Wednesday, April 26, 2017 | 9:09 a.m.
WASHINGTON — A proposal to revive the stalled Republican health care bill is gaining support, Speaker Paul Ryan said Wednesday, but he stopped short of saying the plan has garnered the votes the GOP would need to finally push the high-profile measure through the House.
Ryan spoke to reporters after leaders briefed rank-and-file Republicans on details of changes to the legislation aimed at breathing life back into one of President Donald Trump's premier but most problematic priorities. While there are indications that the revisions appeal to conservatives, some of them were still balking and there was little evidence that it was winning backing from moderates, leaving the measure's fate uncertain.
"We think it's very constructive" Ryan said of the proposed revisions. "I think it helps us get to consensus."
The proposed changes would let states get federal waivers to some coverage requirements President Barack Obama's law imposed on insurers. Republicans want to repeal much of that statute.
Meanwhile, bipartisan talks on a separate $1 trillion budget bill aimed at preventing a partial government shutdown on Saturday were jarred over a disagreement about payments made to insurers under Obama's health care law.
Both sides have been saying they were making strong progress toward a deal that would prevent a shuttering of federal agencies, after Trump abandoned his demand that the measure include money for his proposed wall with Mexico.
Ryan and House Minority Leader Nancy Pelosi, D-Calif., are wrestling over a Democratic demand that the must-pass spending bill keep money flowing under the health care law that helps low earners pay out-of-pocket medical costs.
Pelosi is insisting on addressing those payments Trump threatened to cut them off as a negotiating chip. But Ryan told reporters that "we're not doing that."
With Trump's 100th day in office coming Saturday, a White House looking for achievements has pressured GOP leaders to try pushing health care legislation through the House this week.
That seems unlikely, and Ryan reiterated that the House will vote when Republicans have enough support to win. Leaders want to avoid a replay of last month's embarrassing retreat from a planned vote when they realized the measure would be defeated.
To gain support, bargainers from the GOP's conservative and moderate camps have proposed letting states get federal waivers to Obama's requirements that insurers charge seriously ill and healthy customers the same premiums, and that they cover specified services like maternity care.
The plan was crafted by Rep. Tom MacArthur, R-N.J., a leader of the moderate House Tuesday Group along with Rep. Mark Meadows, R-N.C., head of the conservative House Freedom Caucus. It's also had the backing of Vice President Mike Pence, Republicans say.
Besides Meadows, another influential conservative and Freedom Caucus member, Rep. Jim Jordan, R-Ohio, has said he backs the proposal. He and Meadows were among the conservatives who opposed the initial version of the bill last month, as did many moderates.
But other conservatives were reluctant to commit. Rep. Paul Gosar, R-Ariz., said he was undecided and would prefer a bill that goes far further in erasing Obama's law.
"The whole thing is repeal," Gosar said.
Moderate leader Rep. Charlie Dent, R-Pa., said the changes ignored his concerns that the health care bill would cut too deeply into the Medicaid program for the poor and leave many people unable to afford coverage. Dent is another leader of the Tuesday Group and is considered a good gauge of the views of many of its roughly 50 members.
"Same concerns, and this didn't really address them," said Dent, who like Jordan said he'd not yet seen legislative details.
Under the proposed revisions, states could not obtain exemptions to Obama's requirements that insurers offer coverage to everyone and that family policies cover grown children up to age 26. States getting waivers so insurers could charge higher prices to people with illnesses would have to have high-risk pools, or government-subsidized funds to help those consumers cover costs.
Critics say allowing insurers to boost premiums on the ill means insurers can charge them exorbitant premiums, effectively making such coverage unaffordable. They also say high-risk pools have a history of being underfunded.
In the separate budget bill, Trump seemed poised to procure about $15 billion to boost the military. Aided by Senate Majority Leader Mitch McConnell, R-Ky., Democrats were pushing to extend health benefits for 22,000 retired Appalachian coal miners and their families whose medical coverage is set to expire at the end of April.