WASHINGTON ― As Senate GOP leadership tries to bring conservatives on board with their health care bill, House conservatives are working to reinforce the far right’s negotiating position, signaling they won’t support the Senate legislation without changes.
Freedom Caucus Chairman Mark Meadows (R-N.C.) told reporters Monday night and Tuesday morning that there would not be enough votes in either chamber to pass the Senate legislation “without significant amendments.”
“This bill, in its current form, would lose significant conservative votes, which would make it almost impossible to pass,” Meadows said late Monday.
By Tuesday morning, Meadows pointed to two amendments from Sen. Ted Cruz (R-Texas) that “if adopted, would go a long ways to make us get where we need to be in the House and the Senate.”
This bill, in its current form, would lose significant conservative votes, which would make it almost impossible to pass. Freedom Caucus Chairman Mark Meadows (R-N.C.)
The first amendment would allow insurers to offer plans that don’t comply with Obamacare regulations ― like the mandate that plans include 10 “essential health benefits,” or that insurers not charge people with pre-existing conditions more ― as long as insurers offered at least one plan that did comply with the Affordable Care Act regulations.
The effect of that amendment would be healthier people signing up for those noncompliant plans, bringing down the cost for them (perhaps for skimpier coverage) but driving up the costs for sick people. In effect, an insurer could offer unreasonably priced plans for people with pre-existing conditions and then make their money by selling plans with limited coverage to healthier people. The amendment would also likely have the effect of bringing much higher prices to women seeking coverage with maternity care. The Congressional Budget Office projected in the House health care bill that maternity care would be sold as a rider policy and would cost women more than $1,000 a month, in addition to whatever other health care plan they selected.
The other amendment would expand Health Savings Accounts, which are tax-free accounts meant to help people pay high deductibles, expensive medical treatment and costs not covered by medical insurance, such as dental and vision care. The idea, popular among conservatives, is to introduce some market forces into health care and make people more cost-conscious.
Meadows and other conservatives aren’t happy with the Senate bill. It undid some of the major changes they demanded, particularly allowing states to opt out of regulations that ensure that sick people are not charged more than healthy people.
Meadows had previously quietly signaled that he and most other conservatives in the Freedom Caucus would accept what came out of the Senate. They still might, should Senate Majority Leader Mitch McConnell (R-Ky.) miraculously be able to move the bill without changes. But Meadows’ new position reflects a reality that McConnell doesn’t have the votes at the moment, and changes are expected.
Conservatives are angling to make sure that the changes McConnell makes appease them rather than moderates, and Meadows’ new posturing might just help conservatives make the case that their direction is ultimately the only one that works.
Meadows and other conservatives could set up an irreconcilable disagreement between the House and Senate, particularly if they insist on undermining those pre-existing conditions protections and McConnell insists on keeping them.
That all assumes McConnell can get the bill out of the Senate and doesn’t make the changes that conservatives want. For now, conservatives in both chambers are watching to see what amendments McConnell makes to the bill.
McConnell met with Cruz on Tuesday morning, but both sides were cagey about what progress they had made. Prior to that meeting, McConnell and other Senate GOP leaders had avoided negotiating with conservatives like Cruz and Sen. Rand Paul (R-Ky.). Meadows called that position “troubling.”
“If there are no discussions going on now, that means there will be no amendments,” he said. “And if there are no amendments, that means there will not be the votes there to pass it in the Senate or the House.”