The U.S. House could vote as early as this week on a revised health care bill following the filing of amendments designed to bridge the gap between different camps that led to an earlier version being pulled before a vote.
The most significant amendment, introduced last week by Rep. Tom MacArthur (R-NJ), gives waivers to states from various mandates included in the Affordable Care Act.
Tom Miller, a resident fellow at the American Enterprise Institute, said MacArthur is part of the more moderate wing of the House Republicans, and the amendment is an attempt to split the difference.
Miller told Patient Daily that there is a chance they will get the 216 votes needed to pass the House. He added that the more conservative Freedom Caucus members know they were largely responsible for the failure of the initial bill, and that the pressure to deliver "will shift to them."
But Miller, who said MacArthur and other members trying to bridge the gap "mean well," added, "This is what happens when you legislate on the fly."
The House could vote as early as Wednesday on the amended American Health Care Act.
President Donald Trump, in weekend interviews, urged House Republicans to pass the amended bill. He also promised that no person would be discriminated against because of pre-existing conditions.
“This bill has evolved … But we have now pre-existing conditions in the bill." Trump told CBS's "Face the Nation." "We have – we’ve set up a pool for the pre-existing conditions so that the premiums can be allowed to fall."
But he also added, "We’re talking across all of the borders or the lines so that insurance companies can compete.” There are no provisions in the bill that would allow for the sale of insurance across state lines.
When host Chris Dickerson pointed this out to the president, Trump said, “Of course, it’s in.”
The amendment introduced by MacArthur will allow states to apply for waivers on essential benefits, the age rating ratio and community rating.
Obamacare has a list of essential benefits that must be covered by insurers, including doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, and mental health services. States would be allowed to draw up their own list.
States would also be allowed to set their own age rating ratio higher than the 5-1 already in the Republican American Health Care Act. The ACA bars insurers charging older people more than three times their younger customers.
The bill explicitly states insurers cannot use pre-existing conditions to deny insurance. But the waiver on community rating, which essentially bars insurers charging different rates within a geographical area based on the health status of an individual, troubles some critics.
This waiver, according to critics, including some House Republicans, could allow insurers to charge prohibitively expensive premiums based on pre-existing conditions. But supporters claim this will be covered by high risk pools and reinsurance programs.