Obamacare repeal gains new momentum

UPDATE: House Majority Leader Kevin McCarthy of California told reporters Wednesday night that Republicans now have enough yes votes to hold a vote Thursday to repeal and replace Obamacare.

OUR EARLIER REPORT (4:43 p.m.): WASHINGTON—GOP leaders flipped a few more holdouts into the yes column today, but Republicans still don’t have enough guaranteed support to hold a vote on their Obamacare repeal-and-replace legislation.

Late Tuesday evening, Reps. Fred Upton, R-Mich., and Billy Long, R-Mo., drafted a new amendment to the American Health Care Act (AHCA) to help appease concerns with the bill’s treatment of patients with pre-existing medical conditions. This morning, Upton, Long, and a few other House Republicans discussed the new amendment with President Donald Trump in the Oval Office.

Upton and Long now say GOP leaders can count on their vote for the AHCA as long as it contains the new amendment, which adds an additional $8 billion over five years to help some people with pre-existing conditions pay costly insurance premiums.

House Speaker Paul Ryan, R-Wis., said today the GOP is “extremely close” to whipping enough Republican votes to pass the healthcare bill. Republicans can lose no more than 22 votes from their conference with zero support from Democrats. Around 18 Republicans publically oppose the bill in its current form, and more than a dozen are still undecided, leaving a vote on an Obamacare fix this week still in question.

The AHCA received a boost last week when it got the endorsement of the House Freedom Caucus. In March, Trump called out Freedom Caucus members individually for tanking the first GOP effort to gut Obamacare. But caucus chairman Rep. Mark Meadows, R-N.C., negotiated with moderate Rep. Tom MacArthur, R-N.J., to include a revision to the bill to make it more palatable for the conservative group.

Meadows released a statement saying the approximately 35-member group officially supported the bill, which meant at least 80 percent of members were in favor. Conservatives said even with the MacArthur amendment, the AHCA is not the full Obamacare repeal they promised constituents, but it will have to be good enough for now.

The Meadows and MacArthur compromise would allow states to waive certain regulations that exist under Obamacare, including the community rating requirements that bar insurers from setting premium prices based on patient health status.

Rep. Dave Brat, R-Va., a Freedom Caucus member, said this was not the bill he wanted but allowing states to opt out of those regulations would help drive costs down and was the best piece of legislation that has a chance of passing.

“Taking into consideration the political dynamics of a diverse Republican conference, I firmly believe this bill is the best path forward for conservatives to get any real and beneficial healthcare reform passed,” Brat said.

But more moderate Republicans said the MacArthur amendment would leave elderly patients and those with pre-existing conditions unprotected with skyrocketing out-of-pocket costs.

For that reason, Upton and Long abandoned the bill but came back after the additional $8 billion safety net was added. Many moderate Republicans still remain wary.

Democrats and most healthcare experts claim the $8 billion will do little to help the millions of Americans with pre-existing conditions.

The Center for American Progress estimated the AHCA would cause a $200 billion shortfall over the next 10 years for those with pre-existing conditions.

After Upton and Long returned from the White House, Senate Minority Leader Chuck Schumer, D-N.Y., scoffed at the $8 billion deal: “The proposed Upton amendment is like administering cough medicine to someone with stage 4 cancer.”

Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation, wrote on Twitter 27 percent of healthcare enrollees have pre-existing conditions and $8 billion won’t do much to subsidize them.

The House leaves town for 11 days after Thursday, and GOP leaders are hard at work drumming up support to vote as soon as possible.

But even for Republicans leaning toward yes, the pre-existing conditions problem weighs heavily on their minds.

“You know, the most sincere anger I’ve noticed comes from people that are sincerely scared, people that may have a pre-existing condition that feel like they’re about to lose it and they’re going to die, and they’re going to die because of a vote that we might be taking,” Rep. Tom Rooney, R-Fla., told reporters Tuesday. “And if we cannot explain to people that that is not going to happen, then it is going to be very difficult to ever bring a bill to the floor.”

Despite the new momentum and negotiations between congressional leaders and the White House, Republicans may never be in 100 percent agreement on healthcare.

Rep. Ileana Ros-Lehtinen, R-Fla., told me it doesn’t matter what changes GOP leaders make to the bill, it won’t be enough for her. When I asked why she said it throws too many people out of insurance coverage and it discriminates against older and less healthy Americans: “So many reasons.”