A moderate House Republican is proposing a new deal to secure GOP votes for a health care bill that was pulled before a vote nearly a month ago, but it’s unclear whether the latest proposal would bring the party together when several previous efforts have failed.
The proposal comes after weeks of talks between Rep. Tom MacArthur (R-N.J.), a co-chairman of the moderate Tuesday Group, and Rep. Mark Meadows (R-N.C.), chairman of the House Freedom Caucus, a group of ultra-conservative Republicans.
But the proposal, which has not been formally introduced, may have trouble winning over more moderate members of the caucus.
MacArthur had already been a “yes” vote on the GOP’s previous measure, the American Health Care Act, before it was pulled by House leadership in March. But other moderates have been skeptical of proposals that could undermine their campaign promises, such as repealing the Affordable Care Act’s protections for people with pre-existing conditions.
“The question is whether it can get 216 votes in the House and the answer isn’t clear at this time,” a senior GOP aide said, referring to the number of votes needed to bypass support from Democrats. “There is no legislative text and therefore no agreement to do a whip count on.”
The White House is pushing for a health care vote next Wednesday or Thursday, just before President Donald Trump’s 100th day in office, according to a Politico report. But a White House aide told Morning Consult that there was no timetable or set date for a vote.
According to a summary of the proposal, states would get a limited waiver option where they could apply for exemption from certain federal standards, including essential health benefits and community rating. Previous GOP plans had also floated giving states more waiver options, but this plan clearly details what states would be allowed to waive. It does not include waiving guaranteed issue, which ensures access to health insurance, as some conservatives had wanted.
On the community rating issue, states would not be able to waive rules related to gender, age and health status unless the state has established its own high-risk pool or is participating in a federal pool. States would also have to show their plan would reduce premium costs, increase the number of individuals with health care coverage or advance another benefit in the state’s public interest in order to get approval.
Unlike the failed bill, the newest plan would reinstate the ACA’s essential health benefits and would maintain certain protections, such as prohibiting insurers from denying coverage to people with pre-existing conditions and keeping guaranteed issue. It would also keep the ACA’s most popular provisions, such as allowing young adults to remain on their parents’ insurance policies until age 26 and prohibiting discrimination based on gender.
But policy experts warn guaranteed issue would not work in practice if people with costly pre-existing conditions could be charged more for coverage.
The proposal comes as Republicans are preparing to return to D.C. after a two-week recess and are hopeful they can finally get a health care deal that would bring at least 216 members of their party on board, out of 237 GOP members in the House. But other priorities may have to come first, including striking a deal with Democrats by April 28 to prevent a government shutdown.
The GOP added one amendment focused on federal high-risk pools to the legislation before leaving town, but leaders acknowledged that was not enough for the conference to come together. The proposal did not appear to sway any votes on its own.
Update: This story has been updated to reflect the White House comment on a timing of a vote.