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GOP health-care push faces new obstacles as concerns about pre-existing conditions grow

House Paul Ryan of Wis., accompanied by Washington Rep. Cathy McMorris Rodgers, speaks to reporters on Capitol Hill on Tuesday, May 2, 2017, following the Republican Caucus meeting. (Cliff Owen / Associated Press)
By Sean Sullivan and David Weigel Washington Post

WASHINGTON – The revamped Republican push for a sweeping overhaul of the nation’s health-care system ran into a new roadblock on Tuesday when a key lawmaker, Rep. Fred Upton, R-Mich., said he would vote against the current proposal.

In an interview with WHTC radio in Holland, Michigan, Upton, a former chairman and current member of the House Energy and Commerce Committee, said he could not support the latest version of the House GOP plan because he does not believe it does enough to protect people with preexisting medical conditions — a growing concern among Republicans.

“This amendment torpedoes that and I told the leadership I cannot support the bill with this provision in it,” said Upton. “I don’t know how it all will play out but I know there are a good number of us that have raised real red flags.

Upton’s comments came the day after Rep. Billy Long, R-Mo., a longtime opponent of the federal health-care law known as Obamacare, came out against the current Republican plan to repeal and replace key parts of it – also citing concerns about preexisting conditions.

The growing opposition among influential House Republicans has stoked deep uncertainty about when or even if GOP leaders will hold a vote on a revised measure. The Energy and Commerce Committee that Upton sits on has played a leading role in health-care reform this year.

House GOP leaders stayed quiet Tuesday as they were asked about prospects for a vote on a health-care bill this week. As they left a morning news conference, House Majority Whip Steve Scalise, R-La., was asked about the current vote tally.

”It’s better,“ he responded.

A Washington Post analysis shows 20 House Republicans either opposed to or leaning against the bill, and another 23 either undecided or unclear in their positions. If no Democrats support the bill, the Republicans could lose no more than 22 GOP votes to pass it in the House.

The current GOP plan would allow insurance providers in some states to deny coverage or charge higher premiums to people with preexisting conditions or costly health problems, as long as that state set up ”high-risk pools“ that could help cover the cost of care.

Comments by President Donald Trump have cast a national spotlight on that element of the Republican plan. Trump said in an interview broadcast on CBS News’s ”Face the Nation“ Sunday that latest bill would ”beautifully“ protect those with preexisting conditions — which is not fully true.

Ryan said Tuesday that Trump has been ”nothing but helpful“ on health care. He and Scalise tried to defend the GOP plan against criticism that it would harm Americans with preexisting conditions.

”Our bill protects people with preexisting conditions and it actually provides multiple layers of protection for people with preexisting conditions in ways that Obamacare doesn’t do,“ said Scalise.

Republicans left their weekly conference meeting Tuesday with no vote on the schedule.

”Hopefully we’re just a handful away,“ said Rep. Mark Meadows, R-N.C., the chairman of the far-right House Freedom Caucus chairman, who helped put together the alternative bill. ”There’s still a lot of undecided, but generally, at this stage of the game, you can address the concerns of the undecideds.“

Several reluctant Republicans continued to talk as if the bill could be negotiated. Rep. Elise Stefanik, R-N.Y., a leader of the moderate Tuesday Group who has not taken a position on the bill, told reporters she was ”involved in all of the discussions.“

Rep. Steve Pearce, R-N.M., who had joined his Freedom Caucus colleagues to support the bill, said he would have to reevaluate if some changes were pushed through.

”If they don’t make changes, I’m a yes,“ he said. ”But they don’t have the votes, so they could change it.“

Rep. Tom MacArthur, R-N.J., a Tuesday Group co-chair negotiated the amendment with Meadows, dodged questions about possible further changes. ”I’m not in every conversation, so I can’t really say,“ he said.

Rep. Rodney Frelinghuysen, R-N.J., the chairman of the Appropriations Committee who opposed the previous version of the bill, which GOP leaders pulled back earlier this year, evaded repeated questions on whether he would vote yes now.

”The position I’m taking is that the most important thing is to keep the government open for business.“

By late Monday, House leaders had collected more votes than ever but still appeared to be shy of the 216 Republicans they need to pass the measure. They’re stuck between conservatives and moderates, both keenly aware of how they can be attacked on the issue next year.

The White House, where aides have suggested a Wednesday vote is possible, continued to lobby members Monday even though no vote had been scheduled. Vice President Mike Pence hunkered down in his office on the House side of the Capitol, with undecided and yes-voting members stopping by to talk.

Conspicuously absent from the House Republican effort to get to 216 is much talk about what happens in the Senate. There, Republicans will run up against the Senate parliamentarian, who must rule on whether some provisions are allowable in a budget reconciliation bill – the vehicle they’re using to repeal the health-care law to avoid a Senate rule requiring a 60-vote win that would require Democratic votes.

”If you’re in the House, what you should be thinking now is that if it doesn’t survive, it all comes back to you,“ said Sen. Roy Blunt, R-Mo. ”I think what they should be focused on is getting the process moving and, frankly, passing the obligation over to the Senate.“

Senate Majority Leader Mitch McConnell, R-Ky., is likely to introduce a substitute version removing those provisions, just as he did back in 2015, when Congress passed a bill repealing the ACA that then-President Barack Obama vetoed.