Policy

Pence Pitches Ideas to Build Support for Health Care Bill

Vice president met with House Freedom Caucus members

Vice President Mike Pence makes his way to the Republican Senate Policy luncheons in the Capitol, March 14, 2017. (Tom Williams/CQ Roll Call)

Vice President Mike Pence pitched moderate House Republicans on a change in Republicans’ stalled health care legislation in a Monday afternoon meeting at the White House, the first in a series of planned meetings this week that are aimed at reviving the chamber’s efforts to pass legislation replacing the 2010 health care law.

Later Monday, Pence met with House Freedom Caucus members on the same proposal, an effort that attendees said was aimed at setting up a vote on the legislation as early as this week.

Pence, along with Office of Management and Budget Director Mick Mulvaney, Chief of Staff Reince Priebus, and Domestic Policy Council Director Andrew Bremberg, unveiled a series of tweaks to the earlier Republican plan aimed at generating more support for the package. Rep. Chris Collins, R-N.Y., said the pitch dropped a controversial last-minute amendment proposed in March that was intended to win over House conservatives. It would have ended the health care law’s requirement that every insurance plan in the marketplaces cover 10 categories of health care benefits.

Instead, the White House proposal offered to let Health and Human Services Secretary Tom Price work with states who want to waive the requirements, if they have a plan in place to ensure costs drop and access remains the same or improves. The change resembles a provision in current law known as a 1332 waiver. The White House also presented to moderates changes that would more specifically target a $115 billion fund in the package aimed at stabilizing state marketplaces.

“The folks that were there today were all yeses, to make sure that we were still yeses,” Collins said. “Since we are yeses, and problem solvers, [the administration wanted] to get our opinion on some folks, whether we thought this could be helpful or not, and we thought it could be.”

Other attendees in the meeting included Reps. Tom MacArthur, R-N.J.; Bruce Poliquin, R-Maine; Martha McSally, R-Ariz.; Pat Tiberi, R-Ohio; Adam Kinzinger, R-Ill.; and Rodney Davis, R-Ill.; and Energy and Commerce Chairman Greg Walden, R-Ore.

Congressional Republicans hope to reinvigorate efforts to replace the 2010 health care law. Trump gave the party a dramatic ultimatum last month, vowing that if they couldn’t find a compromise on the health care bill, he would move on to other parts of his agenda. A long list of moderate and conservative lawmakers publicly opposed the replacement legislation, and House Speaker Paul D. Ryan of Wisconsin ultimately canceled an anticipated floor vote.

Talks with both moderates and conservatives quietly continued in the 10 days after that defeat, especially among members who had signaled they would vote “no.“ 

Building a consensus remains an immense task. Though Collins said he and his fellow attendees said the change could win over some wary moderates, it is unclear what impact it would have on access to health care. Many moderates balked at an early analysis that showed the Republican proposal would leave more than 24 million more people without insurance coverage in 2026, compared to expected insurance rates under the 2010 law.

Rep. Charlie Dent, R-Pa., previously an opponent of the bill, said Monday he hadn’t heard anything about a new plan — and did not yet have any meetings with Pence on his calendar.

Courting the Freedom Caucus

The new package would also have to win over the conservative Freedom Caucus, who had suggested that leaving changes to the agencies would not win their votes.

Before his own meeting late Monday with Pence, Meadows said he was relatively optimistic but that “no deal” had been reached. 

“It’s too early to tell without looking at the legislative text, but certainly having these kind of discussions are good,” he said.

He declined to comment on plans for a vote on Friday. “I’ve learned that is a recipe for disaster,” he said.

After the meeting, Meadows said he and several other Freedom Caucus members said they would reserve their judgment until they saw the legislative text, which they expected within 24 hours.

“No one made any definitive changes in terms of moving from ‘no’ to ‘yes,’ primarily because there’s not enough detail to do that, but I can tell you that all the members, every one of the ‘no’s,’ expressed a willingness to look at this in a detailed manner,” Meadows said.

He suggested the new amendment on waivers would be targeted at essential benefits and a health care law provision that prevents insurers from raising prices for people with pre-existing conditions. Those are the two main requests for the conservatives. Meadows said the group was interested in making sure the waiver process would be an easy one.

Meadows added that the administration was interested in a vote as soon as possible, possibly this week.

The Freedom Caucus previously outlined several much more expansive priorities in a Friday meeting with the Washington Examiner, a wish list that includes ending the health care law’s so-called essential health benefit requirements, which ensures that insurance companies cover 10 specific categories of medical care. They also want to end so-called “community ratings,” a policy that ensures sicker patients can’t be charged more for their health insurance.

Timing of debate

Repubilcans were divided Monday on whether the House would attempt to vote this week. Ways and Means Committee Chairman Kevin Brady, R-Texas, suggested Monday afternoon he didn’t expect a vote on any new health care plan before the April recess.

“One of the lessons, I think, from the health care discussion was to not rush things,” Brady said. “I think that should continue on that sort of organic timetable, instead of pushing a date that this needs to be done.”

Attendees at the White House meeting were more optimistic.

MacArthur, who backed the previous bill, said he was encouraged that the new effort was driven by the administration, rather than any Republican faction.

“It’s possible that people will be able to move,” MacArthur said. He added that GOP groups undertaking such sensitive negotiations by themselves “sort of takes everything away from the authorizing committees that are responsible for it.”

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