The House of Representatives is expected to vote Thursday morning on the revised GOP health care bill after a new amendment secured at least two additional votes for the stalled legislation on Wednesday.
But the House vote is expected to be very close. If all Democrats vote against the bill as expected, the legislation would fail if just 22 Republicans vote against it. The Associated Press estimated that 21 Republican lawmakers now oppose it. Congress will recess for two weeks beginning on Thursday.
The fortunes of the beleaguered American Health Care Act changed on Wednesday when Reps. Fred Upton of Michigan and Billy Long of Missouri voiced their support for the bill after meeting at the White House with President Donald Trump.
Upton and Long had previously opposed the legislation. Their amendment would add $8 billion to a proposed $115 billion pot of money that states could use to fund high-risk pools to provide health coverage for people with expensive medical conditions.
The GOP legislation to replace the Affordable Care Act would steer people with costly medical conditions who haven’t maintained continuous individual coverage into the high-risk pools in order to lower premiums for other plan members.
But a new analysis by the liberal Center for American Progress estimates the new amendment would subsidize care for only 76,000 more people out of millions who have pre-existing medical conditions. The money would fill only 4 percent of the shortfall in funding needed to sustain the pools, according to the analysis.
In a statement Wednesdsay evening, House Democratic Whip Steny Hoyer said “no number of amendments can fix this terrible bill – it is irredeemable.”
House Minority Leader Nancy Pelosi blasted the GOP for forcing a vote without waiting for a cost and impact analysis by the Congressional Budget Office. Doing so shows Republicans are "terrified of the public learning the full consequences of their plan to push Americans with pre-existing conditions into the cold," Pelosi said.
Similar conerns have kept Republican moderates from supporting the GOP legislation. It’s unclear whether the Upton and Long amendment will change their minds.
Rep. Walter Jones, R-N.C., who has opposed the bill for two months, said the new amendment had done nothing to sway him.
“It’s a bad bill. I think it would be a bad bill, should it pass or fail,” he said Wednesday.
Jones said fellow Republicans were “panicky” about showing they had enough votes for passage.
“Anytime you get panicky, you start making little tweaks to make people happy. Then what in the hell do you have when it’s all said and done? Nobody knows,” Jones said.
The legislation was pulled from the House floor for lack of support only minutes before a scheduled vote in March. Health care advocates say they still can’t support the amended legislation.
“None of the legislative tweaks under consideration changes the serious harm to patients and the health care delivery system” that would occur if the bill passes,” said a statement from Dr. Andrew W. Gurman, president of the American Medical Association.
Dr. Gurman said the proposed changes to the bill “tinker at the edges without remedying” the legislation’s fundamental failing: “that millions of Americans will lose their health insurance as a direct result of this proposal.”
Greg Walden, R-OR, the House Energy and Commerce Committee chairman, disagreed.
“This amendment is an important step that dedicates even more funding to reduce premiums or other out-of-pocket costs for these patients and decidedly improves the American Health Care Act,” Walden said in a statement.
Gurman said the “history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class health care coverage – if they are able to obtain coverage at all.”
The Republican health care legislation has been widely criticized for weakening consumer protections in Obamacare, slashing funding for Medicaid and leaving 24 million people without health insurance by 2026. It was pulled from the House floor for lack of support only minutes before a scheduled vote in March.
This week, 10 patient advocacy groups, including the American Diabetes Association, the March of Dimes and the American Lung Association, reiterated their opposition to the measure. No patient group, medical organization or hospital group has voiced support for it.
The legislation was languishing until another proposed amendment by Rep. Tom MacArthur, R-N.J., revived it. MacArthur’s proposal would allow states to escape an ACA requirement that individual insurers cover 10 “essential” health benefits. The amendment also lets states bypass ACA rules that ban individual insurers from charging higher rates to people with pre-existing medical conditions.
But after securing Upton’s and Long’s new support for the legislation, Vice President Mike Pence traveled to Capitol Hill on Wednesday afternoon hoping to convert other Republican moderates who were undecided or opposed to it.
Trump has been pushing for a House vote on the health care bill this week before the House begins a two-week recess.