May 8, 2017 Update: Obamacare Repeal: Last week the House passed an amended version the American Health Care Act (H.R. 1628) by a final vote of 217 to 213 with 20 Republicans joining all Democrats in opposition. Earlier in March, Speaker Paul Ryan was forced to pull the bill from the floor 18 days after it was first introduced due to serious concerns from both conservatives and moderate Republicans. Most conservative organizations and nearly all conservative health policy experts opposed the original version of the AHCA because it failed to repeal the regulatory architecture of Obamacare (Title I) that is responsible for the rising cost of health care premiums by a national average of 44.5 to 68 percent. Republicans of all stripes campaigned for over seven years to repeal all of Obamacare, including the Title I regulations, as clearly outlined in Speaker Ryan’s “A “Better Way” plan.
Over the Easter recess, House Freedom Caucus Chairman Mark Meadows (R-NC) and Rep. Tom MacArthur (R-NJ), co-chairman of the moderate Tuesday Group, worked out a deal to allow states to easily opt-out of core elements of Obamacare’s Title I insurance regulations if they set up high-risk pools to assist those with pre-existing chronic conditions. This compromise, along with a second amendment offered by Rep. Fred Upton (R-MI) and Rep. Billy Long (R-MO) adding $8 billion in assistance to those with pre-existing conditions, convinced enough conservatives and moderates to vote for the AHCA. Heritage Action withdrew its original key vote after House Republican leaders adopted the MacArthur-Meadows Amendment.
Heritage Action released the following statement from chief executive officer Michael A. Needham:
“Today’s vote ensures the Obamacare repeal effort can continue to move forward. Surely more must be done in the Senate, but the months-long negotiations in the House identified many of the key issues for senators to tackle. Representatives MacArthur and Meadows deserve tremendous credit for their good faith effort to address Obamacare’s regulatory architecture.
“There is no doubt the Republican Party is divided in fundamental ways, but for the years-long repeal effort to be successful, the Senate will have to demonstrate a level of cohesion and commitment that eluded House leaders. The process up until now has been disastrous, but we have confidence the bill can be improved upon in the Senate.”
It was clear House Republicans were not capable of doing better given the disastrous process, which is why nearly every House conservative voted for the amended AHCA and are eager to see the Senate take up and improve the bill. Trusting the Senate to make conservative improvements is usually a very bad idea, but when it comes to the budget reconciliation process it have proven successful in the recent past. The initial 2015 reconciliation bill passed by the House was dreadful — Heritage Action key voted against that bill too and only a handful of Republicans opposed by House leaders said it was the best they could do — but the Senate made the bill substantially better.
As counterintuitive as it sounds, conservatives have leverage and a great opportunity to make the bill better in the Senate. Senator Mitch McConnell is already leading a 13-member health care working group in the Senate that includes conservatives such as Mike Lee (R-UT) and Ted Cruz (R-TX). Although there are no guarantees the outcome will be ideal, conservatives like you are making a difference by moving the bill in a better direction.
Heritage Action statement on the Obamacare repeal effort, click here.
Heritage Action statement on the MacArthur-Meadows Amendment, click here.
Heritage Action face sheet on Obamacare Title I regulations, click here.
Heritage Action key vote, click here.
Sentinel Brief, click here.