Republicans consider deal on health-care bill

By Paige Winfield Cunningham, The Washington Post

WASHINGTON – Republicans, under heavy pressure from the White House, are inching closer to passing a bill repealing and replacing parts of the Affordable Care Act, but possible revisions released Thursday aren’t likely to clinch a deal.

House Republican leaders are downplaying the likelihood that changes to the GOP health-care bill proposed by leading moderate Rep. Tom MacArthur, R-N.J., would win over enough conservative and moderate holdouts, who have butted heads over removing some of the Affordable Care Act’s key insurance regulations.

“The question is whether it can get 216 votes in the House, and the answer isn’t clear at this time,” said a senior GOP aide. “There is no legislative text and, therefore, no agreement to do a whip count on.”

The MacArthur amendment tries to shore up moderate support for the bill by reinstating the health-care law’s so-called “essential health benefits,” a list of federally-mandated health services that marketplace plans must cover. The GOP health-care bill as it stands would instead allow states to spell out essential health benefits.

But the amendment also tries to win over conservatives in the House Freedom Caucus by giving states a way to opt out of some insurance regulations. With special permission from the federal government, states could write their own essential health benefits and allow insurers to charge those with preexisting conditions higher premiums, as long as they also make a high-risk pool available to those patients.

The White House is pushing hard on the GOP-led Congress to pass a bill repealing and replacing much of President Barack Obama’s health-care law, as Republicans have vowed to do for years. Republicans departed for recess unable to reach agreement on a replacement, but as they return to Washington next week some are holding out hopes for still reaching a deal.