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Trump Administration Floats Compromise on Health Care

Vice President Pence headed to Capitol Hill Tuesday to present a proposal he worked on with GOP moderates to the conservative House Freedom Caucus.
Image: Mike Pence
In this Saturday, April 1, 2017, photo, Vice President Mike Pence speaks at DynaLab, Inc. in Reynoldsburg, Ohio. Pence and a few other White House officials made a new offer to conservative House Republicans late Monday on the GOP's failed health care bill, hoping to resuscitate a measure that crashed spectacularly less than two weeks ago. (AP Photo/John Minchillo)John Minchillo / AP

Hours after President Donald Trump told NBC News that he was serious about reaching a deal on health care with members of his party, Vice President Mike Pence headed to Capitol Hill Monday night armed with a compromise proposal for the House conservatives who had helped doom the Republican health care bill a little more than a week ago.

Details of the proposal emerged after Pence met with moderate Republican members at the White House earlier in the evening on Monday. The administration is trying to hash out a compromise on insurance regulations, a component of the American Health Care Act (AHCA), the failed GOP health care bill to partially repeal and replace the Affordable Care Act, or Obamacare, that caused one of the biggest splits between moderate and conservative Republicans.

But reality set in Tuesday morning when most of the Republican conference met behind closed doors. Members left the meeting admitting that discussions were taking place but that no deal has been agreed upon.

"I don’t get the impression we’re close (to a deal), but I do have the solid impression we are still talking about those prospects," said Rep. Steve Womack, R-Ark.

The compromise Pence and the moderate members of the House discussed — and that Pence has taken to the conservative members on the Hill — would give states the opportunity to ask the federal government for a waiver so they don't have to impose those requirements on the condition that states show that getting rid of the insurance regulations, such as essential health benefits and the community health rating, will lower the cost of premiums, according to a Republican aide. The community health rating says that insurance companies can only charge older people five times as much as they charge a young, healthy person.

The compromise would not allow states to waive those requirements for dependents under 26 or allow an opt-out for pre-existing conditions or impose lifetime spending caps.

Rep. Mark Meadows, R-N.C. and head of the conservative Freedom Caucus, called the administration's new measure for compromise "a solid idea."

"We remain open minded and willing to look at details for the plan, so we're hopeful," Meadows said after emerging from his group's meeting with Pence Monday night. "We are encouraged by at least the idea — intrigued by the idea — but would certainly need a whole lot more information before we take action in support or opposition."

But some conservative lawmakers on Tuesday expressed frustration with the proposal.

Rep. Dave Brat, R-Virginia, said the idea still includes "a whole lot of federalism."

"The federal government is still the big boss. We may throw some crumbs to the states when actually we’ve taken so much power form the states the states shouldn’t have to ask the federal government for a waiver. The states should ask the federal government for permission," said Rep. Louis Gohmert, R-Texas.

The administration is pushing the proposal, but Trump allies thought it was a good sign that Rep. Greg Walden, chair of the Energy and Commerce Committee and a close ally of House Speaker Paul Ryan, was involved in the White House meeting.

House Speaker Paul Ryan has taken a back seat since the bill's failure and putting the onus on his members to work out their differences.

Other participants in the meeting included Reps. Chris Collins of New York, Tom MacArthur of New Jersey, Adam Kinzinger of Illinois and five other lawmakers.

In another sign that Trump is motivated to make progress on health care, Trump also invited Sen. Rand Paul, R-Kentucky, to play golf on Sunday. Paul was an opponent of the House bill that failed to even come up for a vote because of too much Republican opposition, despite the party's majority in the chamber.

But when asked what he thought about the idea Pence is floating, Paul wasn't sold.

"I'm hearing that and there was some discussion on that yesterday," Paul said. "There is still an opportunity for compromise on this, but I think it still needs more time."

Members of the conservative caucus objected when the AHCA did not repeal the Affordable Care Act's requirement that all health insurance policies taking part in the marketplaces must cover specific procedures, known as essential health benefits. Moderates had their own concerns, including cuts the AHCA made to Medicaid.

Trump told NBC News Monday night that he rejected the idea of working with Democrats right now and said that the best way to finish the bill is to reach consensus among Republicans.

The timeline for Republicans, however, is tight to pass health care. The House leaves Friday for a two-week recess, and when they return they will have to pass a government funding bill before April 28.