House Speaker Paul Ryan was optimistic on Sunday about having the 218 votes necessary to pass the American Health Care Act if it is brought up for a vote this Thursday.
“I feel very good about it actually,” Ryan told Fox News host Chris Wallace. “The reason I feel so good about this is because the president has become a great closer. He’s the one who has helped negotiate changes to this bill with members from all over our caucus.”
Ryan, speaking from Janesville, Wis., said Thursday will “most likely” be the day the Obamacare replacement legislation is voted on, following its stint before the House Rules committee.
As part of regular order before the vote, the AHCA is being looked over by four House committees. Ryan added that the bill is still being amended by those bodies, including changes that the budget and rules committees had requested.
“We’re still having conversations with our members, we are making fine-tuning improvements to the bill to reflect people’s concerns, to reflect people’s improvements,” Ryan added.
Some of the final possible additions to the bill being discussed include allowing states to impose work requirements on able-bodied Medicaid recipients, allowing states to accept a fixed block grant for Medicaid, and increasing tax credits for lower-income and elderly people.
If Ryan decides to increase tax credits for low-income seniors, it would be a huge concession to moderate Republicans, who were worried such seniors weren’t getting enough.
Under the AHCA, someone 60 years and above would get $4,000 in tax credits, double the amount of a younger person at $2,000. However, an insurer could charge that same senior five times more what it charges a younger person.
Under Obamacare, the senior would only pay up to three times the amount charged to a younger person.
The change in the AHCA could result in more younger people joining the insurance risk pools but, but it could cause seniors not old enough for Medicare dropping out due to higher costs.
Ryan didn’t hint at what the increase for seniors would be. Moderate Republicans have been clamoring for an increase to the tax credit for seniors.
While the move would help shore up support among moderates, it remains unclear how far-right conservatives would feel. Members of the conservative House Freedom Caucus already believed the tax credits were a new entitlement.
The caucus is expected to issue an amendment to the AHCA on Monday and didn’t appear persuaded by the recent changes to Medicaid announced on Friday.
