Sunday, April 23, 2017

The GOP's Little Shop of Horrors crafts worse health bill and has but four days to keep the government open

Here’s where things stood Friday afternoon from NBC News: House GOP Moves Forward on a New Compromise Addition to Health Care. But it’s not getting any better. It still hits the sick and poor hardest.

With President Donald Trump pushing for a legislative victory before his 100th day in office next Friday, pressure is mounting on House Republicans to move forward with a new idea that would amend their health care bill.

The measure, written by Rep. Tom MacArthur, a moderate Republican from New Jersey, was hashed out with Rep. Mark Meadows R-N.C., the chair of the conservative Freedom Caucus, in an attempt to bring together enough members to pass health care reform in the House.

Their plan, which was just bullet points on Thursday, could be released as legislative text as early as Friday night or Saturday according to sources familiar with the discussions.

Republicans are holding a conference call Saturday afternoon to touch base ahead of their return to Washington on Tuesday, and the new legislative language could be distributed to them ahead of the call.

A senior GOP leadership source says its “definitely possible” that the House could vote next week on the bill, but acknowledged that no decision has been made.

The White House has been pushing for a deal on health care since the GOP bill was pulled from the House floor just prior to a final vote in March for lack of support.

The compromise under consideration addresses some of the conservatives’ concerns over regulations imposed on insurance companies that they say drive up the cost of premiums.

Congress also has to focus on funding the government, which runs out on April 28 — Trump’s 99th day in office.

But it’s still too early to tell if this will convince enough Republicans to support the bill, despite pressure from the White House to pass something as early as next week. The president took an optimistic tone on the chances Thursday, saying, “we’ll see what happens, but this is a great bill, this is a great plan and this would be great health care and it’s evolving.”

Rep. Charlie Dent, R-Penn., a moderate who opposed the House GOP’s Obamacare replacement bill in March, told NBC News that the proposed changes by MacArthur and Meadows aren’t sufficient to make him change his mind.

“It doesn’t do anything to change the problems with the underlying bill,” Dent said, adding that he’s still concerned about the cuts to Medicaid and that the tax credits aren’t generous enough to help the low-income and seniors.

It allows states to apply for a waiver from providing essential health benefits in their insurance plans, which are services the federal government mandated that insurers must cover like maternity care, hospitalization and emergency care. States would be able to set up high risk pools for the most costly people to insure with the goal of bringing down the cost of insurance for healthier individuals.

But the plan doesn’t address other conservatives’ concerns, including the mandate on pre-existing conditions and other insurance regulations.

It does allow for states to apply for a waiver on the community rating, a mandate that limits the amount health insurance can charge certain people more. But increased charges can’t be because age, health and gender, essentially keeping intact the component known as the community health rating.

The plan also doesn’t address the concerns of moderates who are worried about cuts to Medicaid and tax benefits that are too small to help people purchase individual coverage.

UPDATE: Politico.com (among other sources) reports that House GOP leaders won’t rush health care vote On a members-only call, Speaker Paul Ryan issues a subtle signal to the White House, which is pushing for a deal before President Trump’s 100 day mark.

… Republican leaders want to avoid an embarrassing repeat of what happened last month, when Ryan had to pull an earlier health care bill from the House floor because he didn’t have enough votes to pass it. Members of the conservative House Freedom Caucus bucked the leadership and committed to voting no, and moderates also started peeling off. This time, Ryan and other GOP leaders want to nail down the votes first; before calling the legislation to the floor.

The call was initially scheduled to discuss plans to pass a spending bill. Government funding expires on Friday, leaving lawmakers just four legislative days to pass an appropriations package.

Ryan and his top lieutenants were adamant that they will keep the government open, as expected. They did not specify how exactly they intend to avoid a shutdown.

White House officials insisted this week that Republican leaders include funding to build Trump’s border wall with Mexico. Democrats have vowed to block any deal that includes funding for that project, which Trump repeatedly said on the campaign trail he’d force Mexico to pay for. And since the Senate requires at least eight Democrats to pass the bill, GOP leaders eager to avoid a shutdown fight have been trying to convince the White House to drop its demands for wall funding.

While leadership said they have to deal with government funding this week, they said they’d be working on a parallel track on finalizing the health care agreement crafted by Vice President Mike Pence, Freedom Caucus Chairman Mark Meadows (R-N.C.) and Tuesday Group leader Tom MacArthur (R-N.J.).

So the Little Shop of Horrors is still grinding away.

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