Burlington County Times

Health Care Bill Revision Draws Mixed Reviews

Burlington County Times — April 27, 2017

By David Levinsky, staff writer

U.S. Rep. Tom MacArthur's amendment to revive the Republicans' stalled health care legislation drew closer to a possible vote Wednesday, even as it continued to draw fire from Democrats and progressive groups that claim it makes the original bill worse.

MacArthur, R-3rd of Toms River, introduced the amendment this week after spending most of the last month crafting it with input from Vice President Mike Pence and Rep. Mark Meadows, of North Carolina, chairman of the conservative House Freedom Caucus.

The so-called "MacArthur Amendment" to the American Health Care Act is intended to breathe life into the GOP's effort to overhaul former President Barack Obama's Affordable Care Act, after the party's first effort crashed and burned last month due to opposition from both conservative and moderate members of the party.

The amendment aims to flip some of the opponents with key changes to the original bill, among them giving states the option to seek a waiver from some, but not all, of the Affordable Care Act's insurance requirements and standards.

House Speaker Paul Ryan praised the amendment Wednesday, but stopped short of saying it has garnered enough votes needed to push the controversial legislation through the House. While there were indications that the revisions appeal to conservatives, there was little evidence that it was winning backing from moderates, leaving the measure's fate uncertain.

"We think it's very constructive," Ryan said of the proposed revisions. "I think it helps us get to consensus."

In a statement, the Freedom Caucus said Wednesday that it could support the proposal as amended by MacArthur.

"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 health care costs," the statement said. "We look forward to working with our Senate colleagues to improve the bill. Our work will continue until we fully repeal Obamacare."

MacArthur, who is cochairman of the centrist Tuesday Group caucus, said he was "cautiously optimistic" that his changes would move enough members that leadership will be comfortable bringing the bill back for a vote.

The former insurance executive addressed the entire Republican conference Wednesday, telling members that the amendment's goal was to give states enough flexibility to bring costs for health insurance down, while still protecting the most vulnerable residents.

"I respect that other people may see things differently, but I believe if we don't fix this soon, the individual marketplace will collapse and a lot of people will get hurt," he said.

His amendment would restore the ACA's essential health benefits and protections, such as the mandate that insurers provide coverage to people with pre-existing conditions and not discriminate against consumers based on gender. But it also would allow states to seek waivers from some of the coverage requirements and restrictions, provided they attest that the changes were intended to bring down the costs of health care or increase the number of people covered.

Among the most controversial provisions that states could potentially waive is the so-called "community rating" rule restricting insurers from charging higher premiums based on health status. MacArthur's amendment permits that rule to be waived if a state participates in a federal "high risk pool" for people with serious health conditions or creates its own high-risk pool with subsidies to help obtain affordable coverage.

MacArthur insists that people with pre-existing conditions would still be protected and able to obtain reasonably priced insurance coverage. He said the federal government was providing about $130 billion to aid people with health care costs, on top of $160 billion in assistance included in the original GOP bill.

"This is significant help from the federal government," he said.

Opponents countered that the amendment does little to address the original bill's faults and creates new problems.

"Tom MacArthur calls it a compromise, but it only makes the American Health Care Act worse," said Maura Collinsgru, a leader with the progressive advocacy group New Jersey Citizen Action, which has helped organize protests outside MacArthur's district offices in Evesham and Toms River.

Left-leaning think tank New Jersey Policy Perspective also criticized the amendment Wednesday, saying it would likely cause hundreds of thousands of New Jerseyans to lose insurance coverage.

Ray Castro, an analyst with the think tank, said the amendment's language mandating that people with pre-existing conditions can't be refused coverage means little if insurers are free to charge them more.

"They can't deny, but they can increase premiums to such a level that they won't be able to afford it," Castro said, adding that while the waivers are optional, states will be under pressure to seek them in order to keep the costs passed on to other consumers from skyrocketing.

Risk pools won't work unless they are adequately subsidized, which will be difficult because of the high cost of covering seriously ill patients, he said.

Opponents also jumped on language in the amendment that would guarantee that members of Congress and their staffers, who are required to obtain insurance from the same ACA marketplaces where individuals and small organizations shop, would continue to have access to plans with essential health benefits, even if they reside in states where those minimum benefits are waived.

The Democratic Congressional Campaign Committee planned to highlight the language in digital ads targeting MacArthur and other Republican lawmakers. "

Rep. MacArthur is leading the charge to remove protections for people with pre-existing conditions, which will go down in infamy as one of the most heartless acts of this Republican Congress. As proof of the repeal bill's devastating impact, Rep. Tom MacArthur is exempting himself from the punishment his own amendment will inflict on his constituents," DCCC spokesman Evan Lukaske said. "This digital ad campaign will educate voters in MacArthur's district about this morally bankrupt congressional carve-out."

Save My Care, an advocacy group that previously criticized MacArthur because of his support of the Republican legislation, also indicated it was planning more television advertising targeting the New Jersey congressman.

MacArthur said the exclusion was not intended, but was added to his amendment at the behest of the Senate Budget Committee so that the legislation would comply with its rules regarding reconciliation with an earlier budget resolution passed to avoid a Senate filibuster. He promised it would be removed with separate legislation at the same time the bill is brought to the House floor.

"Leadership has already committed to a fix. If we vote on health care, we'll vote on that at the same time. I'm personally committed to it," he said.

Collinsgru said the language was insulting to consumers.

"It just adds insult to injury to this whole mess," she said. "It sends the message that this may be good enough for you to swallow, but not good enough for (members of Congress)."

MacArthur said the technical language was unfortunate and added to the "noise" surrounding the controversial legislation, but he vowed to continue pressing for a solution.

"The anchor for me has always been that this is about people, not politics," he said. "Pm trying to bring my professional and personal experience to bear. And if we can fix the individual marketplace, it will help a lot of people."

The Associated Press contributed to this story.

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