Meadows-MacArthur Amendment Getting Closer to #FullRepeal

4/27/2017 Meadows MacArthur amendment info

Heritage Action

" ... This amendment, which is the product of weeks-long negotiations by Rep. Tom MacArthur (R-NJ) and Rep. Mark Meadows (R-NC), is an important step forward in rolling back the Title I regulations of Obamacare because it would allow states to say “NO” to some of the most harmful parts of Obamacare. As Mike made clear, “this is not full repeal and it is not what Republicans campaigned on” but it does “represent important progress”. That means there is more work to do. ..."

FreedomWorks Urges House to Adopt MacArthur-Meadows Amendment to AHCA

FreedomWorks President Adam Brandon released the following statement about the amendment to the American Health Care Act, H.R. 1628, proposed by Reps. Tom MacArthur (R-N.J.) and Mark Meadows (R-N.C.):

“We’ve maintained that the American Health Care Act must do more to reduce cost of health insurance. The House Freedom Caucus realized that the bill failed to address premium costs, which have skyrocketed under ObamaCare. The MacArthur-Meadows amendment addresses two costly parts of ObamaCare, community rating and the essential health benefits, providing states with much-needed flexibility to stabilize the market, enroll more people in health plans, and bring down the cost of premiums.

“We thank Reps. MacArthur and Meadows for their work on this amendment, which represents a path forward on health care in House. If the MacArthur-Meadows amendment were adopted, we would immediately withdraw our key vote against the American Health Care Act.”


“…House Freedom Caucus has taken an official position in support of the current proposal.

The MacArthur amendment will grant states the ability to repeal cost driving aspects of Obamacare left in place under the original AHCA. While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower healthcare costs. We look forward to working with our Senate colleagues to improve the bill. Our work will continue until we fully repeal Obamacare. ..."

With Support FromConsevatives House Republicans Move Closer The Obamacare Repeal Deal

Under the amendment, states can apply for federal waivers to opt out of Obamacare’s essential health benefits requirement, a list of 10 services that insurance plans are required to cover.

The measure leaves in place a provision of Obamacare that prohibits insurers from denying coverage to patients with pre-existing conditions, but allows states to waive its community ratings rules, which ban insurers from charging sick patients more than healthy ones.

States could opt out of the community ratings rules only if they implement a program designed to minimize costs for patients with pre-existing conditions, such as a high-risk pool.

High-risk pools, subsidized by the government, are insurance pools for patients with pre-existing conditions.

Additionally, only patients who fail to maintain continuous coverage could be charged more by insurers.

National Review:

"As Capitol Hill faces the looming threat of government shutdown this Friday, House leadership continues to wrangle over changes to the American Health Care Act in an attempt to develop a compromise to unite the opposing factions of the Republican party.

As of later this morning, top Republicans seem to have settled on something that will please at least the more conservative wing in the House: the Meadows-MacArthur Amendment. The amendment, described in more detail last week at NRO, offers states limited waivers to opt out of parts of the AHCA, including essential health benefits and some community-rating rules. This compromise is the outgrowth of the efforts of representatives Tom MacArthur, co-chairman of the moderate House Tuesday Group, and Mark Meadows, chairman of the hardline conservative House Freedom Caucus (HFC) to reconcile the two halves of the party on health-care reform. So far, a number of right-wing groups, including the Club for Growth and Heritage Action, have hailed the amendment as a step in the right direction toward lowering premiums and allowing for greater choice in the health-care market.

More importantly, the amendment has gained enough support from members of the HFC to garner the caucus’s official support, meaning that at least 80 percent of its members will vote for the AHCA if this amendment is attached. This is a key step in the negotiation process, as the HFC holds votes crucial to passing any party-line bill in the House, and most of its members were unhappy with the first draft of the AHCA because it left intact much of Obamacare’s regulatory structure. It remains unclear, though, how moderates will come down on this new amendment. Though the Tuesday Group co-chair was essential in crafting this compromise, some moderate members of the House have expressed concerns that limited waivers allow states to take steps that will lead to a greater number of uninsured people or cause those insured under Obamacare to lose coverage

Conservative Review

" ... But now the focus is on liberal Republicans. Several reports, released hours after the new compromise was announced, noted how some ‘moderates’ are starting to balk at the amendment.

One Tuesday Group member told POLITICO that several in the caucus are “pretty hot right now” about the measure, alleging that co-chair Tom MacArthur, R-N.J., — who helped author the deal — “is kind of on his own” in supporting it. Meanwhile, co-chair Charlie Dent, R-Penn., has spoken out against the amendment and publicly denied his support along with Dan Donovan, R-N.Y., Ileana Ros-Lehinten, R-Fla., and Frank LoBiondo, R-N.J., The Atlantic reports.

The split within the Republican caucus is pretty simple to understand. There are those who want to follow through on the unifying message of repealing Obamacare and those who don’t. The doers in the equation stopped a measure that would have been disastrous for the GOP and helped guide the final product to something that — while it doesn’t repeal the 2009 law — is much closer to that goal. Now the question is how leadership will deal with its new crowd of obstructionists. ..."

"... The proposal, he (Rep Mark Sanford) said, would let states like Vermont pursue a bigger government role in health care and let his own state execute a more “market-based” system. ..."

FreedomCaucus Tried Its Best, But Obamacare Bill Is Still Lousy


First, it’s important to remember that the proposed amendment is not a replacement of the original bill, it is added to the original RINOcare bill. Therefore, it still maintains Medicaid expansion and the entire premise of subsidies for the middle class, which distort the market. In terms of Obamacare’s regulations, the bill still maintains every morsel of the ACA and its exchanges. What the amendment does is grant states the opportunity to request a waiver from HHS from some of the regulations — community rating and essential health benefits — if they register in the federal high risk pool program funded in the broader bill or implement their own risk pool to deal with the chronically ill.

To be clear, the regulations would not be statutorily repealed and would remain on the books, but HHS would have the option of granting reprieve in some form upon request.

Some supporters are messaging this bill as de facto full repeal of Obamacare for red states and a laudatory exercise in federalism. While probably the best we can get from an irremediably broken Republican Party, this bill falls far short for a number of political and policy reasons:

  1. It proves Speaker Paul Ryan, R-Wisc., was lying all along: