Conservatives in the House and Senate may have come out swinging against the House GOP’s plan to replace Obamacare, but the skeptical lawmakers have stressed that on the future of Obamacare, they’re willing to negotiate.
So far, conservatives seem to have found a willing negotiating partner in President Donald Trump, though the president and his administration have endorsed the House Republican leadership’s Obamacare replacement bill.
But the House’s most powerful Republican, Speaker Paul Ryan, and his deputies appear less willing to play ball with the lower chamber’s right flank.
Soon after two House committees on Monday evening released the text of the highly anticipated health care plan, the American Health Care Act, Trump and top administration officials began courting support from conservative lawmakers and outside groups.
Their target: the members of the roughly 40-member House Freedom Caucus and conservative organizations such as The Heritage Foundation and Americans for Prosperity.
The charm offensive has been ongoing and swift.
Vice President Mike Pence met Tuesday with House Republicans, including members of the conservative Freedom Caucus, to discuss the legislation.
Then, Wednesday afternoon, Trump summoned leaders of key conservative groups who strongly oppose the bill—The Heritage Foundation, its sister organization Heritage Action for America, Club for Growth, FreedomWorks, Americans for Prosperity, and Tea Party Patriots—to talk about the Obamacare replacement plan.
And in a further attempt to gin up support for the proposal, Trump invited skeptical Freedom Caucus members to a night of bowling at the White House next week.
The efforts are part of the White House’s full-court press to get legislation that both repeals and replaces Obamacare, at least in large part, across the finish line.
And the Freedom Caucus is the key faction for the White House to sway.
The lawmakers oppose the timeline for phasing out Obamacare’s expanded eligibility for Medicaid, which the leadership proposal rolls back in 2020, and also creation of advanceable, refundable tax credits based on age to help Americans buy health insurance.
“The first thing Republicans are bringing forward is a piece of legislation that we’re going to put on a Republican president’s desk that says repeal [Obamacare], but keeps Medicaid expansion and actually expands it, that keeps some of the tax increases,” Rep. Jim Jordan, R-Ohio, told reporters Tuesday at a press conference.
“That is not what we promised the American people we were going to do,” the former Freedom Caucus chairman said.
Instead, Jordan, along with Sens. Rand Paul, R-Ky., and Mike Lee, R-Utah, and other conservative lawmakers have stressed that the vehicle for Obamacare’s repeal already exists: the 2015 bill to dismantle the health care law’s key provisions that passed both chambers of Congress but was vetoed by President Barack Obama.
Though conservatives ideally would like to see GOP leaders bring up the 2015 bill once again—Jordan and Paul actually introduced that same legislation this week in their respective chambers—they’re not opposed to negotiating.
“This is the beginning of the negotiation,” Paul said at the press conference Tuesday. “The House Freedom Caucus’ power and the power of several conservatives in the Senate is to withhold our support and to make it better. If they have 218 votes, we won’t get any change.”
In the House, the Obamacare replacement plan needs 218 votes, a majority, to pass. So Ryan can’t afford to lose more than 19 votes.
Conservatives already have attempted to use the legislative process to tweak the bill’s phaseout of the Medicaid expansion.
Rep. Joe Barton, R-Texas, a Freedom Caucus member, and Rep. Marsha Blackburn, R-Tenn., introduced amendments in the House Energy and Commerce Committee to freeze new enrollment in Medicaid expansion at the enhanced federal matching rate—95 percent for 2017, with a decrease to 90 percent for 2020 and beyond—at the end of this year.
The current plan phases out the Medicaid expansion in 2020. Until then, states would still be able to enroll residents with a federal matching rate of 90 percent.
Beginning in 2020, new Medicaid enrollees would receive the traditional federal matching rate, an average of 57 percent.
Rep. Morgan Griffith, R-Va., also a Freedom Caucus member, introduced an amendment instituting a work requirement for childless adults who are on Medicaid.
Both amendments received the support of the 170-member Republican Study Committee, a group of lawmakers who tend not to be as conservative as those in the small Freedom Caucus.
But Barton withdrew his amendment from the Energy and Commerce Committee on Thursday, after the panel held a 27-hour markup of the Obamacare replacement plan.
So far, it’s not only conservatives who are willing to negotiate. Leaders of conservative groups who met Wednesday with Trump said he, too, seems willing to play ball.