The conservative House Freedom Caucus that helped derail the GOP’s effort last month to repeal Obamacare has formally endorsed a revised measure, potentiality giving it a new lease on life.
“While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health-care costs,” the group said in a statement. “We look forward to working with our Senate colleagues to improve the bill.”
The endorsement could help build support for a new vote as early as next week, but Representative Charlie Dent of Pennsylvania, a leading Republican centrist, says that he believes most moderates remain opposed. He called the new version an effort at “blame-shifting” for the failure of the repeal effort.
House Republicans have been under intense pressure to deliver on years of promises to repeal Obamacare, but GOP leaders weren’t making predictions of an imminent vote, despite renewed pressure from the White House as President Donald Trump approaches his 100th day in office on Saturday.
The new enthusiasm stems from an amendment that would give states the authority to apply for waivers from some of Obamacare’s requirements under certain conditions.
"It’s pretty much everything I was looking for in terms of concessions," said Representative Scott DesJarlais of Tennessee, a member of the Freedom Caucus who had opposed an earlier version.
House Speaker Paul Ryan told reporters Wednesday the amendment provides "a great way to lower premiums, give states more flexibility while protecting people with pre-existing conditions." When asked whether the House will vote next week on the health-care bill, he said, "We’ll see. We’ll vote on it when we get the votes."
"We’re showing people the language now," Majority Leader Kevin McCarthy of California said Tuesday. House Republicans held a closed-door meeting Wednesday where Representative Tom MacArthur of New Jersey discussed his amendment.
"Cautious," said Representative Phil Roe of Tennessee, a medical doctor, of the approach that House Republican leaders are taking. Representative Steve Chabot of Ohio said everyone is proceeding quietly so that nothing happens "to blow everything up."
But there are complications, including the revelation that the new amendment would treat health coverage for lawmakers and their staffs differently by barring waivers for their insurance plans.
Changes to the bill may also make it more difficult to pass the Senate. “It will be harder for the Senate to get 51 Republicans,” Republican Senator Roy Blunt of Missouri, a former House majority leader and longtime whip, said Wednesday.
The White House, which has been involved in discussions about the changes, is still eager to resurrect the healthcare bill.
“We’re not going to overpromise anything; when the votes are there, the speaker will bring it to the floor, but no sooner than that," White House Chief of Staff Reince Priebus told reporters late Tuesday. He said he didn’t know if that might be this week or next.
Repeal of the Affordable Care Act was a major Trump campaign promise and a longtime goal of House Republicans.
"We probably had about half of the members of the Freedom Caucus in the first go-around," White House legislative affair director Marc Short told reporters Tuesday. "With this amendment, I’d like to think we have greater than 80 percent—we are very confident in that."
Short said he still believes they could get the healthcare bill passed before the GOP tax bill is introduced in the next four to six weeks.
Much of the renewed optimism stems from new support within the House Freedom Caucus, a group of about three dozen staunch conservatives. Opposition from many inside that group, who wanted a more robust repeal measure, along with skepticism from many Republican moderates, was pivotal to Ryan’s decision last month to abruptly scrap a vote on the bill for lack of votes.
On Tuesday, members of the Freedom Caucus who previously didn’t support the bill, including Representative Dave Brat of Virginia, and DesJarlais, said they now support the measure.
The amendment would allow insurers to charge higher premiums to people with pre-existing conditions in states that get a waiver. To obtain the waiver, states would have to provide sick people priced out of commercial insurance access to a so-called high-risk pool run by the federal government, or establish their own, and satisfy other conditions.
Even Mo Brooks of Alabama, a conservative who opposed the previous version, said he’s considering the amendment. "I believe there will be some movement," he said. "I don’t know how much."
Dent, however, said the bill doesn’t provide a "soft enough" landing for states that expanded Medicaid, and still doesn’t provide sufficient support to help low- and middle-income people, in his view.
Pressure from the White House, combined with fresh support from conservatives, could put intense pressure on moderates to vote for the bill. But those moderates in swing districts, unlike the members of the Freedom Caucus, could end up losing their seats if the repeal bill continues to remain unpopular. "I will vote my conscience," said Representative Leonard Lance of New Jersey, who said he also remains opposed.
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