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Future of revamped health care bill remains dubious in House

21 April 2017

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But it's not clear there would be enough votes in the broader GOP House conference to pass the bill.

Under the amendment, health status is also up for an exception in states that establish a high-risk pool or are participating in a federal high-risk pool.

Eyeing his 100th day in office - which looms April 29 - President Trump tried to breathe new life into a proposed health care bill yesterday, hoping to put it on a fast track.

The important thing to understand is that the changes now under consideration are not motivated by a desire to improve the legislation.

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Republicans still might not have the votes. So, we still believe providing waivers at the state level from numerous Obamacare mandates that drive up costs might be a real path forward so I would say that conversations between moderates and conservatives are very constructive and it's been due in no small part to the active involvement of the White House and leadership in trying to make sure we get a good bill-a better bill-going forward over to the Senate.

The proposal is not much different than ideas discussed before Congress left town for its current two-week Easter recess and it's unclear whether it does enough to convince both moderate and conservative opponents to support the bill.

But the amendment also tries to win over conservatives in the House Freedom Caucus by giving states a way to opt out of some insurance regulations.

The prospect of the government shutting down around the 100-day milestone is not lost on White House and congressional officials. Plus, they aren't ready to move on a tax reform bill.

A White House official confirmed to CNN the administration is aiming to circulate legislative text on a health care replacement plan by Friday or Saturday, though exact timing is still fluid.

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Lawmakers in the centrist and conservative cohorts also want to shift the blame, either to the other group or, if they somehow pass something out of the House, to the Senate.

But a senior House Republican aide said that revised language for a bill hasn't been agreed on and there's no text yet for lawmakers to review. And there are real problems in the Obamacare marketplaces that need thoughtful solutions. "I wouldn't be surprised if they started to lose more moderates". While members are coming closer to a consensus, it appears leadership is still short on the votes needed to pass the bill. So moderates can claim they are protecting people with preexisting conditions.

"This effectively allows states to eliminate the ACA's guarantee of access to insurance at a reasonable price for people with pre-existing conditions, in the interest of lowering premiums for people who are healthy", Larry Levitt, senior vice president at the Henry J. Kaiser Family Foundation, said upon seeing a description of the proposal. But without those policies, prohibiting outright discrimination doesn't matter. First, the $15 billion would only lower annual premiums by about 1 to 2 percent each year. So people with conditions are at risk again.

States could request an exemption from the rule meant to ensure that people with pre-existing conditions could not be charged prohibitive premiums, but only if those states establish a high-risk insurance pool.

"People who want coverage for expensive benefits, such as substance-abuse treatment, might wait until they need the coverage to buy it", wrote Barro. The invisible high-risk pool was made of up individuals who had certain conditions that would have normally placed them in a regular high-risk pool.

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It's dizzying, I know.