GOP Moderates On The Health Care Bill’s Lurch Farther Right: Not So Fast!


Alice Ollstein contributed reporting.

Moderate Republicans are warning that changes to the GOP health care bill made to assuage conservatives could risk a revolt from the the party’s other wing. Of particular concern, especially to rank-and-file members from Medicaid expansion states, is the push from the hard right to phase out the expanded program even sooner than planned.

“I’m totally against that. There’s no way I’m voting for that. I’m undecided now, but that would make me a definite no,” Rep. Peter King (R-NY), told reporters after a GOP House conference meeting Wednesday afternoon.

The Republican health care bill currently freezes Medicaid expansion enrollment at the beginning of 2020. Conservatives, including those in the hardline Freedom Caucus and much larger Republican Study Committee, are lobbying for that date to be moved up to 2018.

“I believe it would lose at least as many votes as it would gain,” said Rep. Luke Messer (R-IN), the chair of the Republican Policy Committee, adding that speeding up the timeline risks not just moderates, but “folks from states that would hit be hard from rolling that expansion.”

But that’s not the only problem spot as GOP leadership is torn between its moderates and conservative wings. While the moderates have been less noisy than the hardliners in their complaints, the release of the Congressional Budget Office’s score of the proposal showing major coverage losses, particularly among older and lower income people, pushed some of them to take public stands against the bill.

Rep. Charlie Dent (R-PA), the chairman of the centrist Tuesday Group, said that in addition to the Medicaid phaseout fight, there were also concerns about the tax credits not being generous enough, how the proposed caps on Medicaid spending would work, and whether the House was making changes to a bill that would make it impossible to pass in the Senate.

“It’s not real helpful to hear United States senators say that this bill is dead-on-arrival,” Dent told reporters after the conference meeting. “I think they’re right that this bill probably doesn’t have a great chance in the Senate.”

Rep. Leonard Lance (R-NJ), another Tuesday Group member, told CNN earlier this week he was a no vote on the current bill for just this reason.

“I do not want to vote on a bill that has no chance of passing over in the Senate,” Lance said. “The CBO score has modified the dynamics.”

In a press conference after Wednesday’s meeting with his conference, House Speaker Paul Ryan (R-WI) conceded that the bill, the American Care Health Care Act, was going to be changed before it heads to a floor vote.

“Now that we have our score we can make some necessary improvements and refinements to the bill,” he said, which was interpreted as an implicit acknowledgement that Republicans didn’t have the votes for the bill in its current form and a shift from leadership’s previous posturing that the legislation was a take-it-or-leave-it proposition.

But exactly what those changes are and who they are aimed to please is not quite yet clear, and might not be until next week’s Rules Committee’s mark-up of the legislation, where members are expected to turn their demands into actual amendments.

Moving up the Medicaid phaseout date, from 2020 to 2018, may be a major flashpoint, but conservatives say they have other ideas that the moderates would support, such an amendment that would allow for work requirements in states’ Medicaid programs.

“We are trying to come up with an amendment that can not only be supported by conservatives but be supported by moderates alike,” House Freedom Caucus Chair Mark Meadows (R-NC) said after Wednesday evening’s meeting with the group, according to the Hill, without going into detail about what proposals they’re looking at.

“Everybody is giving leadership their two cents worth, from all across the spectrum,” Dent told reporters earlier that day.