The New AHCA Is Different In One Tiny Way

Republican lawmakers eager to repeal Obamacare revealed a new plan on Wednesday that they're hoping will go over more smoothly than the last effort. The American Health Care Act failed to garner enough support in the House, and was dramatically pulled from a vote in March. But the new plan isn't a completely new AHCA; it's an amendment meant to appease the ultra-conservative House Freedom Caucus, whose opposition to the original plan ultimately tanked the vote. The new plan doesn't change a whole lot, but if you're not a hard-line conservative, you'll probably consider it worse.

The MacArthur Amendment, as it's called, was negotiated by New Jersey Rep. Tom MacArthur, a moderate, and North Carolina Rep. Mark Meadows, chairman of the House Freedom Caucus. It attempts a compromise on the main sticking points between moderates and conservatives: the Obamacare mandate that insurance companies provide coverage of certain "essential health benefits" such as maternity and mental health care, and the provision that insurers couldn't deny coverage due to age or preexisting conditions. The new proposal suggests that states be allowed to obtain waivers to those rules, and effectively replace them with their own. And if you don't like it, "Figure out a way to change the state that you live in," according to White House budget director Mick Mulvaney, via The Atlantic.

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The waivers would let states lift regulations the require insurance companies to cover essential health benefits, as long as they could prove that patients could receive coverage for such services elsewhere, such as a "high risk pool," according to NBC News. Insurance companies would still be barred from refusing coverage to the elderly and patients with preexisting conditions (two groups who tend to have a more pressing need for health care coverage), but the waivers would also allow states to remove pricing restrictions at their discretion, charging such patients higher premiums that could price them out of coverage completely.

And here's the kicker: Congress is required to purchase their insurance from the Obamacare marketplace, a measure that ensures they don't force taxpayers to accept anything they wouldn't use themselves. The amendment, as it was originally written, included an exemption so that states couldn't use the waivers on Congress or their aides. When Vox called them out, a MacArthur aide claimed that the Senate Budget Committee had added the exemption. But an aide with the Senate Budget Committee said they had nothing to do with it. A bill removing the exemption was posted online late Wednesday night, according to Politico. What a mess. There is presently no vote scheduled, because Republicans still don't have the votes. Whether they'll ever agree on health care is anyone's guess.