As they try and clean up the House health-care bill designed to repeal and replace Obamacare, Trump and House leaders have had to work with both moderate and conservative colleagues in a wild 11th-hour bout of horsesmanship to try and make all sides happy. And since the two sides have been diametrically opposed on some of the components contained in the original legislative proposal, the process has been a bit like herding cars, Washington-style.
On Friday morning, after the Thursday vote was delayed because of a lack of consensus, the House seemed poised to move to a vote.
House Republican leaders introduced nine amendments on Monday night and three more on Thursday. With Trump pushing them hard to work out a deal, the leaders announced Thursday night that they would hold the vote on Friday. It was still unclear Friday morning whether these changes are doing any good to persuade the dozens of Republicans who still have a problem with the bill.
Regardless of what's worked out, here's what's for sure: given that all Democrats are expected to vote against it, the legislation will fail if more than 22 House Republicans vote against it.
Here are some of the amendments worked out over the night in an effort to appease conservatives, who feel the bill was too much like Obamacare, and their more moderate colleagues who wanted other changes before lending their support:
Eliminate federal requirement that plans be comprehensive
Starting next year, would get rid of the Obamacare's requirement that health plans sold to individuals and small businesses must cover 10 "essential health benefits," including care for pregnant women and newborns, mental health treatment and maternity care, among other things. Instead, the bill would direct each state to determine the basic health benefits that insurance must include. Some states would be able to keep the 10 required under Obamacare, known as the ACA, or cut the list, or not set up any minimum coverage. That could mean that in some parts of the country plans could be sold that are more lightweight and, thus, less expensive.
For the moderates:
Increase aid to states for maternity and newborn care.
The amended plan would include maternity and newborn care to a bucket of services that states could use the federal money they's get through a "Patient and State Stability Fund" that the legislation would create.The delay in the repeal of the Medicare tax on wealthy Americans would provide $15 billion to be used for this purpose.
Also for the moderates:
Delay repeal of Medicare tax on wealthy Americans
This amendment would leave in place for another six years a 0.9 percent Medicare tax the ACA created on people who earn above $200,000 if filing individually, or $250,000 if married and filing jointly. The repeal would now take effect in 2023.
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