On Thursday, the world will watch if US President Donald Trump's efforts to roll back Obamacare is successful. A newly revised legislation will come up for vote in the House of Representatives, and there is optimism among the president's aides; House majority leader Kevin McCarthy expressed confidence the bill would pass, while several moderate Republican lawmakers who previously objected to the bill said they could now support it.
Keen to score his first major legislative win since taking office in January, Trump threw his own political capital behind the bill, meeting with lawmakers and calling them in an effort to cajole their support. Trump is seeking to make good on his campaign promise to repeal and replace Obamacare. Aides said he worked the phones furiously.
A report on CNN said Trump committed to backing an amendment spending $8 billion over five years to fund high-risk pools and go toward patients with pre-existing conditions. In a search for votes, the focus has been almost entirely on moderate lawmakers who were hitherto concerned that the bill will erode too many protections in the Affordable Care Act. Democrats, however, will make the case the bill is far too extreme, no matter what tweaks are made in the end.
The report mentioned White House Chief of Staff Reince Priebus saying he is "optimistic about the outcome".
Wavering moderate Republicans had worried that the legislation to overhaul President Barack Obama's 2010 signature healthcare law would leave too many people with preexisting medical conditions unable to afford health coverage.
The compromise proposal
But several Republican sceptics got behind the bill after they met with Trump to float a compromise proposal that is still expected to face unanimous Democratic opposition. The legislation's prospects brightened further after members of the Freedom Caucus, a faction of conservative lawmakers in the House who played a key role in derailing the original version of the bill last month, said they could go along with the compromise.
The key amendment was pushed forth by senator Fred Upton, former chairman of the House Energy and Commerce Committee, and an experienced health care legislator. As reported by Vox, Upton was in the White House on Wednesday, and said he worked on the amendment since Monday. It may have been his conversion that persuaded enough wavering Republicans to come onboard.
The earlier proposal
Before Upton came out with his revised version of the bill, the MacArthur amendment had given states the option of opting out of certain insurance reforms, including the requirement that health plans cover essential medical benefits and the ban on charging customers higher premiums if they have pre-existing conditions.
The hardline conservative House Freedom Caucus was quoted as saying by CNBC: "The MacArthur amendment will grant states the ability to repeal cost driving aspects of Obamacare left in place under the original AHCA. 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."
Opposition from the House Freedom Caucus was cited as among the main reasons that President Donald Trump failed to repeal the American Healthcare Act on 24 March. As reported by The New York Times, the Republican bill would have repealed tax penalties for people without health insurance, rolled back federal insurance standards, reduced subsidies for the purchase of private insurance and set new limits on spending for Medicaid. The bill would have repealed hundreds of billions of dollars in taxes imposed by the Affordable Care Act and would also have cut off federal funds to Planned Parenthood for one year.
House Speaker Paul Ryan had said the bill included "huge conservative wins". But it never won over conservatives who wanted a more thorough eradication of the Act. Nor did it have the backing of more moderate Republicans who were anxiously aware of the Congressional Budget Office’s assessment that the bill would leave 24 million more Americans without insurance in 2024, compared with the number who would be uninsured under the current law.
What comes next
However, even if the bill is passed on Thursday, it will have a steep uphill climb in the Senate, where even a few defections could kill the effort. Democrats have also long thought their best chance of stopping the repeal would be in the Senate.
Furthermore, Democrats are also quietly optimistic from the difficulties in the House, that Republicans would face a major backlash from voters ahead of the 2018 mid-term elections, and may end up losing seats.
With inputs from Reuters
Updated Date: May 04, 2017 12:22 PM