Republicans Eye New Path Out of Health Care Wilderness
GOP moderates, conservatives close to deal allowing states to opt out of Obamacare mandates
Stung by their failure to coalesce around a bill to repeal Obamacare last month, representatives of the moderate and conservative factions of the House GOP caucus are close to a deal, according to several news reports.
The outlines of a compromise between moderate Tuesday Group and conservative House Freedom Caucus members would allow states to seek waivers to opt out of some of the insurance mandates imposed by the Affordable Care Act. The idea is that if insurance companies could sell slimmed-down health plans, premiums would come down.
“At a minimum, things are moving. I don’t think anyone would have predicted that a few weeks ago.”
“It’s real. I just don’t know where it’s going to go in terms of House leadership picking it up,” said Jason Pye, director of the public policy and legislative affairs advocacy group FreedomWorks.
Rep. Tom Cole (R-Okla.) told CNN that, “Differences have narrowed, and this thing is very much alive.”
Rep. Trent Franks (R-Ariz.), a member of the Freedom Caucus, also sounded upbeat on Thursday.
“I’m convinced that the good new is that whatever comes out of this negotiation, I believe is going to result in a better bill than we would have had before,” he told CNN’s Wolf Blitzer.
Pye said holdout lawmakers will not say “yes” or “no” until they review the text of an actual bill. But he said that from the broad outlines under discussion, be believes 20 or so Freedom Caucus members would support it.
“Is the Tuesday Group going to stop being ridiculous and … vote for it?” he said.
Pye noted that many Tuesday Group members have voted multiple times to repeal every word of the Affordable Care Act.
“That is a documented fact, as recently as January 2015,” he said.
Under the broad outlines of the plan, states could opt out of requirements that insurance companies charge the same rates to people with pre-existing health conditions and offer the “Essential Health Benefits,” such as maternity care, mental health services and hospitalization, that insurance companies must cover now.
States would have to participate in a federal high-risk pool or set up their own and demonstrate that their plans would reduce premiums, cover more people, or provide some other benefit to people.
Josh Blackman, a professor at the South Texas College of Law in Houston, said it remains to be seen how many states would actually take the risk of seeking a waiver. He said a better structure might be to repeal the Affordable Care Act regulations and force states to opt in if they want to keep them.
“What state will actually do this? What we don’t know is what states will have to demonstrate” in order to get the waiver, he said. “Governors are not going to risk this because if it doesn’t work, it’s on them.”
But Pye said he believes it is something governors will seriously consider in states where premiums are skyrocketing or where insurance companies are fleeing the market.
Democrats do not appear any more willing to participate in a legislative compromise or concerned that Obamacare is in any jeopardy.
“I’m not sure they’re gonna come up with a deal … There are also a lot of people in the middle who are realizing that it is providing some good services to people,” Rep. Dina Titus (D-Nev.) told CNN.
Grace-Marie Turner, president of the Galen Institute, told LifeZette that real movement likely would not come before the weekend.
"I do think it's going to be hard to get anything definitive until the Saturday call with the Republican caucus and members get back and have a chance to compare their experiences after going home to talk with their constituents," she wrote in an email.
Despite uncertainties, however, any movement represents progress after health reform appeared dead.
"At a minimum, things are moving. I don't think anyone would have predicted that a few weeks ago," said Blackman, author of "Unraveled: Obamacare, Religious Liberty, and Executive Power."