A prominent Republican withdrew his support of the House GOP’s latest Obamacare repeal Tuesday, dealing another setback as Speaker Paul D. Ryan tries to wrangle votes for a do-over this week.
Rep. Fred Upton, Michigan Republican, said he wasn’t comfortable with recent changes to the bill that would let states waive rules requiring insurers to charge sick people the same amount as healthy ones.
It was a major blow, given that Mr. Upton, as former head of a key committee, served as one of the point-men for GOP repeal efforts from 2011 through last year.
“I’m not at all comfortable with removing that protection. I’ve supported the practice of not allowing pre-existing illnesses from being discriminated against from the very get-go,” he told WHTC Radio in Michigan. “This amendment torpedoes that. And I told leadership I cannot support this bill with this provision in it.”
His defection hit one day after a conservative lawmaker — Rep. Billy Long of Missouri — said he could not vote for the bill because it “strips away any guarantee that pre-existing conditions would be covered and affordable.”
Mr. Ryan and his chief aides on Tuesday insisted pre-existing conditions are still covered and said their bill would make plans even more affordable for sicker Americans than Obamacare.
Still, their struggles to cobble together a majority were hurting chances they will be able to vote this week, ahead of a weeklong vacation that begins Friday.
“I think if we can’t get there by Thursday of this week, then we need to look at other ways to get to 218 votes,” said Rep. Mark Meadows, North Carolina Republican. Mr. Meadows helped negotiate the current bill, swaying wavering conservatives.
The changes would allow states opt out of parts of Obamacare requiring insurers to cover “essential” benefits such as maternity and mental health care or prescription drugs. States also can let insurers charge healthy consumers less than sicker ones, so long as states set up risk pools to subsidize those priced out of the market.
Leaders said they would replace Obamacare’s wobbly market with one that makes insurance affordable for everyone, since a variety of federal funding streams would backstop the cost of health care for people with pre-existing medical conditions.
“Our bill protects people with preexisting conditions and it actually provides multiple layers of protection for people with preexisting conditions in ways that Obamacare doesn’t do,” said Majority Whip Steve Scalise, Louisiana Republican.
Leaders cannot afford to lose more than 22 GOP votes in the face of blanket Democrat opposition to a plan that guts President Obama’s 2010 health law. Yet, roughly 20 House Republicans have said they oppose the bill, and nearly a dozen more are skeptical or leaning “no,” according to informal whip counts by various media outlets.
“I don’t think they have the votes. I think we’re gonna win,” said House Minority Whip Steny Hoyer, Maryland Democrat.
The House passed a procedural rule on Tuesday, known in Capitol-speak as “martial law,” that will allow leaders to bring the measure to the floor swiftly if they get the votes.
Rep. Paul Gosar, Arizona Republican and member of the conservative Freedom Caucus, said he flipped to “yes” after the administration assured a Senate vote on his bill to apply federal antitrust laws to health insurance.
Rep. Tom MacArthur, New Jersey Republican and a former insurance executive who negotiated the current deal with Mr. Meadows, said holdouts should realize that sicker Americans would get insured “like everyone else” under his plan.
“Their expenses get paid out of a different bucket,” he said. “And that allows them to have coverage, without driving everyone else’s premiums up.”
The GOP bill offers $115 billion in federal “stability” funding over 10 years for the high-risk pools and an additional $15 billion for a risk-sharing mechanism to pay for sicker consumers who could be priced out of the market.
A battery of patient and health care groups, including the American Medical Association, said in recent days that risk pools are often underfunded and wouldn’t work now, leaving Americans worse off.
House Minority Leader Nancy Pelosi said Republicans shouldn’t hold a vote until the Congressional Budget Office is able to evaluate the latest bill.
The CBO’s previous evaluation showed the GOP bill, before the new changes, would have resulted in 24 million fewer people with health insurance a decade from now.
⦁ David Sherfinski contributed to this report.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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