Centrists express frustration with MacArthur on health bill

Members of the centrist Tuesday Group expressed frustration at a Wednesday meeting with Rep. Tom MacArthur (R-N.J.) over his ObamaCare negotiations, according to two GOP aides.

The lawmakers expressed frustration with MacArthur, a co-chairman of the group, for appearing to negotiate on behalf of the group and creating the pressure Tuesday Group members now face to back the deal, the aides said.

Some Tuesday Group members said the changes negotiated by MacArthur and Rep. Mark Meadows (R-N.C), chairman of the conservative House Freedom Caucus, push the bill to the right.

Asked after the meeting, which MacArthur attended, if he was surprised that an amendment pushing the bill to the right came from a Tuesday Group member, Rep. Charlie Dent (R-Pa.) responded simply, “Yeah.”

Dent, another co-chairman of the group, did not explicitly criticize MacArthur after the meeting but made clear he disagreed with his colleague’s approach.

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“The only thing I will say is many members of the Tuesday Group made it very clear to me that they didn't want me or anyone else negotiating,” Dent said. He said those members thought the committees with regular jurisdiction over healthcare, Ways and Means and Energy and Commerce, should be discussing any possible changes.

Asked why MacArthur negotiated with the Freedom Caucus, Dent said, “You have to talk to him.”

MacArthur responded generally to criticism later in the day.

“I made it explicitly clear to everyone that I talked to that I was acting as an individual member of Congress, bringing an insurance background and personal background to an issue of vital importance to our country,” MacArthur told reporters.

“I never said I was negotiating for anyone else and I respect all of our members of Congress,” he added. “People have to vote their conscience. People have to vote their district and I’m just acting as an individual trying to solve a problem. That’s what I’m here to do.”

Either way, the pressure is now on centrists to come on board after the Freedom Caucus announced its support of the bill due to the amendment. MacArthur acknowledged there is pressure but said it was not intentional.

“Anybody who’s wavering feels some pressure because the vast majority of our conference wants to pass this bill,” MacArthur said. “It’s always been a fairly small minority of the conference that had difficulty with it. I’m sure people feel pressure. That’s not my intent.”

The MacArthur amendment allows states to apply for a waiver of one of ObamaCare’s core protections for people with pre-existing conditions, known as community rating. If that were waived, an insurance company would be allowed to charge premiums based on a customer's health, putting coverage out of reach for many and in particular for those with pre-existing conditions.

However, people who maintained "continuous coverage," meaning they did not have a gap in coverage, would still be protected from being charged higher premiums, and states could also waive a 30 percent surcharge in the bill for people who did have a gap. 

States could also apply for waivers to ObamaCare’s essential health benefits, which mandate that insurance plans cover a minimum range of services, such as mental healthcare and prescription drugs.

A study from the liberal Center for American Progress released last week found that waiving community rating would lead to sharp premium increases for sick people, such as an increase of roughly $4,000 for those with asthma or as much as $71,000 for those with severe cancer.

Several moderates also pointed out that there are problems in the underlying bill that remain unaddressed. The GOP plan is still projected to result in 24 million fewer people with insurance over a decade and makes deep cuts to Medicaid, which moderates like Dent object to.

Illustrating the predicament, one moderate House Republican was overheard in the Capitol cafeteria on Wednesday telling an aide, "If I vote for this healthcare bill it will be the end of my career.”

Scott Wong contributed.