Trump released Wednesday afternoon.
As moderates and conservatives huddled to figure out who would vote for the deal, GOP leaders set to work figuring out how to fix the member exemption matter.
Several GOP sources indicated that the inclusion of exempting language was a technical requirement because of the Senate’s rules. Any change to Congress’ health care would fall outside the jurisdiction of the Senate’s health committee. That technicality would require a different set of procedures in the Senate and prevent the legislation from passing with a bare 51-vote majority, instead subjecting it to a 60-vote requirement that would be insurmountable without Democratic support.
Filed Under: ACA/Health Reform