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White House pushes uncertain bid to revive health care bill

| Thursday, April 20, 2017, 7:54 p.m.
REUTERS
President Trump reacts to the AHCA health care bill being pulled by Congressional Republicans before a vote as he speaks about the bill in the Oval Office of the White House in Washington on March 24, 2017.

WASHINGTON — Eager for a victory, the White House expressed confidence Thursday that a breakthrough on the mired Republican health care bill could emerge in the House next week.

The chamber's GOP leaders, burned by a March debacle on the measure, were dubious and signs were scant that an emerging plan was gaining enough votes to succeed.

During a White House news conference, Trump said progress is being made on a “great plan” for overhauling the nation's health care system, though he provided no details.

“We have a good chance of getting it soon,” Trump said. “I'd like to say next week.”

The White House optimism is driven largely by a deal brokered by leaders of the conservative Freedom Caucus and the moderate Tuesday Group aimed at giving states more flexibility to pull out of “Obamacare” provisions. A senior White House official acknowledged that it is unclear how many votes Republicans have but said House Speaker Paul Ryan, R-Wis., has told the White House that a vote could come together quickly.

Yet GOP lawmakers and aides to party leaders, conservatives and moderates alike are skeptical that the House would vote next week on the health legislation. They cite the higher priority of passing a spending bill within days to avert a government shutdown, uncertainty over details of the developing health agreement and a need to sell it to lawmakers.

Trump said he plans to get “both” a health care deal and a spending bill.

Many Republicans also expressed doubts that the health care compromise would win over enough lawmakers to put the bill over the top, especially among moderates. The bill would repeal President Barack Obama's health care law and replace it with less generous subsidies and eased insurance requirements.

“Every time they move the scrimmage line, you risk losing other people who were ‘yes,' but this changes them to a ‘no,' ” Rep. Dan Donovan, R-N.Y., said Thursday of attempts to win over one end of the GOP spectrum without losing votes from the other side. The Staten Island centrist said he remains a no vote, partly because the legislation would increase Medicaid costs for New York City's five boroughs.

An outline of a deal has been crafted by Rep. Mark Meadows of North Carolina, who heads the hard-line Freedom Caucus, and New Jersey Rep. Tom MacArthur, a Tuesday Group leader. Vice President Mike Pence also played a role in shaping that plan, Republicans say.

It would deliver a win to moderates by amending the GOP bill to restore Obama's requirement that insurers cover specified services such as maternity care. But in a bid for conservative support, states would be allowed to obtain federal waivers to abandon that obligation.

In addition, states could obtain waivers to an Obama prohibition against insurers charging sick customers higher premiums than consumers who are healthy — a change critics argue would make insurance unaffordable for many.

To get those waivers, states would need to have high-risk pools — government-backed insurance for the most seriously ill people, a mechanism that has often failed for lack of sufficient financing.

“It looks to me like we're headed in the right direction,” Rep. Dave Brat, R-Va., a Freedom Caucus member, said Thursday.

The Tuesday Group has roughly 50 members. They don't necessarily vote as a bloc, and it is unclear how many colleagues MacArthur would bring with him to such an agreement.

Ryan sent a mixed message about the bill's prospects in remarks Wednesday to reporters in London.

“It's difficult to do. We're very close,” he said, adding, “It's just going to take us a little time.”

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