Only two weeks after appearing to concede defeat on the issue, a group of Republicans are continuing to try to reach a deal to repeal the Affordable Care Act.
Members of the House Freedom Caucus, the group of hardline conservatives who were nearly united in their opposition to the health care bill backed by President Trump and Speaker Paul Ryan, are in talks with administration officials over the types of changes they would need to see to the bill in order to support it.
“No one made any definitive changes in terms of moving from ‘no’ to ‘yes,’ primarily because there’s not enough detail to do that, but I can tell you that all the ‘nos’ — every one of the ‘nos’ — expressed a willingness to look at this in a very detailed manner,” Rep. Mark Meadows, R-N.C., the chairman of the Freedom Caucus, tells Politico.
According to Meadows, the proposal they are pondering would allow states to opt out of certain parts of the ACA, such as the requirement that health plans provide a minimum certain level of coverage and the prohibition on charging customers different rates based on pre-existing medical conditions.
Sen. Rand Paul, R-Ky., one of the most vocal critics of the American Health Care Act, has floated a compromise that he said might be able to garner support from conservatives and moderates alike.
He suggested a bill that would maintain some subsidies for individuals to buy health insurance, but at lower levels than currently offered by the ACA.
However, Paul has not commented on how a potential compromise would affect Medicaid or whether the current federal and state health insurance marketplaces set up through the ACA would continue.
The dilemma the White House faces is that any changes it makes to win over support from the party’s most conservative members may further damage the bill’s standing among moderates.
In particular, some moderate Republicans from states that accepted the ACA’s Medicaid expansion do not want to see the major coverage gains from that policy reversed.
However, Freedom Caucus members are vehemently opposed to the Medicaid expansion, and want to see it scrapped entirely.
Barring insurers from discriminating based on pre-existing conditions is one of the most popular provisions of the ACA. Trump himself repeatedly promised during his campaign that he would maintain the protection.