The stubbornly ideological members of the House Freedom Caucus found a way to say yes to President Donald Trump's second attempt to overhaul Obamacare weeks after the ultraconservatives helped sink his first one.
But by negotiating the bill even further to the right, the caucus may have created a bill anathema to more moderate Republicans, many of whom were already uneasy with Trumpcare 1.0.
The Freedom Caucus, a group of about three dozen House Republicans, announced Wednesday afternoon that the majority of members would support the compromise amendment brokered by caucus chairman Mark Meadows of North Carolina and Tom MacArthur of New Jersey, a co-chairman of the House's more moderate Tuesday Group.
"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," the Freedom Caucus said in a statement. Conservative groups Club for Growth, FreedomWorks, and Heritage Action, who opposed the initial reform plan, also announced they would also support this one.
The proposed Obamacare replacement would permit states to opt out of Obamacare regulations that make insurance companies cover people with pre-existing conditions and procedures deemed "essential health benefits." States would create high-risk pools to provide coverage for those with pre-existing conditions, but it's unclear if those pools would be properly funded or save money compared to the current system. States would also have to propose an alternative system that would lower premiums, increase the number of insured people, or foster more competition among health insurance companies — an ambiguous goal.
Allowing states to remove protections for pre-existing conditions would break Trump's long-standing promise to keep the popular provision. That fact, along with the possible removal of the essential health benefits, which include things like maternity and ambulatory care, may alienate too many moderate Republicans to guarantee passage of a new bill.
Although MacArthur is a co-chair of the Tuesday Group, he has largely been negotiating with the Freedom Caucus on his own. Many of his members have already said no to or are being silent about the bill, perhaps hopeful they will not have to take a public position. MacArthur's fellow Tuesday Group co-chair Charlie Dent of Pennsylvania not only opposes the new bill, he told Buzzfeed News it was "simply a matter of blame-shifting and face-saving."
The Freedom Caucus bore the brunt of the blame from both Republican House leadership and Trump for the failure in March of the first health care proposal. Trump sent out several tweets attacking members and privately had his budget director threaten Rep. Mark Sanford of South Carolina with a primary challenge.
Members of the Freedom Caucus chafed at Trump's criticism, especially since many moderates also opposed the legislation, which had a meager 17 percent approval rating at the time, according to a Quinnipiac poll. If this new compromise is ultimately sunk by the Tuesday Group, however, it may be the target of Trump's next tweetstorm.
Topics: health care