House Republicans passed a revised version of the American Health Care Act (AHCA) on Thursday.
The bill passed after moderate Republicans fretted this week about how well the bill will protect patients with pre-existing conditions. Many, including former Energy and Commerce Committee chairman Fred Upton (R-MI), previously came out against the bill, but now support it after GOP leaders agreed to add an amendment adding $8 billion to help cover people with pre-existing conditions.
The vote comes after a tumultuous process for the bill, which has seen previously scheduled votes pulled after Speaker Paul Ryan failed to accumulate enough Republican support. Speaker Ryan received widespread criticism after drafting the bill in secret and retaining many parts of Obamacare. Pundits dubbed the original bill, “Ryancare.”
House Freedom Caucus chairman Rep. Mark Meadows (R-NC) stepped up and brokered a revised version of the bill, known as the MacArthur amendment, along with Tuesday Group co-chairman Rep. Tom MacArthur (R-NJ). The addition of the amendment collected enough Republican votes to pass the bill.
Meadows’ efforts in no small part seem to have succeeded where Ryan failed, rallying his House Republican colleagues behind a years-long campaign promise to repeal and replace Obamacare–despite the fact that this bill does not constitute a full repeal of the previous president’s signature law.
Vice President Mike Pence, White House Chief of Staff Reince Priebus, and others have worked alongside congressional Republicans, especially Meadows–who has emerged as a force in the negotiating process so strong that some have begun calling him the acting speaker of the House in the wake of Ryan’s failures–to bring the new bill to the brink of passage.
Meadows, in an exclusive interview with Breitbart News earlier this week, commended the actions of President Donald Trump, Vice President Mike Pence, and Congressman Tom MacArthur. He said:
Not only have we made good progress, we have to get give a good shout out to Tom MacArthur and the President and the Vice President for their efforts in the last couple of weeks. It would be a mistake to suggest that had Tom MacArthur, the President, and the Vice President have not gotten involved in this process, then we would not have the options now for everyone to consider. Tom has worked closely hard with Energy and Commerce Chairman Greg Walden and the committee to make sure that what we do is keeping in line with repealing and replacing Obamacare and drives down premiums and keeps pre-existing conditions.
The agreement, brokered by the House Freedom Caucus chairman and Tuesday Group co-chairman Tom MacArthur (R-NJ), would allow states to eliminate Obamacare’s community rating system — a rule that prohibits health insurers from pricing health care plans based on age, gender, or health status. States that repeal Obamacare’s community rating rules would have to join a high-risk pool to obtain the waiver.
The deal, known as the MacArthur amendment, would also reinstate Obamacare’s Essential Health Benefits, although states could waive these if they were to prove that eliminating those regulations would lower premiums, increase the number of people insured, or “advance another benefit to the public interest in the state.”
Essential Health Benefits require that health insurance plans must cover certain services such as doctors’ services, inpatient or outpatient hospital care, prescription drugs, pregnancy, childbirth, and mental health.
The American Health Care Act replaces a number of Obamacare’s taxes and subsidies with age-based tax credits to help people buy health insurance on the individual market. Freedom Caucus members, including Congressman Jim Jordan, previously said that the tax credits would create a new entitlement program. The AHCA repeals Obamacare’s employer mandate, while it replaces the individual mandate with a 30 percent insurance premium surcharge for those who forgo health insurance. The bill will also cap Medicaid per capita starting in 2020.
If the bill passes the House, it will most likely see changes in the Senate. Sens. Bob Portman (R-OH) and Shelley Moore Capito (R-WV) remain concerned about a provision in the American Health Care Act that freezes Medicaid expansion. Senator John Thune (R-SD), the third highest-ranking Republican in the Senate, has crafted a measure to better compensate older Americans for the high cost of health insurance.
Congressman Mark Meadows (R-NC) told Breitbart News that he will work with Senate colleagues to push for a more conservative version. “I am having conversations with my colleagues in the Senate,” he explained, “where we can push for even more conservative solutions, because it was more difficult to push amendments procedurally in the House.”
Senators Rand Paul (R-KY), Mike Lee (R-UT), and Ted Cruz (R-TX) were the strongest opponents of the American Health Care Act. Senator Paul crafted his own conservative plan for repealing Obamacare and worked with the Freedom Caucus to push for an even more conservative Obamacare repeal bill. The Freedom Caucus endorsed Sen. Paul’s plan.
Meadows told Breitbart News, “I fully expect that we will repeal most aspects of Obamacare by the end of May. It may have been a deterrent in the first 100 days, but by the end of the first 120 days or so it will be seen as a significant accomplishment. It’s not how you start, it’s how you finish, as the as song used to say. We will have an excellent finish.”
Rep. Ron DeSantis (R-FL) joined SiriusXM host Alex Marlow to highlight five key facts about the GOP’s Obamacare replacement bill on Thursday’s Breitbart News Daily.
The new plan is closer to full repeal than the old GOP bill was. “The original Ryan bill left the architecture of Obamacare in place, which is responsible for driving up premiums and deductibles for millions and millions of Americans,” DeSantis recalled.
