Recent talks among Republicans have given some members hope they are moving closer to their goal of repealing and replacing the 2010 health care law, but the reality is they are still well short of shoring up support as they head home for a two-week recess.
Several House Republicans on Tuesday believed a deal was so close that they could extend the current legislative week to vote on the bill. (The House is scheduled to adjourn for the recess Thursday afternoon).
By Wednesday, though, members had all but closed the door on the idea of delaying the recess, with House Majority Whip Steve Scalise calling a vote this week “very unlikely” and House Freedom Caucus Chairman Mark Meadows saying that would be a “Herculean task.”
While Meadows and other negotiators remain open to discussions and hope a deal can be struck, the latest proposal to allow states to seek a waiver against complying with certain insurance regulations seems to have lost steam.
More “yes” votes are lost than gained by adding that provision, House Chief Deputy Whip Patrick McHenry told reporters Wednesday.
“It’s a bridge too far for our members,” McHenry said of the proposal that he believes would undo parts of the 2010 health care law that many Republicans believe are important protections for ensuring sick individuals have affordable access to health care.
Moderate members echoed that sentiment, but Meadows said the waiver is the only way to deal with issues with insurance regulations that has the ability to unite the GOP.
“A full repeal of Obamacare may be a bridge too far [for a lot of the conference]; anything less than that is not a bridge too far,” Meadows said.
But McHenry argued that many of those regulations guarantee people don't suffer discrimination because of pre-existing conditions.
“It goes counter to the president’s campaign promises, counter to the campaign promises of nearly 200 members of the House,” he said. “This is not a moderate problem, it’s a math problem. And when you have a diverse group of members unwilling to touch an area of law, it’s not an ideological issue, it’s a practical issue of the impact it has on people or people’s personal experiences.”
Energy and Commerce Chairman Greg Walden said House Republicans agreed in the formation of their “A Better Way” blueprint “that we would not go backwards on the issue of pre-existing condition protections, lifetime caps, 26 years old, those basic things that we frankly all think are pretty good.” Walden did not close the door on the waiver proposal, but said there are many unanswered questions about it.
McHenry said the intent of the proposal may not be to get rid of guarantees to cover pre-existing conditions but that many members see that as the effect. “It is either a misunderstanding of the offering or an offering that simply cannot pass,” he said.
Meadows said conservatives have no intention of voting for a bill that doesn’t offer protections for pre-existing conditions and that some of the Freedom Caucus members have authored an amendment that would strengthen the bill’s high-risk pool provision that is designed to ensure coverage for people with preexisting conditions.
New York Rep. Tom Reed, a member of the moderate GOP Tuesday Group and co-chair of the bipartisan Problem Solvers Caucus, said he has “grave” concerns about allowing states to opt out of so-called community ratings regulations, which require insurance companies to offer the same prices to everyone, regardless of their health status.
“To me that was moving the ball way too far,” he said. “I was a ‘yes’ on the last negotiations because I wanted to be part of the effort to move it forward. But that to me is another example of maybe going too far, too quick.”
Not only was it too far for many members, but it was a surprise that it was even on the table. Rep. Chris Collins, also a Tuesday Group member, said during a meeting at the White House Monday, that administration officials did not mention community ratings as part of any calculus.
“The thing that was front and center was EHB’s,” Collins said referring to a proposal to allow Health and Human Services Secretary Tom Price to review states’ proposals for which essential health benefits the states wanted to keep as requirements.
The New York Republican said officials agreed to not change pre-existing conditions, allowing children to stay on their parents plan until they turn 26 years old or lifetime limits.
“To the best of my recollection in that meeting, the community ratings was not even a topic of conversation,” Collins said.
Collins, a member of the Energy and Commerce Committee Health Subcommittee, said he does not support the community ratings provision because it could increase premiums for sick people. Still, if such a proposal made into the health care bill, Collins said he would still vote in favor of the measure.
Meadows said the Freedom Caucus was told Monday that community ratings would be part of a proposed waiver, but he declined to assign any ill intentions from anyone involved in talks.
“Sometimes we hear what we want to hear on both sides,” he said. “And so perhaps it was a difference of interpretation.”
Rema Rahman and Erin Mershon contributed to this report.