Healthcare

GOP centrists push back on ObamaCare repeal

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Centrist Republicans are throwing cold water on prospects that the House is getting closer to a deal on ObamaCare repeal.

The centrists object to demands from conservatives that states be given waivers that would allow them to repeal certain ObamaCare requirements.

The conservatives say the state waivers would reduce premiums, but centrists worry the move would also put insurance out of reach for people with pre-existing conditions.

Preventing insurers from denying coverage to people with pre-existing conditions is one of the most popular parts of ObamaCare.

{mosads}“I certainly learned … that under no circumstances should we pass legislation that would in any way diminish the pre-existing condition matter, that nobody in our society should ever be denied healthcare coverage for a pre-existing condition,” Rep. Leonard Lance (R-N.J.), a member of the centrist Tuesday Group, told reporters this week after hosting a raucous town hall in Flanders, N.J. 

Lance was one of dozens of centrists who opposed an earlier GOP repeal bill that was pulled from a planned House vote in March.

During Congress’s current spring recess, GOP lawmakers have faced pressure from constituents at town halls to vote against repeal and protect the pre-existing condition provisions. 

And it’s not just rank-and-file centrists feeling the pressure.

Rep. Greg Walden (R-Ore.), the chairman of the House Energy and Commerce Committee, which played a major role in writing the GOP legislation, told a town hall on Wednesday that he could not vote for legislation that eliminated community rating.

Community rating is a lesser-known ObamaCare provision that requires insurers to charge the same amount for health insurance to people of the same age who live in the same geographic areas — with a few exceptions, such as for smokers.

Critics say eliminating community rating would almost certainly mean that people with pre-existing conditions would pay much more for insurance.

“We’re not going back to the days when they could underwrite you, say, ‘Oh yeah, we’ll cover you, it’ll just be so expensive you can’t afford it,’ ” Walden said. “That is not a plan I can support.” 

After the initial repeal bill was pulled from a vote in an embarrassment for the White House, President Trump initially signaled he would move on to tax reform and an infrastructure package.

Some Republicans argue tax reform would be easier if ObamaCare were repealed first because it would take ObamaCare taxes out of the equation. That would make it easier to avoid increasing the deficit by cutting taxes, they say.

Conservative GOP lawmakers have been signaling that they are close to reaching a deal.

Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus who has been speaking to Vice President Pence and top aides to Speaker Paul Ryan (R-Wis.), said this week that “we’re very close” to a healthcare deal.

Rep. Dave Brat (R-Va.), one of the most outspoken conservative opponents to the GOP repeal bill, separately told USA Today that a deal could be in place within weeks.

The White House and GOP leaders need to win over conservatives to get a bill through the House. Every House Democrat is expected to vote against the bill, meaning Republicans can afford only 22 defections from their own party.

The problem is that Republicans risk losing centrist votes by moving the bill toward conservatives.

A chief of staff to a moderate House Republican questioned the need to try to force a deal on healthcare using roughly the same legislative package that many GOP members rejected last month.

“They need to step back and circle back in a month or two with a vastly different product,” the top aide told The Hill.

Conservative groups are frustrated by the resistance among more moderate members to repealing community rating and other ObamaCare protections, saying lawmakers are going back on their word to repeal the healthcare law. 

The conservative Club for Growth is launching ads in 10 GOP districts calling for lawmakers to agree to a deal to repeal ObamaCare with the Freedom Caucus. Those targeted include Walden and Rep. Patrick McHenry (R-N.C.), the chief deputy whip, who last week said the Freedom Caucus’s calls were a “bridge too far for our members” and could not pass. 

Lawmakers, though, are facing pressure from their constituents not to repeal the law. One woman told moderate Rep. Ryan Costello (R-Pa.) at a town hall this week that she would be dead without ObamaCare and asked if he would come to her funeral. 

Referring obliquely to conservatives, Costello told the crowd “right now there are some” who want to allow states to eliminate ObamaCare protections like essential health benefits. Costello called that idea “problematic on a number of levels” and said “essential health benefits are extremely important.” 

At Mount Olive High School in Flanders, N.J., Lance heard some personal stories of how constituents had benefitted from ObamaCare — the health insurance law congressional Republicans have been trying to dismantle for seven years but which still remains popular in the Garden State. 

“The insurance company, before the Affordable Care Act, didn’t really want to touch me with a 10-foot pole,” Whitehouse Station resident Elizabeth Lewandowski, 55, who has a pre-existing condition, told Lance. “This latest version, TrumpCare 2.0, would have made it impossible for me to get insurance.

“It would take away coverage for pre-existing conditions, and that’s a huge problem.”

Under Obamacare, three of Lewandowski’s four adult children were able to stay on their parents’ plan until the age of 26, she said. And at one point, three of her children received healthcare through the state exchanges. Lewandowski received a standing ovation after her remarks.  

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