“Conservatives looked at that and said that’s the main reason people hate Obamacare, we’ve got to deal with that. The problem, though, that we had is that we have a critical mass of members who, even though they campaigned on repealing Obamacare, did not want to roll back the architecture of Obamacare, so we were kind of at a standstill,” he explained. “And then, with the work of people like Mark Meadows and Tom McArthur from New Jersey, what we were able to do is say, ‘Let’s at least give the states the ability to opt out of the Obamacare regulatory structure and set up functioning markets, which will obviously allow people to have cheaper policies and will lower premiums for people.’”
“That’s not ideal,” DeSantis conceded. “We should just repeal it all. That would be the easiest thing.”
It shows Republicans can work together to craft a replacement bill. “I think the big upshot from this debate, what its revealed, is that people had always said ‘oh, these Republicans, they had seven years to come up with a replacement and they can’t do it.’ That’s not really the issue. I mean, there’s issues with the replacement that I would change if I could, but it is what it is. I think most members are fine with it,” said DeSantis.
He pointed out the political reality that Republicans “don’t have the 216 votes to repeal” Obamacare outright.
“Even though we voted to do it time after time, now we’re here, the iron’s hot, and we have some members that don’t want to do that. That’s why we ended up in this compromise situation. But I believe, and other conservatives believe, that this is as good as we can do right now, given where our votes are,” he said.
It will lower insurance premiums. DeSantis said the new bill “provides a path to lower premiums in a way that the original bill I think did not.”
“Actually there was a good argument that that original bill, by retaining the Obamacare regulations and insurance mandates, but defunding the individual mandate for healthy people to purchase insurance, actually may have created more adverse selection in the insurance markets, which would have of course raised premiums,” he noted. “I think this bill corrects for that and gives governors the ability to really put some market forces back into their insurance markets. That’s what we’re looking to do.”
It takes care of people with pre-existing conditions. “I think it’s important to point out, people act like before Obamacare there was no coverage for pre-existing conditions. The fact is, if you either got your insurance through employer, Medicare. V.A. – pretty much everything but the individual market – pre-existing conditions were covered. It wasn’t an issue,” DeSantis contended.
“Now in the individual insurance market there were roughly, between 2010 – 2014, Obamacare had a pre-existing insurance program before the exchanges stood up,” he recalled. “There were about 130,000 people that signed up for that who were either denied coverage, or denied coverage that was even remotely affordable for them.”
“That’s a legitimate issue, but it’s a very discrete issue,” he said. “It’s frustrating when the media will act like without Obamacare, you wouldn’t have any protection for pre-existing conditions for 300 million-plus Americans. That’s just not true. Second of all, if you really said pre-existing was the reason you needed Obamacare, you didn’t need to do a 2,000-page bill. You could have done a five-page bill. You could have appropriated money for those folks. This way, you would have saved all the crippling premium increases and deductible increases, and the plan cancellations, and all the stuff that’s happened with Obamacare.
It cleans up the expensive morass of Obamacare regulations. “Our plan has always been as Republicans – whether it’s Tom Price’s plan, whether it’s Paul Ryan’s Better Way, anything that had been proposed – was you have to fully repeal Obamacare,” DeSantis said.
“The regulatory structure is dysfunctional. It leads to insolvent markets,” he explained. “And then when you replace it, you do provide continuous coverage protection so that the insurance companies can’t kick you off if you get sick, or jack up your rates, as long as you’re paying your premiums.”
“If people are not paying premiums and are effectively uninsurable, you still provide a backstop for them, but it’s a general public fund, rather than imposing those costs on the premium holders and jacking up their rates,” he added. “So it’s a way to deal with folks who are not insurable under the traditional definition of insurance that also spares policyholders and the individual market.”
“I mean right now, eHealth.com just came out with how much it costs right now, and then they sell individual market plans unsubsidized, for a family of four the average per-year and premium costs right now: $14,300,” DeSantis noted. “That’s more than some people’s mortgage payments, depending on what part of the country you live in, so that’s not a sustainable system. That is being driven because of the dysfunctional Obamacare regulatory structure.”
“This bill, it not only deals with pre-existing conditions, it deals with it three different ways. There’s a massive $100 billion fund. Then there was a Palmer-Schweikert $15 billion fund that is modeled after the main invisible risk-sharing program. And then there is another $8 billion just with this Fred Upton stuff,” he said, the latter a reference to Rep. Fred Upton’s (R-MI) decision to support the bill after an $8 billion amendment to protect people with pre-existing conditions was added.
“So you’re talking about probably 100,000 to 130,000 people, but maybe even less because anyone that has a policy now, it doesn’t matter if you have pre-existing conditions, you can renew it and they’re not going to jack up your rates. So it’s taken care of in multiple ways, but basically the media sets a narrative, and I think some Republicans unfortunately accept this, that Obamacare is the only way to deal with pre-existing conditions. We’ve never accepted that previous to this debate. We shouldn’t accept it,” DeSantis urged.
“Actually, Obamacare is not good for pre-existing conditions because if you’re in Iowa and you have a pre-existing condition, and the insurers are totally fleeing the market now, guess what? Nobody gets issued a policy at all,” he added. “So yes, under the law you can’t be discriminated against because of that, but if no one’s issuing a policy to anybody, a lot of good that does you. The first thing you have to have if you want to protect both healthy and sick people is a functioning, solvent market, and Obamacare clearly doesn’t deliver that.”
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