While hardline House conservatives are falling in line behind the latest Republican Obamacare repeal bill, there’s ominous silence from most moderates whose support is also essential to getting the measure passed in the House.
The latest version would allow states to opt out of several key Obamacare protections, allowing insurers to charge older and sicker people more than younger and healthier people, according to a summary obtained by POLITICO. So far, none of the moderates who opposed an earlier repeal bill have publicly committed to supporting the latest version.
“This amendment doesn’t do anything to change my position on the health care bill,” said Rep. Charlie Dent (R-Pa.), who co-chairs the centrist Tuesday Group. “This amendment seems too much about meeting an artificial 100-day timeline,” he added, referring to President Donald Trump’s upcoming milestone date.
A proposal from Tom MacArthur (R-N.J.), and negotiated with the leader of the Freedom Caucus, would allow states to decline to require insurers to offer a minimum set of benefits and provisions allowing health plans to charge people more based on their age and health status. States can also opt out of enforcing a 30 percent surcharge for people who don’t maintain insurance coverage, according to a brief update sent to Energy and Commerce members.
The legislative text had been expected over the weekend. But the House has no plans to take up a repeal measure this week, despite the White House’s urging last week to do so. Republicans are expected to remain focused on funding the government past a Friday deadline for a new spending bill, with Obamacare repeal discussions likely continuing in the background. Members of the Freedom Caucus are expected to review the legislation together on Tuesday or Wednesday.
So far, moderates have largely remained mum on the latest changes to the repeal bill. Several moderates who opposed the bill said Monday through spokespersons that they hadn’t yet seen the legislative text.
“That hurts any timeline of [a vote] this week or next week,” said an aide to one lawmaker.
MacArthur is one of three co-chairmen of the Tuesday Group. At least some of the group of moderate Republicans would have to support the repeal bill if it has any chance of getting through the House.
“It’s our party, frankly, that has to get together and really realize sometimes you can’t vote for a perfect bill,” Rep. Adam Kinzinger (R-Ill.) said. “We need to work together, and that’s a learning process, I think, for Republicans in the House right now.”
MacArthur spent the congressional recess negotiating the deal directly with Freedom Caucus Chairman Mark Meadows (R-N.C.), leaving the Tuesday Group largely out of the loop. Indeed, some members had not seen any of the proposal’s details until drafts of the amendment were leaked out through the press.
States would be allowed to opt out of several of Obamacare’s consumer protections as long as they have set up high-risk pools, where consumers with costly medical expenditures would presumably be able to get coverage.
The waivers would strongly encourage people to maintain continuous coverage — even more than prior versions of the Republican repeal bill. In states that get a waiver, people who don’t stay insured can be charged more for insurance policies based on their health status.
The latest changes appear to preserve Obamacare’s requirement that insurers accept anyone regardless of their pre-existing conditions. But critics of the repeal bill argue that allowing insurers to charge sicker people more could in effect shut out those individuals because insurers will be able to charge whatever they want.
Under the Affordable Care Act, insurers had to charge sick and healthy consumers the same, with only a limited number of exceptions, including for age and tobacco use.
And with the House set to return to Washington on Tuesday, members of the Tuesday Group said there hasn’t been any coordination aimed at building support for the changes.
“Mr. LoBiondo has tweeted his thoughts thus far on the discussion — nothing additional to add at this point,” said an aide to Frank LoBiondo (R-N.J.), who tweeted Friday he’ll continue to oppose the bill. “I’m sure Politico will have any copy of the legislative text before members do.”