Rep. Mark Meadows, chairman of the conservative House Freedom Caucus, said Thursday that he and other members of the caucus would vote in favor of a bill to repeal Obamacare if it includes allowing states to opt out of three of the law’s mandates, including guaranteeing that insurers will offer a plan to customers regardless of their health status.
“If those offers that were made over the last couple of days [were in the bill], the majority if not all of the Freedom Caucus will vote for this bill,” Meadows said, speaking at an event in Washington hosted by Politico Playbook.
The mandate requiring insurers to offer coverage to those with pre-existing conditions, known as guaranteed issue, was not raised by Meadows in an interview with the Washington Examiner last week, when negotiations were focused on a total repeal of the mandates at the federal level. Since then, however, talks have shifted to allowing states to waive various provisions, and members of the House Freedom Caucus have broadly been opposed to a range of Obamacare mandates.
In meetings with the White House earlier this week, the group said it discussed allowing states to waive other requirements in the law, including obligating insurers to cover 10 categories of “essential health benefits” and shielding the sickest customers from paying higher premiums than healthier customers. Without the latter guarantee, critics have argued, insurers could offer plans to sicker customers because for many premiums would be prohibitively expensive.
When presented with this argument, conservatives have stressed that their plan would include government funding for high-risk pools, an attempt to deliver coverage to those with serious illnesses outside of the broader insurance market. By separating those who are most expensive to cover, the assumption is that insurers could offer cheaper insurance to healthier customers. The provisions in Obamacare provide more comprehensive coverage, but also tend to drive up premiums for customers overall.
Rep. Justin Amash, R-Mich., a member of the Freedom Caucus who was also at the breakfast, said that he would have to read the bill before determining whether he could support it. The group emphasized that even with these provisions it would like for the House to hold additional hearings involving healthcare experts, medical providers, and beneficiaries.
“I would not support it being on the floor in a couple of days,” Amash said.
Jim Jordan, R-Ohio, said that the bill Republican leadership put forward, the American Health Care Act, should have faced such scrutiny in the first place.
“If you had done that you might have gotten a product that had higher than a 17 percent approval rating,” Jordan said, referring to findings from a Quinnipiac University poll.
Repealing these provisions, even if left to the states, could be a tough sell to less conservative Republicans. Rep. Chris Collins, R-N.Y., said Wednesday that he and other centrists are opposed to provisions that would allow insurance companies to charge sicker customers more. House Republicans have been unable to coalesce around legislation to repeal Obamacare, and after Thursday will be taking a two-week recess.
When asked whether a bill with these provisions would be able to win over other members of the House, including centrists, Meadows replied: “We have a pretty sophisticated whip operation.”
He added, “We have got to lower premiums, and until I am convinced it does that I can’t vote yes.”
Editor’s note: This story has been updated to more clearly convey Rep. Amash’s position.
