With conservatives in the House Freedom Caucus (HFC) now supporting an altered version of the GOP health care bill, the GOP's hopes for health care reform now rest in the hands of its moderate members.
A negotiated deal between HFC Chairman Rep. Mark Meadows (R-N.C.) and Tuesday Group Co-Chairman Rep. Tom MacArthur (R-N.J.) would allow states to apply for waivers to repeal some of the Affordable Care Act's mandates, most notably the Essential Health Benefits and community ratings provisions, which protect people with pre-existing conditions.
The amendment would make the bill decidedly more conservative — a win for the Freedom Caucus both on policy and in shifting the burden of passage from themselves to moderates. And the deal does little to appeal to those centrist members.
“The amendments that we've seen so far really don't address the concerns I had with the original replacement plan,” Rep. Dan Donovan (R-N.Y.) told reporters on his way to a Tuesday Group meeting.
Other Tuesday Group members expressed similar comments, raising issues with, among other things, the American Health Care Act's (AHCA) Medicaid cuts, raising prices on seniors, and the MacArthur amendment's provisions for states to scrap some pre-existing conditions protections — as long as those states enroll in federal high-risk pools or establish their own in doing so.
When asked if the situation puts more pressure on himself and his colleagues to support the bill, Tuesday Group Chairman Charlie Dent — who opposed AHCA before the changes and remains against it with the MacArthur amendment — assured reporters he could handle the pressure.
“Certainly, I've often felt that a lot of this has simply been an exercise in blame-shifting,” Dent said. “Because we know that this bill, in its current form, with or without the amendment, will be gutted in the Senate. So this is simply a matter of blame-shifting and face-saving.”
While Dent didn't take an official whip count, he believes his colleagues who previously opposed AHCA have not changed their minds on the bill.
The Tuesday Group was tight-lipped when leaving the meeting, with those who already opposed AHCA generally saying they were either still against it or that they were reviewing the amendment.
The eight-page amendment doesn't take too long to read, though.
“We don't have adequate information to make a decision,” Rep. Barbara Comstock (R-Va.) told reporters. When asked what kind of information she was referring to, the lawmaker answered, “background information,” not providing further details on what it would take for her to make a decision.
Conservative aides told Independent Journal Review that the moderate members who have concerns will be more likely to tow the party line on health care than the Freedom Caucus was. If that winds up being true, a vote on the bill could happen sooner rather than later.
Optimistic estimates from GOP leadership and the White House hope for a vote on Friday of this week. Most lawmakers have indicated they are unconvinced of the feasibility of that timeline, however, aiming instead for a vote sometime next week.
And after last month's AHCA disaster, House Speaker Paul Ryan (R-Wis.) won't bring the bill to the floor again until the GOP leadership is certain of its passage.
No one really knows where the votes stand, but it looks like it could be tight. The GOP can only afford to lose 20 votes from Republican members, and nearly that many moderates have previously publicly stated their opposition.
The choice moderates face is to stand against President Donald Trump and congressional leaders, or to potentially go back on their promises to protect people with pre-existing conditions. With the clock ticking on Trump's 100th day, the White House can be counted on to be pushing the bill to members aggressively in the coming days.
In the meantime, Meadows and his Freedom Caucus colleagues may enjoy their time out of the hot seat.