Freedom Caucus Backs Updated GOP Health Care Bill

The House Freedom Caucus officially backs an updated version of the GOP health care bill that includes a significant amendment co-sponsored by the group’s chairman, the conservative bloc’s spokeswoman announced early Wednesday afternoon. She did not respond immediately to a Twitter inquiry asking if the caucus’s support meant all of its members would vote yes on the legislation.

The so-called Meadows-MacArthur amendment, from House Freedom Caucus chairman Mark Meadows and moderate Tuesday Group co-chairman Tom MacArthur, would allow states to waive a limited number of Obamacare regulations under certain conditions. Conservatives have argued that the regulations in question are health care cost-drivers, and their total preservation in the original draft of the American Health Care Act was behind the lawmakers’ initial opposition to the legislation.

Although the Freedom Caucus’s endorsement of the updated language helps push the bill closer to majority support in the lower chamber, there is a risk that moderate members who were already concerned could be driven away. Whip counts published in the media including one from the New York Times, placed the number of moderate representatives who were unclear, concerned, or against the legislation previously pulled from the House floor near 30. Rep. Charlie Dent, a Tuesday Group co-chairman, said that he believes most moderates who opposed the bill originally still do—”and some supporters could flip too,” according to Politico’s Kyle Cheney. There are 238 Republicans in the House; the party can afford to lose 22 of them and pass the legislation, if all members on both sides of the aisle vote.

The Meadows-MacArthur amendment comprises policy relevant to the Affordable Care Act’s “pre-existing conditions” and “essential health benefits” provisions, which makes many moderates uneasy. But the amendment also provides several hedges to help retain them. THE WEEKLY STANDARD wrote about the amendment’s principles last week:

According to draft principles of an amendment to the AHCA from Meadows and moderate Tuesday Group co-chairman Tom MacArthur, state governments could seek “limited waivers” from two mandates of particular interest to conservatives: “community rating,” which requires insuring groups at the same price no matter what their individual differences in age, sex, health status, etc., and a portfolio of “essential health benefits” required in all plans. (The amendment still prohibits considering gender in calculating premiums.) Preventing insurers from differentiating premiums based on health status while still forcing them to cover all comers has long troubled conservatives who worry that such policy leads to economic disaster. The Meadows-MacArthur document, first published by Politico, retains Obamacare’s “guaranteed issue” of insurance. But tampering with community rating would make plans more expensive for higher-risk consumers. Pumping money into risk pools figures to offset that. Republicans are playing soft-toss with an egg on this one. A March CNN poll found that 87 percent of Americans support “maintaining the protections offered to people with pre-existing conditions under Obamacare.” The mechanism for those protections is complex and rarely discussed in the mainstream media; it’s unlikely even 8.7 percent of Americans understand the details. But word spread even before last week that the White House and the Freedom Caucus were discussing the waiver idea, and ominous headlines permeated the press. Not just from partisan shills, either: The excellent New York Times health care reporter Margot Sanger-Katz, for example, wrote a piece headlined “Republican Health Proposal Would Undermine Coverage for Pre-existing Conditions.” Imagine you’re a GOP lawmaker having to defend why you support “undermining” a major provision of law supported by 9 out of 10 constituents.

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