The American Health Care Act might not be dead after all — at least not entirely.
The Obamacare repeal-and-replace plan failed to get enough support in the House of Representatives for Speaker Paul Ryan (R-WI) to hold a vote on it. But its most vocal critic, conservative Freedom Caucus Chair Rep. Mark Meadows (R-NC), now says the American Health Care Act is still a viable vessel for health care reform.
“You have to make the assumption that the speaker put out a plant that was agreed to by the majority of the majority,” Meadows told reporters Wednesday. “To modify that is a better starting point than most.” As of last Friday, Meadows was a “no” vote on AHCA, along with more than two dozen other Republicans, many of them from the Freedom Caucus.
House Republicans have quietly continued negotiations on health care reform this week. But the belief was that AHCA was “dead,” as Rep. Greg Walden (R-OR) said after Ryan was forced to pull the bill from the floor last Friday.
On Wednesday, Republicans began hinting the opposite. White House press secretary Sean Spicer said Republicans were “starting with where we are and trying to move that forward” — a sentiment Meadows said was “prudent.”
But Meadows is operating on a shaky assumption: that AHCA has the support of a majority of Republican legislators. House Republicans were more unified behind AHCA before Meadows and the Freedom Caucus got involved in negotiations.
AHCA put House Republicans in a Catch-22
The original version of the American Health Care Act would have caused 24 million people to lose coverage by 2026, according to a nonpartisan analysis from the Congressional Budget Office. For the Freedom Caucus, the problem was that it didn’t do enough to repeal Obamacare, which they wanted entirely gutted.
But the more House leadership and the White House gave in to the Freedom Caucus’s conservative demands on the health bill, the less popular the bill became with other members of Congress.
By Friday afternoon, it became clear that if AHCA were given a floor vote, it would lose. It was a Catch-22, said Rep. Chris Collins (R-NY).
“For every vote you pick up on the right, you lose two on the left; for every vote you pick up on left, you lose two on the right,” Collins said during the height of negotiations last week. “This is the sausage making of compromise ... there is nothing you can do to help the right that doesn’t lose on the left, and vice versa.”
Speaker Ryan made large concessions to the bill, to try to appease the party’s most conservative faction, but still the party’s conservatives could not get on board, and the amendments lost votes among the party’s more moderate members.
At the time, Collins, a close ally of President Donald Trump, said any changes to AHCA would have this effect: “I will just say rhetorically, what changes between tomorrow and another day? And the answer is nothing. The answer is nothing.”
Meadows, however, has changed his tune. He is making the case that the Republican Party is more unified on the policy provisions than last week.
“I think it’s possible to get to a solution in the next hour,” he said when asked if House Republicans could strike a deal by next week. “The differences are not that different policy-wise. It’s more political in nature.”
But Meadows refused to give details on any policy specifics that would go into that solution.