Trump's hardball tactic on health care may backfire

Those parts of Obamacare have been core to the Republican plan's political problems.

The group's endorsement of the measure is significant because it brings along a solid chunk of conservatives who had previously opposed the measure, taking House Republicans closer to the 216 votes the conference needs to pass legislation to repeal and replace the Affordable Care Act.

A draft amendment obtained by CNN, first reported by Politico, gives renewed insight into where the GOP may be moving next. States could also waive a rule preventing insurers from charging older people over three times more than younger people, as well as a rule that prevents insurers from charging more to people with pre-existing conditions.

Two leaders of the House GOP's warring moderate and conservative factions devised a compromise during the recess to let states get federal waivers to ignore some requirements of the health law.

Ryan's insistence that the vote count will dictate timing of new health care legislation seemingly contradicts the assertion of some in the White House - including President Donald Trump himself - that health care reform might happen next week. Since the defeat of the Ryan-led bill, Republicans have been tweaking it to attract more conservatives from the Freedom Caucus. "I think they are trying because it's politically important, but it doesn't seem like this round is materially different than what we have seen before".

Leaving the Capitol Tuesday night, Meadows told reporters that he was still working with his group to garner support for the amendment.

An administration official said the payments will continue, but Trump told the Wall Street Journal earlier this month that he hadn't made a final decision. More, some find they are excluded for up to a year and run into long waiting lists. Rep. Lou Barletta, a Pennsylvania Republican who'd been supportive of House leadership's bill before, described the process as "very frustrating". Even more broadly, the public, by 79 to 13 percent, says Trump should seek to make the current law work as well as possible, not to make it fail as soon as possible, a strategy he has suggested.

"Bringing their catastrophic bill back, repackaged but unchanged, will not make it any more likely to pass; nor will it make it any less risky to the health of the American people", Hoyer said. But some of the proposals floated reportedly could undercut the law's popular provision that insurers not be allowed to deny coverage for people with pre-existing conditions.

The other provision, known as "community rating", bars insurers from varying premiums based on health status or medical history. Health policy experts have said that without the payments, many insurers could not afford to stay in the market and will likely exit, which would leave some U.S. counties without an insurer.

Their support shifts the onus to moderates to also back the GOP's health care measure and follows through on campaign promises to repeal the ACA, even as some of them worry the MacArthur amendment could leave some Americans worse off. Many experts don't believe that setting up high-risk pools, the on-paper protection to make sure people with preexisting conditions are covered, in a nod to moderate concerns, would be foolproof.

  • Larry Hoffman