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Trump White House Pushes New Health Plan as GOP Seeks Details

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(Bloomberg) — House lawmakers hope Tuesday to release a new Trump administration-backed version of the American Health Care Act bill they had to abandon last month in an embarrassing setback to their pledge to repeal Obamacare.

“We’re at that conceptual stage right now,” House Speaker Paul Ryan told reporters Tuesday morning. “We don’t have bill text or an agreement yet.” GOP leaders barely mentioned health care in the private conference meeting Tuesday morning and offered few details.

Rep. Mark Walker, chairman of the conservative Republican Study Committee, said Tuesday that the Energy and Commerce Committee is “putting it together and language should be ready this evening.”

(Related on ThinkAdvisor: 4 ACA change paths that just got more popular)

Late Monday, Vice President Mike Pence and White House chief of staff Reince Priebus met with House conservatives to lay out the details of the plan. One lawmaker said it could allow states to charge higher rates to sick people. President Donald Trump’s budget director, Mick Mulvaney, was also in the meeting.

House GOP leaders said earlier that no health care vote is planned, but several lawmakers, including a close ally of Trump’s, said they think a vote could still occur this week.

“The administration is saying it would like it this week,” Republican Rep. Chris Collins of New York said Tuesday morning. Collins and several Republican moderates went to the White House Monday to discuss the plan.

Republicans have little space on the calendar to hold a new vote this month. They are scheduled to begin a two-week recess on Friday, and when they return they will have five days to pass a spending measure to keep the government funded after April 28.

Freedom Caucus

Mark Meadows, chairman of the House Freedom Caucus, which helped block the last health care bill, said Monday that he hadn’t seen the administration’s new proposal in writing.

“We’re hopeful that we’ll get the legislative text within the next 24 hours,” said North Carolina’s Meadows, who added that the new talk of a deal is being driven by the White House. “There’s no deal in principle.”

The details are still emerging, but the White House and Republicans are discussing a plan that would allow states to apply for waivers on some Affordable Care Act requirements, while still preserving its ban on excluding coverage of those with pre-existing conditions. States would have to show that their waiver “would improve coverage and reduce costs,” Collins said.

Democratic National Committee Chairman Tom Perez on Tuesday called the Republican leadership “heartless” in how they are dealing with a law that extended health care to 24 million people.

“I believe anyone who wants to vote to repeal the Affordable Care Act should be required to spend five hours in an emergency room watching what the Affordable Care Act has done in their community and the country,” Perez said on MSNBC.

Varying Premiums

Meadows said that a proposal to change the ACA community rating system, which prevents insurers from varying premiums within a geographic area based on age, gender, health status or other factors, would be eligible for the waivers. Such a change would allow insurers to charge sick people more for coverage.

The plan would rely on risk-sharing pools to be the “backstop” for people with pre-existing conditions who could be subject to higher premiums if the requirement on community rating were to be removed, Meadows said. “Marginally sick people” would pay the “risk cost associated with their coverage.”

“Those that have premiums that would be driven up because of catastrophic illness or long-term illnesses, we’ve been dealing with that for a long time with high-risk pools, so we believe in doing that is a way to keep premiums down for everybody to ensure everybody’s covered and ultimately where you don’t get priced out of the market,” he added.

Meadows said lifetime and annual caps weren’t discussed explicitly, because they aren’t the main drivers of insurance premium costs.

‘Hope’ for a Vote

When asked if the changes Pence offered would lose moderate votes, Meadows said it was his understanding that the administration had met with moderate members and were working to shore up support in the center.

Meadows said the “hope” is that a vote could occur before the recess, but they’re not setting any artificial deadlines. He said he instructed his members to be at the ready with their relevant policy people to examine the legislative text as soon as it’s available.

But he also said he didn’t necessarily expect that new estimates on the plan’s cost or coverage projections would be available from the Congressional Budget Office before a vote.

“No one made any definitive changes,” to how they would vote, but “all the noes expressed a willingness to look at this,” Meadows said, speaking of the Freedom Caucus.

Meadows said he doesn’t expect the Freedom Caucus to take an official position supporting or opposing the revised bill, but he would offer a detailed vote count of its members after the text is made available.

— Read Trump Tees Off With Rand Paul to Show GOP ‘Love’ on Health Care on ThinkAdvisor.


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