Moderates balk at conservative-backed, revised health bill
WASHINGTON — The White House and Republican leaders worked Thursday to wring votes out of resistant moderate GOP lawmakers for the House health care bill, but remained shy of the support they’d need to fully rouse the measure back to life.
Centrist Republicans were the primary target of the lobbying, a day after the conservative House Freedom Caucus announced its support for a revised version of the legislation. The fresh backing from that group exhumed the bill from the legislative graveyard, but leaders still need moderates who’ve resisted the effort to jump aboard.
White House officials and party leaders were eager for a vote this week if possible, before the 100th day of Donald Trump’s presidency, which falls this Saturday. But Speaker Paul Ryan, R-Wis., wants to avoid an encore of last month’s embarrassment, when he abruptly canceled a vote on a health care overhaul because of opposition from moderates and conservatives alike.
Ryan told reporters that leaders were making progress but added, “We’re going to go when we have the votes.” He noted that he had spoken earlier this year about a 200-day legislative plan because of the complexity of revamping the nation’s health system, its tax code and border security.
In at least one instance, Trump and Vice President Mike Pence spoke to one recalcitrant conservative who is now a yes vote. Rep. Mo Brooks, R-Ala., said he’d already decided to switch to backing the revamped bill on Wednesday before he got two phone calls from Pence, who on the second call handed the phone to Trump.
“Donald Trump expressed his appreciation for the position I was taking,” Brooks said Thursday. “That gives you a good feeling inside about what you’re doing.”
The recast bill would let states escape a requirement under former President Barack Obama’s health care law that insurers charge healthy and seriously ill customers the same rates. They could also be exempted from Obama’s mandate that insurers cover a list of services like maternity care, and from its bar against charging older customers more than triple their rates for younger ones.
Overall, the legislation would cut the Medicaid program for the poor, eliminate Obama’s fines for people who don’t buy insurance and provide generally skimpier subsidies.
Conservatives embraced the revisions as a way to lower people’s health care expenses. Moderates saw them as diminishing coverage because insurers could make policies for their most ill — and expensive — customers too costly for them to afford.
“No bill is going to solve every issue,” said Rep. Tom MacArthur, R-N.J., who crafted the newest edition of the legislation with Rep. Mark Meadows, R-N.C., who heads the hard-line Freedom Caucus. MacArthur is a leader of the roughly 50-member moderate House Tuesday Group, but it is unclear that he has won over many of their votes and he conceded that some lawmakers “are struggling to get to yes.”
The American Medical Association said it opposed the newly reshaped bill, as it did the original legislation.
The doctors’ group said letting insurers boost premiums on people with pre-existing conditions “will likely lead to patients losing their coverage.” It also said a provision requiring insurers to cover such people “may be illusory” because companies could make such policies unaffordable.
Some lawmakers and GOP aides suggested leaders were less than 10 away from the 216 votes Republicans will need to prevail. Others were more cautious, and there was little overt indication of new support from the party’s moderates.
Many of them oppose the legislation, citing its cuts in Medicaid, its less generous federal subsidies for people buying insurance and estimates that 24 million people would lose coverage.
“I still think there’s a lot of work to be done” before a vote can be held, said Rep. Steve Stivers, R-Ohio, a member of the House GOP leadership.