A GOP source close to the health care negotiations told Independent Journal Review late Tuesday night that moderate Reps. Fred Upton (R-Mich.) and Billy Long (R-Mo.) are considering a deal granting $8 billion in additional funding to the plan's state stability fund in exchange for the lawmakers' support on the health care bill.
The plan currently allocates roughly $130 billion to the stability fund and high-risk pool funding.
A GOP lawmaker told IJR early Wednesday morning that House Freedom Caucus Chairman Mark Meadows initially offered Upton and Long $5 billion. Moderate members of the Tuesday Group then countered, demanding $15 billion. The parties ended on $8 billion over five years, and Meadows briefed HFC members on the deal during the Freedom Caucus meeting Tuesday night.
Meadows indicated he believes $8 billion will be the number to get the job done, but Upton has yet to make a decision.
Upton told the Associated Press on Tuesday night that the potential change was “not quite a done deed yet, but it addresses many of my concerns.”
“The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable," the lawmaker said in a statement.
The proposed $8 billion change would do little to address moderate concerns related to pre-existing conditions, but might just be enough to bring some members back on board with the plan.
Some estimates indicate AHCA's high-risk pools would need far more than just $8 billion in additional funds to fully protect individuals with pre-existing conditions. The Center for American Progress said in a statement Tuesday that, by its numbers, the high-risk pools funded by AHCA “would fall short by at least $19.7 billion per year, or by about $200 billion over 10 years.”
“High-risk pools are expensive, and they have a history of being underfunded,” Emily Gee, a CAP health economist said in the statement. “In the past, insufficient funding meant that patients seeking high-risk pool coverage regularly encountered waiting lists, sky-high deductibles, and premiums double those of standard rates. The high-risk pools that the American Health Care Act would create would be no different.”
Republican lawmakers disagree. “The AHCA provides significant resources at the federal and state level for risk-sharing programs that lower premiums for all people,” a press release from House Speaker Paul Ryan asserted Tuesday morning.
Moderate members who currently oppose AHCA were skeptical about the possible amendment when IJR asked them about it on Tuesday afternoon.
Upton and Long's positions on the bill and whether the extra $8 billion would change their votes should become more clear following their expected visit to the White House on Wednesday.
Mind you: any changes to the health care bill to bring the lawmakers on board could tip the already-precarious balance of the Republican conference, potentially losing conservative votes in the process.
But that might be a risk the White House is willing to take in the push to get health care out of the House before Congress takes another recess next week.
Republicans can only afford to lose 22 votes on the bill before it loses its chances in the House.
The leadership's pivot away from treating the bill with the MacArthur amendment as the final version and toward a stance more open to negotiations is telling, at least in terms of the vote count. Members told IJR the tally is tight, and the leadership is singling out members to try to win votes.
It's tight enough that nobody really knows where things stand. There is some optimism the effort could yield results, though.
“I think we're finding that sweet spot,” a Republican aide told IJR early Wednesday morning.