2017-04-26 15:54:03
Hard-Line Republican Caucus Backs Revised Bill to Repeal Obamacare

WASHINGTON — The House Freedom Caucus, a group of hard-liners who were instrumental in blocking President Trump’s plan to repeal the health care law, gave its approval to a new, far more conservative bill than the one that failed in the House last month.

That backing breathed new life into Republican efforts to replace the Affordable Care Act, but it was not clear that the revised legislation — which the Trump administration still hopes to see on the House floor this week — could garner the Republican votes needed to pass and move on to the Senate, where its fate is grim.

The latest proposal, drafted by Representative Tom MacArthur, a moderate Republican of New Jersey, would allow states to obtain waivers from the federal government exempting insurers from some of the more important requirements of the Affordable Care Act, which many Republicans argue have driven up premiums.

It also would permit states to define the benefits that must be provided by insurers; the current law requires benefits in 10 broad categories, including maternity care, mental health services and treatment for drug addiction, which are popular in many Republican districts.

The House Freedom Caucus members, acutely aware that the White House and Republican colleagues blamed them for the failure of an earlier bill to get off the ground in the House, are eager to shift the blame to more moderate members who may now reject the measure.

“Over the past couple of months, House conservatives have worked tirelessly to improve the American Health Care Act to make it better for the American people,” Alyssa Farah, a spokeswoman for the House Freedom Caucus, said in a prepared statement. Because of those changes, she added, “the House Freedom Caucus has taken an official position in support of the current proposal.”

The group agrees to take an official position when 80 percent of their roughly three dozen members agree.

But what is good for the most conservative corners of the House is not necessarily going to please their colleagues, including the dozens who had already rejected a less-conservative version of the bill. Republican senators had been equally wary. “I think a better approach is to stabilize the insurance pool,” said Senator Bill Cassidy, Republican of Louisiana.

But Mr. Trump, seeking a major legislative victory in the first 100 days of his presidency, has been pressing hard to get a floor vote on a measure to repeal President Barack Obama’s signature health care law and to fulfill a campaign promise of most Republicans for the better part of a decade.

Vice President Mike Pence and other White House staff have been feverishly trying to get the most conservative members to support a bill, even one that is not viable in the Senate, and without the input of many moderate members.

Speaker Paul D. Ryan said Wednesday that a new bill could come to the floor at some point if sufficient support surfaced. “We’ll vote on it when we get the votes,” he said.

There is also a provision in Mr. MacArthur’s effort that the amendment does not apply to members of Congress and their staff. This is intended to help it get past complex rules in the Senate, but has already become fodder of Democrats attacks.

Under another waiver included in the new measure, insurers could charge higher premiums to sick people who want to buy insurance after experiencing a gap in coverage of 63 days or more. This would undo a core provision of the existing law, which generally prohibits insurers from considering a person’s health status or medical history in setting premiums.

To qualify for this type of waiver, a state would have to operate some kind of program to help “high-risk individuals” obtain coverage, or a program to help stabilize premiums or to help pay high-cost claims.

“The key is, all of us recognize we and the president made campaign promises to repeal and replace Obamacare,” Representative Chris Collins, Republican of New York and a top Trump ally. “We, as a team, all recognize we need to get to yes.” He added: “I am guardedly optimistic. We’ve got a bridge to yes.”