Republicans are trying once again to repeal the Affordable Care Act and replace it with something more to their liking, with the hopes that a new, slightly tweaked proposal will close the rifts that made their first effort crash and burn, according to Politico
. This is evident in the authors of the proposed changes: Reps. Tom MacArthur (R-NJ), co-chair of the more moderate Tuesday Group, and Mark Meadows (R-NC), who heads the Freedom Caucus. The tentative deal, called the MacArthur Amendment to the American Health Care Act, would:
* Reinstate the essential health benefits as federal standard, which was a sticking point for the more conservative Freedom Caucus members;
* Maintain the prohibition on denying coverage for preexisting medical conditions, the prohibition on gender discrimination in health insurance, the guaranteed issue of coverage to all applicants, the guaranteed renewability of coverage, the coverage of dependents on parents' plans up to age 26, and community rating rules (except for limited waivers).
* Allow states the option of obtaining Limited Waivers from the federal standards on essential health benefits, community rating rules (except for gender, age and health status), provided states attest that they are requesting the waiver to reduce premium costs, increase the number of persons with healthcare coverage, or advance another benefit to the public interest in the state.
The exceptions for gender, age and health status in the community rating rules will, themselves, have exceptions. States can get waivers on age for reducing the 5:1 age ratio, and can get waivers on health status if the state has established its own high risk pool or is participating in a federal high risk pool.
The changes to the health bill would secure 25 to 30 "yes" votes from the Freedom Caucus, getting it very close to the required 216 votes needed to pass, according to CNBC
. A vote has yet to be scheduled.