Influential GOP moderate a 'no' on health care bill, offers revision for languishing measure

Associated Press

An influential Republican moderate who had announced his opposition to the party's health care bill said Tuesday he's crafting an amendment with the backing of GOP leaders that could gain crucial support for the languishing measure.

Rep. Fred Upton, R-Mich., said the proposal would provide $8 billion over five years to help people with pre-existing medical conditions pay their costly insurance premiums. It comes with many party moderates opposing the high-priority legislation, even as GOP leaders press holdouts to back it and push it through the House before the chamber begins a week-long recess scheduled to start Friday.

Upton described the plan to The Associated Press late Tuesday, hours after he revealed he was opposing the bill because it weakened insurance protections President Barack Obama's health care overhaul provides people with pre-existing illnesses. Republicans want to repeal much of that 2010 law.

The White House and congressional leaders are short of votes needed for House passage. Whether the new proposal would resuscitate the legislation was initially unclear.

Including Upton, The Associated Press has counted 21 GOP lawmakers opposing the Republican bill, one shy of the 22 needed to kill it, assuming all Democrats vote no. At least 11 others said they were undecided, but all the figures are subject to fluctuation as both sides lobby heavily.

Upton is a respected authority on health care who formerly chaired the House Energy and Commerce Committee. His views can be influential with many moderates.

The existing version of the health care legislation would let states get federal waivers allowing insurers to charge higher premiums to people with pre-existing illnesses who'd let their coverage lapse. That infuriated many moderates, who have promised to continue protections for such people. Under Obama's law, insurers must charge healthy and seriously ill customers the same rates.

The money in Upton's plan would help people with pre-existing illnesses pay premiums in states where insurers can charge them more. He said he was working on the proposal with Rep. Billy Long, R-Mo., another lawmaker who's said he opposes the GOP bill.

"It's not quite a done deed yet, but it addresses many of my concerns," Upton said.

The issue seeped into popular culture after late night talk show host Jimmy Kimmel delivered an emotional 13-minute monologue Monday describing the recent birth of his son, who had heart disease that required immediate surgery that proved successful. Kimmel said before Obama's law took effect, many such infants could die because they'd be uninsured due to their pre-existing conditions.

"If your baby is going to die and it doesn't have to, it shouldn't matter how much money you make," Kimmel said in comments viewed online by over 4 million people. "We need to make sure that the people who are supposed to represent us, people who are meeting about this right now in Washington, understand that very clearly."

The bill is a top priority for President Donald Trump and House Speaker Paul Ryan, R-Wis., since it embodies a long-standing GOP pledge to annul much of former President Barack Obama's health care law.

Despite White House prodding, House leaders have said a vote will occur only once they can succeed.

House passage would send the measure to the Senate. The bill's fate is uncertain there, but a more moderate measure it is widely expected to emerge there.

Earlier Tuesday, Upton had pointedly noted that the bill's language opening the door to higher premiums for people with pre-existing conditions was backed by the House Freedom Caucus, whose deeply conservative members mostly support the legislation.

In a radio interview earlier on "WHTC Morning News" in Holland, Michigan, Upton made similar remarks and said "a good number of us have raised real red flag concerns" with leaders.

A senior Trump adviser said the White House counts them five votes short on the bill, which he said could drop to zero or grow to 15. The official signaled that the White House would blame GOP leaders for falling short, saying "Let's see if the hill can deliver."

Ryan said leaders are "making very good progress," but other Republicans voiced pessimism.

Rep. Chris Collins, R-N.Y., a Trump ally who supports the legislation, said GOP lawmakers were worrying that Democrats could use the pre-existing condition issue for damaging if inaccurate attack ads in next year's congressional elections.

"In the last 24 hours, things have moved in the negative direction," Collins said of the bill's support.

Under the revised GOP bill, states obtain waivers to raise premiums on people with pre-existing illnesses must have a high-risk pool or another mechanism to help such people afford a policy.

The bill's supporters say it protects those with pre-existing conditions and that the exclusion would affect only some of them.

Opponents say it diminishes their protections by letting insurers charge unaffordable prices. They say high-risk pools have a mixed record because government money financing them often proves inadequate.

The bill would let states get waivers to Obama's requirement that insurers cover specified services like preventive care and would let them make premiums on older people more than five times higher than for younger ones.

Associated Press reporters Julie Pace, Mary Clare Jalonick and Jill Colvin contributed to this report.

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