Future of revamped health care bill remains dubious in House

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The Trump administration and House Speaker Paul Ryan presided over an historic flame-out four weeks ago when a conservative faction known as the House Freedom Caucus torpedoed their Obamacare replacement bill over concerns that it didn't go far enough.

Capitol Hill sources said an amendment to the GOP-sponsored American Health Care Act would be circulated to the Republican caucus in a matter of hours - a series of Band-aid patches created to make the bill palatable to both the centrist and conservative wings of the GOP.

'We have a good chance of getting it soon. "I'd like to say next week".

The GOP has a new plan to repeal and replace Obamacare that aims to bridge the gap between the conservative Freedom Caucus and moderates, according to a document obtained by CNBC.

"The question is whether it can get 216 votes in the House, and the answer isn't clear at this time", said a senior GOP aide.

But Republican politicians and aides to party leaders, conservatives and moderates alike, were sceptical that the House would vote next week on the health legislation. Because the negotiations between Democrats and Republicans to prevent a government shutdown have deliberately avoided bringing up a border wall, Mulvaney's announcement could undermine one of the key premises that have allowed both parties to move forward in developing a stopgap spending bill.

Republican leaders and the White House have been searching for a health-care agreement that could placate enough moderates and hard-line conservatives to win passage in the House.

Rep. Dan Donovan (R-N.Y.), a centrist lawmaker, said on MSNBC Thursday that he is still opposed to the bill despite the changes. The Staten Island centrist said he remained a no vote, partly because the legislation would increase Medicaid costs for New York City's five boroughs. However, none of the text of the new bill has been released, and it's unclear why House Republicans would be able to strike a compromise on health care now after proving incapable of doing so in March. Vice President Mike Pence also played a role in shaping that plan, Republicans say.

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It would deliver a win to moderates by amending the Republican bill to restore Mr Obama's requirement that insurers cover specified services like maternity care.

The House legislation would dismantle the Obamacare extensive system for expanding health insurance coverage to millions of Americans, cutting almost $1 trillion in federal aid that has allowed states to expand the Medicaid safety net programs and scaling back tax subsidies that help millions of low- and middle-income Americans buy commercial health plans. Any states that allow insurers to charge consumers more based on health status would also have to set up a high-risk pool to assist those affected.

Grow said insurers would back the requirement that people with pre-existing conditions receive coverage and support the establishment of high-risk pools if there is a mechanism in the new health care law that requires people to keep continuous coverage.

"It looks to me like we're headed in the right direction", Rep. Dave Brat (R-Va.), a Freedom Caucus member, said Thursday. He said that assuming the outline is translated into legislative text he backs and is added to the health care bill, he would now support the legislation and believes most of the Freedom Caucus' three dozen members would also back it. But moderates, including the Tuesday Group, balked, saying that this could severely harm the care of those with pre-existing conditions - one of the most popular parts of Obamacare.

Trump will mark his 100th day in office April 29.

In an interview Thursday with The Associated Press, budget chief Mick Mulvaney said he was surprised at "the toxicity levels" that have divided the GOP over health care and hoped lawmakers' two-week break would prove "healing".

The National Association of Insurance Commissioners sent a letter on Wednesday to Democratic and Republican House leaders urging them to fully fund the fiscal 2017 cost-sharing subsidy payments.

That was a major embarrassment to Ryan and Trump, and House leaders are loath to bring a revised health care bill to the House floor unless they are convinced it would pass.

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