Policy

Conservatives Begin to Accept Health Care Bill, Moderate Votes Unclear

‘Whether it’s this vehicle or another vehicle, it will be addressed.’

Rep. Mark Meadows, R-N.C., arrives for a hastily called House Republican caucus meeting after Speaker Ryan canceled the vote on the American Health Care Act of 2017 on Friday, March 24, 2017. (Bill Clark/CQ Roll Call)

By LINDSEY McPHERSON and ERIN MERSHON

UPDATED 1:50 p.m. 04/26/17

Several conservative Republicans said they are ready to support the GOP health care bill after a new proposal that would allow states to opt out of certain insurance regulations, but moderates who had opposed the bill have not yet indicated they will budge.

Both extremes of the House Republican conference will need to put up some new “yes” votes on the measure to ensure its passage. The moderate Tuesday Group and the conservative House Freedom Caucus, the caucuses where much of the opposition had been concentrated and whose chairs proposed the latest amendment, were scheduled to meet separately Wednesday to discuss the matter.

The Freedom Caucus took an official position in support of the bill given the most recent changes.

Caucus member Joe Barton confirmed that more than 80 percent of the group, the threshold needed to take an official position, voted to support the latest changes. The Freedom Caucus does not reveal a formal roster but membership is estimated somewhere around three dozen. That suggests that at least 25 conservatives and likely are planning to support the measure, nearly a third of whom were already planning to vote “yes.”

“I think ultimately we will repeal and replace Obamacare,” House Freedom Caucus Chairman Mark Meadows said when asked if there’s a risk Republicans will conclude this month and the next without any substantial legislation being signed into law. “Whether it’s this vehicle or another vehicle, it will be addressed.”

Rep. Tom MacArthur, the Tuesday Group co-chair who worked with Meadows on the amendment, has not publicly expressed a position. When media approached MacArthur after a Wednesday GOP conference meeting, an aide interrupted to say they were not commenting at this time but would later.

House Majority Leader Kevin McCarthy said leaving the conference meeting that there was “great movement” toward agreement on the health care bill. Other proponents of the bill echoed that sentiment.

FreedomWorks and the Club for Growth, outside conservative political groups, announced support for the amendment Wednesday, a sign of likely significant backing among congressional conservatives.

But moderates who had been opposed to the measure have yet to indicate any movement in their positions. Several said they still need to review the amendment, which was leaked in the press Tuesday evening.

“My own sense is that many of our members who were opposed to the bill are probably still opposed,” Tuesday Group co-chairman Charlie Dent

Members of the centrist caucus made clear to Dent and the other two Tuesday Group co-chairs that they did not want them to negotiate on behalf of the group, he said. 

Dent himself remains unswayed.

He confirmed MacArthur spearheading an amendment that moved the bill further to the right surprised him, and said he feels the latest proposal “is simply a matter of blame shifting and face saving.”

Tuesday Group member Barbara Comstock, who had previously expressed opposition to the health care bill, told reporters she’s not ready to take a position on the amendment. “I want to look at the facts and look at the language,” the Virginia Republican said.

Pennsylvania Rep. Ryan Costello, a Tuesday Group member who had previously indicated concerns about the bill, said he would have to think “long and hard” about the new amendment and the change to let states get a waiver from some of the health care law’s most onerous requirements. He said he’s not yet a “yes” or a “no.” 

House Republican Whip Steve Scalise told members during the conference meeting that he was counting on anyone who voted “yes” to hold that position, but said anyone whose views have changed should meet with him, New York Rep. Chris Collins said.

Collins, a Tuesday Group member who has been supportive of the bill and remains so, said “this puts pressure on every member who’s a ‘no.’” He said he is “guardedly optimistic” about a vote on this measure as soon as next week.

Ways and Means Health Subcommittee Chairman Patrick Tiberi said during an event hosted by Baker Hostetler that the House could vote on the health care bill next week “if we have the votes.”

Speaker Paul D. Ryan, also speaking at the Baker Hostetler event, reiterated that the House will vote on the health care bill when they have the votes to pass it, but suggested a sense of urgency.

“We’re very aggressive on our time table,” he said. “We really believe this law is collapsing.”

The reconciliation measure for repeal and replace still remains one piece of a “a multifaceted process,” Tiberi said. “It won’t be just one and done,” he said, suggesting Medicaid is an area that may need to be refined in future legislation.

While gains from moderates remain key to passage, the beginning signs of conservative opponents moving toward “yes” provided members some hope that a deal is possible.

Freedom Caucus members Dave Brat of Virginia, Scott DesJarlais of Tennessee and Warren Davidson of Ohio, all previously declared opponents of the health care bill, said Wednesday they were now inclined to vote “yes” thanks the to the amendment.

Desjarlais said he thought the path to 217 (the number of Republicans needed to pass the bill given Democrats’ expected unanimous opposition) was now dependent on the centrist Tuesday Group. 

Maryland Rep. Andy Harris, another Freedom Caucus member who has been a “no” vote, said the amendment was very promising, but that he has not completely made up his mind. Freedom Caucus member Trent Franks of Arizona also would not confirm whether he would support the package, but said, “I think we’re going in the right direction.“ 

The conservative Republican Study Committee will discuss the new amendment but is unlikely to take a formal position, RSC Chairman Mark Walker said. The committee’s board previously endorsed the health care bill. 

“Our position hasn’t changed,” the North Carolina Republican said, noting he personally favors the amendment. “I don’t see where it does any damage to the original content. I believe that any time you’re giving states more options, I believe that’s a good thing.”

Several members of the Tuesday Group spoke in favor of the amendment during the conference meeting, Walker said. But he could not say if those members had previously supported or opposed the bill.

Rema Rahman and Stephanie Akin contributed to this report.

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