With fate of GOP healthcare bill unclear, essential health benefits on chopping block

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It was still unclear as of early Thursday whether Republicans had the votes to pass the American Health Care Act in the House.

The American Health Care Act continued to teeter on the brink early Thursday, with Republican leaders huddling to debate last-minute changes to the bill that may include axing the Affordable Care Act’s essential health benefits.

After a marathon debate that began Wednesday morning, the House Rules Committee called it a night before making a decision on the AHCA. However, it also approved a “same-day rule” that would allow it to create a rule for the bill and allow the House to pass that rule in the space of a day. Typically, the House must wait at least a day before considering a rule approved by a committee.

On the House floor Thursday, Rules Committee member James McGovern, D-Mass., slammed the use of what he called a “blanket martial law rule that lasts past the weekend.” The rule would also essentially allow House leadership to bring the AHCA to the floor anytime through Monday, according to C-SPAN.

“We have no real clue what Republicans will be bringing to the floor later today,” he added.

Rep. Jamie Raskin, D-Md., had a more colorful characterization of what he perceived to be the lack of order on Thursday in Congress. “It’s ‘Lord of the Flies’ day here in the House of Representatives,” he said.

But committee Chairman Pete Sessions, R-Texas, said Republicans were hard at work in the Capitol to iron out a deal that would bring a healthcare bill to the House floor.

“Make no mistake about it Mr. Speaker, my party intends to bring forth an agreed-to bill, that we will be able to show to the American people, and we will own it,” he said.

In order to reach an agreement, though, Republicans are considering easing the requirements on which basic services health insurers must cover in order to win over reluctant conservatives, the Associated Press reported.

The requirements, known as essential health benefits (EHB), were implemented through regulation tied to the Affordable Care Act in 2013. They require coverage of ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services.

Republican advocates of undoing the EHB requirement say it drives up the cost of insurance, the AP noted. Department of Health and Human Services Secretary Tom Price has also advocated doing away with the requirement.

Axing the rule would indeed give insurers more flexibility in benefit design, but there could also be unintended consequences, Kaiser Family Foundation Senior Vice President Larry Levitt pointed out on Twitter:

The potential concessions to conservatives may also be problematic for the Republican leadership's bid to pass the bill, as they have turned off moderates in the party, Politico reported. Moderate Republicans emerged from a two-hour Wednesday night meeting with House GOP leaders without reaching a consensus.