What You Need To Know About The Latest Push To Revive Obamacare Repeal

Additional reporting by Alice Ollstein

If Republicans are praying for an Easter miracle to revive their Obamacare repeal-and-replace gambit, they may need to pray a little harder.

After a round of talks Monday between top White House officials and groups of members about potentially amending the failed GOP health care bill to allow states to waive certain Obamacare insurance standards, Republican House members emerged from their weekly conference meeting Tuesday morning with few new details that would suggest the legislation could be revived before next week’s Easter recess.

At a press conference after the meeting, Speaker Paul Ryan (R-WI) said discussions were at a “conceptual stage” about moving the effort “forward in a way that can get everybody to 216,” the number of votes they need to pass it.

While a handful of Republicans, including Trump ally Rep. Chris Collins (R-NY), were optimistic that a the bill could be brought back up for a vote this week if a deal was made, others GOP members used the new round of talks to pick open old scabs.

“We’ve got some work to do, but I am also concerned that there’s not as much cooperation as there seemed to be there first of last week,” said conservative hardliner Rep. Louie Gohmert (R-TX), referring to when Republicans returned from the weekend after their Obamacare replacement plan was pulled from the floor.

“We really were looking for some way to get to yes,” Gohmert told reporters after Tuesday’s conference meeting. “We’ve gotten there twice working with the President, before people like [White House Chief-of-Staff Reince] Priebus intervened: ‘You can’t agree to that.’ So, we’ll keep pushing, because we have got to do something, people need help.”

White House officials, including Vice President Mike Pence and Office of Management and Budget Director Mick Mulvaney, met with a group of moderate Republicans Monday afternoon and then with the hard-right House Freedom Caucus Monday night to discuss a potential change to the bill that would scale back the Affordable Care Act’s market reforms. Under the proposal, states would be able to waive the ACA’s Essential Health Benefits – the 10 coverage areas insurers must offer in their plans – and its community ratings standards, which prevent insurers from hiking premiums based on a person’s health status.

Here’s where things stand and how the idea is being received by Republicans.

Freedom Caucus types are mixed on the new proposal:

Some conservative hardliners, including House Freedom Caucus Chair Mark Meadows (R-NC), emerged from Monday night’s meeting with the Trump administration optimistic with where things were heading. However, other Freedom Caucus members are already pooh-poohing the idea for not going far enough to scale back the federal government’s involvement in health care.

“It is better to have an opt-out possibility than no opt-out possibility at all. But it’s best if states have that right without having to go to the federal government on bended knee and beg for what should be a state’s right,” Rep. Mo Brooks (R-AL), a Freedom Caucus member, said Tuesday morning.

Gohmert said the proposal would “still mean that federal government is the big boss and we may throw some crumbs to the states, when actually we have taken so much power away from the states.”

“The states shouldn’t have to ask the federal government for waiver. The federal government should have to ask states for permission,” Gohmert said.

Many conservatives said they were waiting until they see legislative text of the proposed amendment before making any decision about whether they would support it.

“I would be thrilled if there was some kind of general agreement this week,” said Rep. Morgan Griffith (R-VA), a Freedom Caucus member who is also a member of the Energy and Commerce Committee, which had jurisdiction over the health care overhaul.

“But then getting that on paper and making sure that people have time to review it and feel like it’s been properly vetted, that would be very difficult,” he said. “Not having something in writing this morning, I think it would be very difficult to get it done this weekend.”

Leadership is lowering expectations:

Despite enthusiasm from some GOP rank-and-file that a new version of the bill could be brought up this week, leadership and key Republicans are setting expectations low and throwing cold water on the possibility of quick action.

“We have to get more into the detail, this is really important work that we have to get right,” Energy and Commerce Chair Greg Walden (R-OR), who participated in the Monday White House meeting with the moderates, told TPM as he entered the conference meeting Tuesday.

House Ways and Means Chair Kevin Brady (R-TX), whose committee also has jurisdiction over the health care bill, said after that it was “too early to focus on one idea because I hear a number of them percolating.”

“We need to make sure there aren’t any artificial deadlines here,” he said. “We should just let these discussions continue very organically and deliberately. Let the solution and consensus drive the timeline.”

Rep. Mike Burgess (R-TX), who chairs the subcommittee on health under Energy and Commerce, was even more measured.

“I am not sure that is exactly direction,” he said, when asked by TPM about the proposal. “But people are talking, so that’s a good thing.”

The concerns from moderates remain:

Any change to the bill would need to earn enough new votes so that it would actually pass on the floor before leadership sought to advance it. So it’s not just conservatives that Republican leaders must keep in mind, but also the moderates who revolted against the original American Health Care Act as it was pushed farther to the right.

“It’s important that we don’t just win the votes of one caucus, or one group, but that we get the votes and the consensus of 216 of our members,” Ryan said at the press conference Tuesday. “It’s premature to say where we are or what we’re on because we’re at the conceptual stage right now.”

It’s worth noting that all the moderates who met with the White House Monday were previous yes votes, so there’s no indication yet that the minds of centrists who opposed American Health Care Act would be changed with this amendment. Even Collins, the Trump ally from New York who was at Monday’s meeting, said that allowing states to opt out of community ratings risked losing votes from the party’s more centrist wing.

And the new idea doesn’t even begin to address the massive cuts to Medicaid that made many purple state Republicans, especially those in expansion states, wary.

House Appropriations Chair Rodney Frelinghuysen (R-NJ) – whose defection from the AHCA was seen as a death knell the morning it was set for a vote – said Tuesday that he was focusing on the “enhanced benefits and the fact that New Jersey is a Medicaid dependent state.”

“I haven’t seen the changes. All I know is what I heard on the radio driving in today,” he said.