With Upton backing, Thursday vote set on health care

Washington — Southwest Michigan U.S. Rep. Fred Upton has crafted an amendment for the GOP health care overhaul bill that House leaders hope will get them enough votes to break a logjam and pass the measure.

The U.S. House will vote Thursday, Majority Leader Kevin McCarthy telling reporters “yes” when asked late Wednesday if Republicans have sufficient votes on the bill.

Upton and other Republican House members gained the backing of President Donald Trump for the changes during an hour-long meeting Wednesday morning at the White House.

The St. Joseph Republican said he read back to Trump a statement that the president had made that the GOP bill would be just as strong on protecting individuals with preexisting conditions as the Affordable Care Act.

“I want him to keep that pledge,” Upton said outside the West Wing after the meeting. “This amendment allows that to happen and cover those who otherwise might have been excluded.”

Upton, who chaired the House Energy and Commerce Committee until January, said his amendment would provide $8 billion in additional money directly into high-risk pools in states that seek a waiver from federal health care regulations under the legislation.

The underlying bill already includes $130 billion for such assistance for costly insurance premium charged to people with preexisting conditions, who are more expensive to insure. Under current law, insurers must charge healthy and seriously ill customers the same rates.

“It’s our understanding that the $8 billion over the five years will more than cover those who might be impacted, and as a consequence keeps our pledge for those that would in fact otherwise be denied because of preexisting illnesses,” said Upton, who in recent years co-wrote bills to repeal former President Barack Obama’s health care law.

“Our understanding is this money will put downward pressure on what premium increases are there.”

Opponents say the GOP bill effectively denies coverage by letting insurers charge the seriously ill unaffordable prices in certain states. They point out that high-risk pools have a mixed record because government money financing them often proves inadequate.

“Now, President Trump and Republicans are twisting arms trying to make a deal to get their terrible health care bill through,” Rep. Dan Kildee, D-Flint Township, said on the House floor.

“No one should be fooled by this last-minute, ditch effort to put some money on the table — as if it’s enough to provide support for preexisting conditions. Let’s be clear: This change eliminates the guarantee that you can get coverage if you have any sort of preexisting condition.”

Other critics noted that, just Tuesday, Upton had told reporters that “more money does not do the trick” concerning the high-risk pools.

Vote getting close

House Speaker Paul Ryan praised the proposal and said the GOP was getting “extremely close” to finally being able to pass the stalled legislation.

White House Press Secretary Sean Spicer said the Upton-sponsored changes helped bring “even more people into this effort and make it an even stronger bill” by providing an “extra layer of protection” for people with preexisting conditions.

But the White House cannot guarantee that $8 billion would be enough to cover premium increases for those with preexisting conditions in affected states, Spicer said.

“There are so many variables that are unknown that to make an analysis with that level of precision seems almost impossible,” he said. “For someone to know how many people that is, how many states are going to ask for and receive a waiver, is literally impossible at this point.”

Upton said he had spoken several times with Michigan Gov. Rick Snyder, including on Wednesday morning, and that Snyder indicated Michigan does not intend to seek a waiver from the coverage protections in current law.

Oregon Rep. Greg Walden, who now chairs the Energy and Commerce Committee, said the amendment language is targeted at the “very, very narrow” group of people with preexisting conditions who might be affected in states that seek a waiver.

“Upton, Long and others put together ideas embraced by all sides and endorsed by the president,” Walden said.

Upton had called Trump on Tuesday afternoon to say he could not support the bill because it didn’t guarantee protections for those with preexisting conditions.

Upton drafted the amendment language later Tuesday, saying he would support the underlying bill with its inclusion, as would GOP Rep. Billy Long of Missouri, who had also come out against the legislation.

The White House meeting included Trump and Upton, along with Walden, Long and Republican Michael Burgess of Texas.

“I commend Reps. Fred Upton and Billy Long for their efforts to bring our conference together and reaffirm our commitment to providing protection and certainty for patients with pre-existing conditions,” Walden said in a later statement.

Weeklong break on tap

The White House meeting and Ryan’s optimism followed weeks during which House leaders lacked the votes to repeal major elements of President Barack Obama’s health care law. House leaders are trying to create momentum to pass the legislation before the House breaks Friday for a weeklong recess.

The office of Rep. Jack Bergman, R-Watersmeet, said Tuesday that he was undecided. He has co-sponsored a bill to remove language from the legislation seeking to preserve Affordable Care Act coverage protections for members of Congress and their staffs if states were to waive them.

The office of Rep. Justin Amash, R-Cascade Township, said he remained undecided Wednesday. The other six Michigan House Republicans supported the original health overhaul legislation.

The health care measure would let states get federal waivers for insurers to charge higher premiums to people with preexisting illnesses who’d let their coverage lapse. To get the waiver, the state must have a high-risk pool or another mechanism to help such people afford a policy.

The American Medical Association said Upton’s amendment would not remedy the shortcomings of the GOP bill, noting that 35 states operated high-risk pools before Obamacare became law.

“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,” AMA President Andrew Gurman said in a statement. The American Health Care Act not only would “eliminate health insurance coverage for millions of Americans, the legislation would, in many cases, eliminate the ban against charging those with underlying medical conditions vastly more for their coverage.”

An initial health care bill failed to get a prescheduled vote in March because of opposition from Freedom Caucus conservatives such as Amash, and some moderate Republicans. The overall bill would cut Medicaid, repeal tax boosts on higher-earning people, eliminate Obama’s fines on people who don’t buy insurance and give many of them smaller federal subsidies.

Associated Press contributed.