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Republicans Still Divided on Health Care Reform After Late Night Meeting

A meeting of Republicans with Vice President Mike Pence that went into the wee hours resulted in no agreement between Republican factions on the next attempt at reforming the Affordable Care Act.

By David Thornton

Even though Republicans represent a majority in both houses of Congress, disagreement on some aspects of the reform legislation resulted in House Speaker Paul Ryan (R-Wisc.) withdrawing the American Health Care Act from consideration last month.

Last night’s meeting included leaders of several of the various Republican factions. Rep. Mark Meadows (R-N.C.) of the Freedom Caucus, Republican Study Committee Chairman Mark Walker (R-N.C.), and moderate Tuesday Group co-chairman Tom MacArthur (R-N.J.), House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) and Ways and Means Committee Chairman Kevin Brady (R-Texas) were also in attendance at the meeting.

“We’re basically working on the concepts where the differences have been. We found a lot of common ground,” said Rep. Jeff Duncan (R-S.C.) in The Hill. “You find common ground, you set that aside, and then you start working on some of the differences.”

The first Republican attempt at health care reform had several problems that eventually drove many conservatives to oppose the bill. The AHCA kept two popular Obamacare provisions that require insurance companies to cover pre-existing conditions and keep children on their parents’ policies up to age 26. The bill also continued to subsidize health insurance premiums although it restructured the subsidies as refundable tax credits. The bill also would have left Obamacare’s Medicaid expansion in place through 2020.

“Even though we have a high-risk pool that deals with this, I think there’s probably a lot more concern over the guaranteed issue [of insurance for people with pre-existing conditions] portion of that and what that may mean,” said Rep. Meadows.

Rep. Walker said that there was “great consensus” among Republicans on high-risk pools for people with pre-existing conditions, but did not provide detail.

Under the high-risk pool concept, the states would set up an alternative insurance plan for people with pre-existing conditions who would otherwise be uninsurable. High-risk pools typically cost more for the policy holder, but some of the cost is subsidized by taxes on other insurance premiums. High-risk pools for people who are uninsurable have been utilized by states for years.

Several Republicans said that the meetings will continue Wednesday as the caucus tries to find a consensus that can pass the House. New legislation will also ultimately have to meet the requirements of moderates in the Senate where four Republicans have promised to oppose any bill that guts the Medicaid expansion.

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