GOP chiefs announced a modest amendment to curb premium increases, but internal divisions still blocked their promised repeal of former President Barack Obama’s law.
“This brings us closer to the final agreement that we all want to achieve,” House Speaker Paul Ryan, R-Wis., said of the new amendment, flanked by about two dozen GOP lawmakers at a news briefing meant to project unity.
But in a sentiment echoed by other leaders, Ryan conceded “we have more work to do” over the “days and weeks ahead.” That underscored the longer timeline Republican leaders acknowledge they’ll need to resolve disputes between conservatives and moderates that blew up their legislation last month, dishing a mortifying defeat to Ryan and President Donald Trump.
Ominously, lawmakers from both ends of the party who’ve opposed the GOP legislation said Thursday’s revision wasn’t enough to turn them around. They included Rep. Mark Meadows, R-N.C., who leads the conservative House Freedom Caucus, a hotbed of opposition, and moderate GOP Rep. Leonard Lance of New Jersey.
“I favor making sure no one is denied coverage due to a pre-existing condition. So I doubt this would be enough,” said Lance.
Frustration over the bill’s dismal performance in Congress spilled out during a meeting Ryan and other House leaders attended late Wednesday at the White House, according to several Republicans who’d been told about the session.
White House chief of staff Reince Priebus and others expressed unhappiness that the legislation remained unfinished, and the fanfare accompanying the amendment introduced Thursday was a direct result of that meeting, the Republicans said.
“The president and the speaker had a very good, long conversation last night and they remain fully on the same page on the path ahead,” Ryan spokeswoman AshLee Strong said. Trump and Ryan spoke after the White House meeting.
The new language was aimed at containing premiums by providing an additional $15 billion over a decade to help insurers cover the costs of seriously ill people, said Rep. David Schweikert, R-Ariz., a sponsor of the amendment. Such customers’ expensive care can drive up premiums for all consumers.
The money would be on top of a $100 billion fund already in the GOP bill that states could use for various purposes, including high-risk insurance pools where people with medical problems can get coverage.
House Majority Leader Kevin McCarthy, R-Calif., emailed GOP lawmakers that if a breakthrough on the bill occurred during the recess, “We will advise members immediately and give you sufficient time to return to Washington.” The prospects for that seemed remote, at best.
Two weeks ago, Ryan called off a House vote on the measure repealing much of the 2010 health care overhaul. The GOP legislation replacing it would scale back the federal role in health care, covering 24 million fewer people over time while cutting taxes for upper-income earners.
Deep differences among hardliners and moderates have impeded the Republican march. Each side blames the other, and the recess could drain more momentum from the repeal drive.
A proposal discussed between the White House and leaders of the Freedom Caucus would let states seek federal waivers of two insurance requirements the law established.
One forbids insurers from charging higher premiums on account of people’s medical problems or pre-existing conditions. The other spells out categories of benefits, like hospitalization and substance abuse treatment, that all insurance plans must cover.
Conservatives who want the federal government out of health care argue that those provisions have driven up premiums and decreased choice.
Critics say eliminating those insurance requirements would raise premiums for people with serious medical problems and threaten to leave many people without coverage they need.