Conservative caucus backs GOP health bill but fate uncertain

Speaker Paul Ryan
Speaker of the House Paul Ryan walks to his office after gaveling the House into session on Capitol Hill, Friday, March 24, 2017, in Washington.
Drew Angerer | Getty Images File

Updated: 1:38 p.m. | Posted: 12:26 p.m.

The conservative House Freedom Caucus announced its support Wednesday for a newly revised GOP health care bill, a month after the group's opposition forced Republican leaders to pull the legislation in an embarrassing retreat.

The group's support, while significant, does not necessarily guarantee passage of the Republican bill to partially repeal and replace former President Barack Obama's Affordable Care Act. A group of moderate Republicans was still reviewing the changes to the bill, and an unknown number remained opposed.

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The developments came days ahead of the 100-day mark of Donald Trump's presidency, as the White House pushes for fast action to revive the stalled health care measure and make good on seven years of GOP promises to get rid of "Obamacare" and replace it with something better.

The proposed changes would let states get federal waivers to some coverage requirements Obama's law imposed on insurers. The revisions were authored in part by Rep. Tom MacArthur of New Jersey, a leader of the Tuesday Group of House moderates, but a number of other members of the group feared the result could be to weaken important protections.

Underscoring centrists' concerns, another Tuesday Group leader -- Rep. Charlie Dent, R-Pa. — opposes the proposed changes and said he was unaware of any moderate opponents of the health care bill switching to become supporters.

Dent suggested that the changes were "simply an exercise in blame-shifting" by conservatives because the health legislation would be "gutted" in the Senate. Many GOP senators oppose the House-written bill and its future should it reach that chamber is bleak.

Another nagging issue was the revelation that the legislation would allow members of Congress and their staffs to continue to receive certain benefits under the health law -- even if their state opted out from the federal requirement to provide such services as maternity and newborn care, preventive care and wellness visits and prescription drug coverage.

In a statement, the Freedom Caucus said it could support the proposal as amended by MacArthur.

"While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health care costs," the statement said. "We look forward to working with our Senate colleagues to improve the bill. Our work will continue until we fully repeal Obamacare."

Earlier Wednesday, House Speaker Paul Ryan said the changes were helping the legislation gain support, but he stopped short of saying the plan has the votes the GOP would need to finally push the high-profile measure through the House. Ryan spoke to reporters after leaders briefed rank-and-file Republicans on details of changes to the legislation aimed at breathing life back into one of Trump's premier but most problematic priorities.

"We think it's very constructive" Ryan said of the proposed revisions. "I think it helps us get to consensus." A White House looking for achievements has pressured GOP leaders to try pushing health care legislation through the House this week.

That seems unlikely, and Ryan reiterated that the House will vote when Republicans have enough support to win. Leaders want to avoid a replay of last month's embarrassing retreat from a planned vote when they realized the measure would be defeated.

To gain support, bargainers from the GOP's conservative and moderate camps have proposed letting states get federal waivers to Obama's requirements that insurers charge seriously ill and healthy customers the same premiums, and that they cover specified services like maternity care. The plan was crafted by MacArthur along with Rep. Mark Meadows, R-N.C., head of the House Freedom Caucus. It's also had the backing of Vice President Mike Pence, Republicans say.

Dent says the changes ignored his concerns that the health care bill would cut too deeply into the Medicaid program for the poor and leave many people unable to afford coverage.

Meanwhile, bipartisan talks on a separate $1 trillion budget bill aimed at preventing a partial government shutdown on Saturday were jarred over a disagreement about payments made to insurers under Obama's health care law.

Both sides have been saying they were making strong progress toward a deal that would prevent a shuttering of federal agencies, after Trump abandoned his demand that the measure include money for his proposed wall with Mexico. Ryan and House Minority Leader Nancy Pelosi, D-Calif., are wrestling over a Democratic demand that the must-pass spending bill keep money flowing under the health care law that helps low earners pay out-of-pocket medical costs.

Pelosi is insisting on addressing those payments Trump threatened to cut them off as a negotiating chip. But Ryan told reporters that "we're not doing that."