The American Health Care Act is doomed because for seven years Republicans have been making impossible promises about making health care more affordable for everyone, though they oppose taking money from wealthier people to make that possible. Now that they actually have the opportunity to get rid of Obamacare, the most conservative Republicans are determined to completely repeal this redistribution, while GOP moderates harbor concerns about making millions of sick and poor people lose their health insurance.
With AHCA’s future looking very uncertain heading into Thursday’s House vote, on Wednesday night GOP leaders offered a big concession to conservatives: eliminating the essential health benefit requirements for insurance. This would give healthy people the freedom to buy cheaper, skimpier health plans, and drive up costs for people who want luxuries, like coverage for maternity care, pediatric services, and hospitalization.
Representative Mark Meadows, chairman of the House Freedom Caucus, said the three dozen conservatives in the group were “encouraged” by this development, but it wasn’t enough to get them to commit to supporting the bill. They’re pushing to repeal Obamacare’s popular protection for people with preexisting conditions as well (though as New York’s Jonathan Chait notes, eliminating essential benefits would make those protections meaningless anyway).
Republicans can only afford to lose 21 House votes, and at the end of the night Freedom Caucus spokeswoman Alyssa Farah signaled that the group may still tank the bill.
Meanwhile, moderates were infuriated that GOP leaders offered to make AHCA even more toxic, and all they got in return was a “maybe.” Following a two-hour meeting with House leakers on Wednesday night, Representative Charlie Dent, who leads the moderate Tuesday Group, announced that he will not back the bill.
“After careful deliberation, I cannot support the bill and will oppose it,” Dent said. “I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals.”
“Everybody’s frustrated,” one lawmaker in the meeting told Politico. “Some moved; some stayed the same.” They clarified that moderates were only moving away from supporting the bill.
Those opposing Trumpcare got a powerful offer of support on Wednesday night when advocacy groups led by the Koch brothers said they were setting aside a “seven-figure” fund that will only be available to Republicans who vote against the bill. (Other funds will still be available to those who vote “yes.”) Unlike Dent, the Koch brothers think AHCA doesn’t go far enough.
The move could counteract President Trump’s threats that he’ll be “coming after” Meadows and others who oppose AHCA during the midterms. Then again, there may not be a safe move for House Republicans, as Democratic Representative Ted Lieu reminded them: