Republican Rep. Fred Upton of Michigan said he will not vote for the latest version of the Republican plan to replace the Affordable Care Act because it allows states to exempt themselves from requiring insurance companies to cover people with pre-existing conditions.
"I’m not at all comfortable with removing that protection. I’ve supported the practice of not allowing pre-existing illnesses from being discriminated against from the very get-go," Upton said in the interview with WHTC, according to The Hill. "This amendment torpedoes that. And I told leadership I cannot support this bill with this provision in it."
"It’s not going to get my yes vote the way it is," he added.
The Hill reported that Upton's "no" vote would bring the total number of dissenting Republicans to 22, which is just one shy of enough to cause the measure to fail and give the GOP another loss in its effort to replace the Affordable Care Act.
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But some GOP leaders are trying to remain optimistic about winning enough support from their own party to push the health care legislation through.
"Right now we know we’re in a stronger position than we were, but we don’t know for sure if we have the votes," said Republican Rep. Tom Cole of Oklahoma, according to Bloomberg.
The new Republican health care legislation, the American Health Care Act, technically requires that health insurance companies cover people with pre-existing conditions.
However, lawmakers inserted the MacArthur amendment, named after its author, Republican Rep. Tom MacArthur of New Jersey, which allows states to apply for waivers from the rule and essentially opt out, giving insurance companies the freedom to deny coverage to anyone who already has a medical condition, according to CNN.
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Despite the MacArthur amendment, Trump has insisted numerous times that the new health care legislation covers pre-existing conditions.
"We have now pre-existing conditions in the bill. We have -- we've set up a pool for the pre-existing conditions so that the premiums can be allowed to fall," he said.
MacArthur, a former insurance industry executive, defended his amendment in an interview with CNN where he said the amendment is necessary to protect the insurance industry, despite the popularity of requiring health insurance providers to cover people with pre-existing conditions.
"People like that and I like that too. It is critical," he said. "What a lot of people don't see [is] -- and after a lifetime in the insurance industry -- I see this system crumbling."
He added: "We have tens of millions of people who cannot afford insurance. We have to do both. But to make one group to pay unaffordable premiums is not the right answer."