GOP factions make deal to sweeten healthcare bill

Paul Ryan speaking
House Speaker Paul Ryan said Wednesday that Republicans are negotiating "finishing touches” on a healthcare bill. Image: Gage Skidmore / CC BY-SA 2.0

As they near their return from a two-week recess, Republican leaders in the House are optimistic that they can quickly get back on track with their bid to dismantle the Affordable Care Act. Whether that push will be successful, though, is anyone’s guess.

House Speaker Paul Ryan told reporters after speaking at an event in London on Wednesday that GOP lawmakers are “in the midst of negotiating sort of finishing touches” on a healthcare bill, The Hill reports.

That progress was made possible by a deal between the leaders of two prominent Republican factions in the House—the moderate Tuesday Group and the conservative Freedom Caucus, according to The Huffington Post.

In a nod to GOP moderates, the deal would reinstate the essential health benefits requirements previously nixed from the American Health Care Act, though states would be allowed to waive those requirements if they met certain conditions, according to a copy of the amendment obtained by Politico. 

And to sweeten the pot for conservatives, states would be allowed to obtain waivers for the ACA’s community rating provision, which prevents insurers from pricing people with pre-existing conditions out of the individual market. Those states that choose that option would have to either participate in a federal high-risk pool or create their own.

Rep. Tom MacArthur, R-N.J., who co-chairs the Tuesday Group and worked with Freedom Caucus Chairman Mark Meadows, R-N.C., on the deal, told NJ.com earlier this week that he’s hopeful Republicans can still find consensus despite the AHCA’s initial failure.

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"I am going to keep fighting to get a compromise bill that helps to fix the current situation without hurting the people who are on the Affordable Care Act today," MacArthur said.

Still, it’s unclear whether concessions made by the Freedom Caucus and Tuesday Group will bring more rank-and-file Republicans on board with the healthcare bill—or alienate more of them. Indeed, moderates have pushed back against the idea of allowing states to opt out of the community rating provision, The Hill notes.

Two conservative healthcare economists, meanwhile, recently touted a different policy idea in an op-ed for The Wall Street Journal. Republicans’ healthcare reform plan would have “better prospects,” argued James Capretta and Lanhee Chen, if it embraced the idea of automatically enrolling uninsured, eligible Americans in bare-bones, no-premium health insurance plans.

To address concerns about whether such a policy would infringe on personal liberty—long a complaint lobbed at the ACA’s individual mandate—those enrollees would be able to opt out or select different coverage.