Pre-existing conditions drive moderates’ concern over repeal bill


http://www.politico.com/story/2017/04/27/healthcare-repeal-pre-existing-conditions-moderates-237713?utm_campaign=KHN%3A%20First%20Edition&utm_source=hs_email&utm_medium=email&utm_content=51306136&_hsenc=p2ANqtz-_Kd2qUCppTF1-MJzmxXc-yctQ3aukhBU3TjgUBmQorQj2jnFsKpRFmI9jaf7tldE1bHi7_7v6CLiebqofmJrqHhkUGzA&_hsmi=51306136

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Moderate Republicans are largely withholding their support for the Obamacare repeal bill, arguing it would hurt people with pre-existing conditions

House Republican leaders hoped that the House Freedom Caucus’s endorsement of the latest Obamacare repeal bill would light a fire under enough moderates to get their whip count to the 216 votes needed to pass the measure. Instead, the holdouts are digging in, saying that the latest changes only moved the bill to the right and could put more Americans at risk of losing their health insurance.

“My concern has always been and what a lot of us talked about: people with pre-existing conditions, the elderly,” said Rep. Mario Díaz-Balart (R-Fla.). “How this makes the original bill better? Where is the part that is better for the folks I’m concerned about it? I’m not seeing it at this stage.”

Protections for people with pre-existing conditions have only been in effect for seven years, but proven to be one of the most popular and well-known features of the Affordable Care Act. Moderate Republicans are worried about stripping the safeguards without a reliable replacement. If the resistance from moderates holds, it would be enough to block Obamacare repeal in the House — or send the effort back to square one.

GOP leaders have been buttonholing moderates for two days, arguing that the latest changes — drafted by Rep. Tom MacArthur (R-N.J.) with consultation from the House Freedom Caucus — would ensure people with pre-existing conditions wouldn’t be priced out of a reconfigured market, pointing to high-risk pool requirements in state that choose to opt out of Obamacare provisions.

Backers of the repeal measure say the bill protects people with pre-existing conditions, arguing that people with coverage, for instance, can’t be priced out if they maintain it.

But buying into the plan would pose big political risks for centrists in swing districts. Voicing concerns about pre-existing conditions could prevent a tough vote on an issue that Democrats would surely spotlight in the 2018 election.

 

Several Republican sources say at least some moderates have climbed aboard, but they’re not inclined to say so publicly. House Appropriations Chairman Rodney Frelinghuysen (R-N.J.), who was widely panned by fellow Republicans for not supporting an earlier version of the repeal bill given his high-profile post, is expected to now support it, according to several sources.

Other than Frelinghuysen, there are no moderates who have publicly flipped to support the bill.

Republicans can absorb no more than 22 defections (depending on how many members are seated when the vote is held) from the 238-member Republican conference. The leaders still need fewer than 10 votes, according to several sources.

Rep. Ryan Costello (R-Pa.) said the latest changes to the bill didn’t bring him to a yes.

“Protections for those with pre-existing conditions without contingency and affordable access to coverage for every American remain my priorities for advancing healthcare reform, and this bill does not satisfy those benchmarks for me,” he said in a statement.

Rep. Barbara Comstock (R-Va.), one of the most vulnerable Republicans in 2018, said she is still a no. Rep. Carlos Curbelo of Florida is undecided— he’s still talking with leadership but claims no one is twisting his arm.

“They know better than to pressure me,” he said.

It’s not just traditional moderates who have qualms. Rep. Chris Smith (R-N.J.), who is very conservative on most social issues, is still a no.

Rep. Pete King (R-N.Y.) doesn’t want Obamacare’s Medicaid expansion repealed under the latest GOP plan, but told POLITICO he would vote to move the bill forward and assumes the Senate would restore Medicaid expansion. If the bill were to come back with Medicaid repealed, “it would be a problem,” he said.

The latest changes may have even eroded the support of moderates who backed the earlier repeal bill that was pulled in March. Rep. Adam Kinzinger of Illinois said he’s undecided. Rep. Steve King of Iowa, one of the House’s most conservative members, told reporters he’s undecided now, too.

Rep. Jim Renacci (R-Ohio), who supported the original repeal bill, is undecided but inclined to move the process forward.

“My biggest concern is that we’re changing things based on amendments written in backrooms and not everyone knows what is said and what’s part of the deal,” he said.

Some Republicans just don’t want to talk about it.

Rep. Darrell Issa of California paused to hear a reporter’s question on his vote, then kept walking.

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