WASHINGTON — The conservative House Freedom Caucus has drafted an amendment package for the Republican Obamacare replacement plan and are warning they have the votes to kill the bill if they're ignored.
Freedom Caucus members emerged from a meeting Wednesday evening with a plan to find "reasonable middle ground" to make the American Health Care Act palatable to both them and moderate Republicans pushing in the other direction.
It's a not-so-subtle show of force from party conservatives who have not had any meaningful talks with Speaker Paul Ryan and House leadership in two weeks, according to Freedom Caucus Chairman Mark Meadows. Instead they have been working directly with the White House on a near-daily basis.
If push comes to shove, Meadows believes his group has the power to kill the AHCA.
"I'm confident that there are not enough votes to pass this bill in its current form," he said.
Earlier in the day, after a whip count, Meadows predicted that there were between 40-50 no votes plus a further 20 undecideds. That's larger than the Freedom Caucus ranks of around 30 and well more than the 24 Republicans needed to defeat the bill.
Republicans are facing a massive divide within their caucus as moderates and hardliners in the House and Senate push for different and often contradictory changes.
Moderates, such as the Tuesday Group in the House, are concerned about the ill effects of repealing the Obamacare Medicaid expansion and financial supports for the poor and elderly.
The Congressional Budget Office projects that under the AHCA a 64-year-old making $26,500 per year would see their premiums jump from $1,700 to a whopping $14,600.
But other Republicans, including members of the Freedom Caucus and Republican Study Committee are trying to accelerate the halting of Medicaid expansion from 2020 to 2018.
Many have also condemned the tax credits as part of the AHCA as a new social welfare program akin to Obamacare. So if you expand them for the needy you alienate conservative Republicans and if you reduce or eliminate them you alienate moderates.
Conservatives also want to do away with the Obamacare essential health benefits that mandate insurance companies to provide certain key services. Some see this as key to bringing down premiums, which they say is the most important goal of reform. It could require an unconventional and controversial move pitched by Sen. Ted Cruz to pass through the Senate, but that's a fight for another day.
First the AHCA must survive a House budget committee meeting Thursday morning. Three Freedom Caucus members are on the committee and it would take four Republicans to vote down the bill.
Rep. Dave Brat is one of those members. He said there is no coordinated plan to vote down the bill, but he personally will vote against it.
There have been some hints at compromise. Meadows said there might be some appetite for preserving the tax credit system if it's designed properly to help the needy. That's a major change from earlier denunciations.
Conservatives are also talking more about a change to Medicaid requiring all able-bodied adults to have a job in order to receive government-funded health care. That could be used as trading chip by moderates to preserve parts of the expansion.
Paul McLeod is a politics reporter for BuzzFeed News and is based in Washington, DC.
Contact Paul McLeod at email@example.com.
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