As Capitol Hill faces the looming threat of government shutdown this Friday, House leadership continues to wrangle over changes to the American Health Care Act in an attempt to develop a compromise to unite the opposing factions of the Republican party. As of later this morning, top Republicans seem to have settled on something that will please at least the more conservative wing in the House: the Meadows-MacArthur Amendment.
The amendment, described in more detail last week at NRO, offers states limited waivers to opt out of parts of the AHCA, including essential health benefits and some community-rating rules. This compromise is the outgrowth of the efforts of representatives Tom MacArthur, co-chairman of the moderate House Tuesday Group, and Mark Meadows, chairman of the hardline conservative House Freedom Caucus (HFC) to reconcile the two halves of the party on health-care reform.
So far, a number of right-wing groups, including the Club for Growth and Heritage Action, have hailed the amendment as a step in the right direction toward lowering premiums and allowing for greater choice in the health-care market.
More importantly, the amendment has gained enough support from members of the HFC to garner the caucus’s official support, meaning that at least 80 percent of its members will vote for the AHCA if this amendment is attached. This is a key step in the negotiation process, as the HFC holds votes crucial to passing any party-line bill in the House, and most of its members were unhappy with the first draft of the AHCA because it left intact much of Obamacare’s regulatory structure.
It remains unclear, though, how moderates will come down on this new amendment. Though the Tuesday Group co-chair was essential in crafting this compromise, some moderate members of the House have expressed concerns that limited waivers allow states to take steps that will lead to a greater number of uninsured people or cause those insured under Obamacare to lose coverage.