House Republicans have signaled they are inching toward enough votes to advance the American Health Care Act after inserting a change that would allow states to waive the federal requirement that insurance companies not discriminate against buyers with pre-existing conditions. One provision in the amendment would also exempt members of Congress from being impacted by this potential law.
The amendment was negotiated between Republican Rep. Tom MacArthur of New Jersey and the House Freedom Caucus, a conservative wing of the chamber whose dissatisfaction with the original AHCA had contributed to that bill failing to pass in March, CNN reports.
The changes would enable states to become exempt from an Affordable Care Act's ban on insurance companies charging higher premiums for those with pre-existing conditions or the requirement to cover maternity care and mental health services. GOP lawmakers have expressed optimism that the amendment would help the AHCA reach the 216 votes necessary to pass in the House.
"I think it's very constructive," said Republican House Speaker Rep. Paul Ryan of Wisconsin, according to The Washington Post. "What we see is progress being made, showing that we're moving and getting on the same page."
Embedded in the language of the amendment is a provision that would exempt members of Congress and their staff from any state waiver, meaning their premiums would not go up even if they had pre-existing conditions and lived in a state that waived the ACA requirements, Vox reports.
The language of the provision is subtle but had been noticed by health law professor Tim Jost. Under the ACA, also known as Obamacare, members of Congress were required to buy their insurance through the marketplace through section 1313(d)(3)(D).
The amendment states "In no case may a waiver ... apply with respect to any of the following provisions ... Sections 1312(d)(3)(D)."
On April 26, the Democratic House Minority Leader Rep. Nancy Pelosi of California, blasted her GOP colleagues for exempting themselves from the AHCA amendment.
"The monstrous immorality of TrumpCare is perfectly encapsulated in House Republicans' plan to exempt their own health coverage from the damage it will do to everyone else," Pelosi said of the AHCA, sometimes called TrumpCare. "If House Republicans are afraid of TrumpCare for themselves, they have no right to force it on hard-working American families."
Republican Rep. Scott Perry of Pennsylvania has called for the provision to be removed.
"We need to ensure that Congress doesn't get some special exemption," Perry said. "Congress can't impose upon the people of the United States things that it is unwilling to have imposed on itself."
The House Freedom Caucus has endorsed the amendment, with one member suggesting the AHCA will not pass if any more changes are made.
"If they make any big changes, I don't think that goes over too well," said Republican Rep. David Brat of Virginia.
MacArthur spokesperson Camille Gallow has released a statement asserting that he wants the provision to be removed.
"Congressman MacArthur does not believe Members of Congress or their staff should receive special treatment and is working with House Leadership to make absolutely clear that Members of Congress and staff are subject to the same rules, provisions, and protections as all other Americans," Gallow said, according to The Hill.
On April 26, a Washington Post-ABC News poll found that 70 percent of national adults want pre-existing conditions protections to apply nationwide while 26 percent believed it should be left for individual states to decide.