White House pushes uncertain bid to revive health care bill

It would also preserve the health law's ban on insurers rejecting customers with pre-existing medical conditions. They'd still be technically eligible for coverage, they'd just ... have no way to pay.

"Republicans' latest plan is to expose Americans with pre-existing conditions to staggering new health costs", House Minority Speaker Nancy Pelosi, D-Calif., said in a statement.

Republicans also are grappling over whether to allow states to opt out of another provision governing essential health benefits - a list of services insurers must provide under the ACA - if they can prove that doing so would reduce premiums or increase the number of insured.

"States must attest that the goal of their requested waiver is to reduce premium costs, increase the number of persons with healthcare coverage, or advance another benefit to the public interest in the state, including the guarantee of coverage for persons with pre-existing medical conditions", the plan says. They also can be more expensive for patients in those pools, as well as for taxpayers funding them.

However, these individuals did not know they were in the invisible high-risk pool and were not charged higher premiums.

As noted in the excerpt, community rating isn't the only thing states could waive under the deal.

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Meanwhile, the healthcare bill keeps getting less popular, congressional Republicans keep getting berated about the bill by constituents at town halls, and more members keep responding to that beratement by making promises to ensure the law protects coverage and holds people with preexisting conditions harmless - promises they will break if they vote for a revived version of the bill. These would allow states to apply for waivers from the ACA's essential health benefit (EHB) requirements. The idea now under discussion is to let states opt out of Obamacare's essential benefits and community rating rules if they choose to. Republicans departed for recess unable to reach agreement on a replacement, but as they return to Washington next week some are holding out hopes for still reaching a deal. What, specifically, had produced a breakthrough in the deadlock between Freedom Caucus members, who want to gut the core requirements of the Affordable Care Act, and Republican moderates, who want none of that? Some House Republicans oppose how the Obama administration funded them, and they won a court case potentially blocking the funding that is now on appeal. Only 17% of voters approved of the plan, according to a Quinnipiac poll released last month.

Republicans argue that the high-risk pools would then cover those people, taking them out of the regular insurance pool and lowering prices for everyone else, but high-risk pools have traditionally been underfunded by states and the federal government, resulting in poor coverage and high costs for those who need insurance the most. Republicans have been attacking high deductibles under ObamaCare for years by noting that having coverage doesn't do you much good if you can't afford actual health care. Democrats will now make the same argument.

Few Republicans want to repeat that debacle.

Those concerns may be significant enough that, even with MacArthur's blessing, the deal does not win over moderates.

House leadership scheduled a conference call this Saturday with rank-and-file members of the GOP to discuss the MacArthur Amendment.

"I am going to keep fighting to get a compromise bill that helps to fix the current situation without hurting the people who are on the Affordable Care Act today", MacArthur said. Insurers say their rates could rise as much as 30 percent. The urgency is clearly political: The White House is anxious to jam something through Congress so that the president can claim that he repealed Obamacare within the first 100 days of his administration. Exit quotation: "216 votes unclear".

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