House Republicans plan to hold a vote on the American Health Care Act on Friday, probably in the late afternoon, and they are apparently still tinkering with the legislation. On Thursday night, President Trump sent White House budget director Mick Mulvaney to Capitol Hill with an ultimatum: He would agree to no more changes, the dealmaking is done, and House Republicans can take it or live with ObamaCare. House Freedom Caucus chairman Rep. Mark Meadows (R-N.C.) wasn't buying it. "Anytime you don't have 216 votes, negotiations are not totally over," he said.
So what will be in the final bill? House Republicans already started amending the original bill on Monday, agreeing to moderate-wooing sweetheart deals for upstate New York and Illinois, a quicker end to the Medicaid expansion, an option to let states require able-bodied Medicaid recipients to work in order to get benefits, $85 billion set aside to possibly help people 50 to 64 afford insurance, and other changes to win over holdouts.
The House Rules Committee is meeting Friday morning to discuss more amendments, notably one filed Thursday night by House Speaker Paul Ryan (R-Wis.). According to Catherine Reynolds at CBS News, the four-page amendment would scrap ObamaCare's 10 "essential health benefits" that every insurance plan must offer — a key demand of the Freedom Caucus — and let states decide what insurance companies have to cover for individual plans; add $15 billion more to a "stability fund" that will help states subsidize coverage for benefits dropped by insurers, most likely maternity care, substance abuse treatment, and mental health services; and delay the repeal of a 0.9 percent Medicare tax for wealthy Americans until 2023.
The heart of the bill remains — repealing the individual mandate that all adults have health care, scrapping subsidies that help most individual insurance buyers for less-generous tax credits, making significant cuts and changes to Medicaid, allowing insurers to charge older people more, pulling funding for Planned Parenthood, and repealing taxes on health companies. "In my district right now, there's a lot of misunderstanding about what it is we're doing, and once we get it done," Rep. Chris Collins (R-N.Y), one of Trump's biggest backers in the House, told MSNBC on Thursday, "then we can have the chance to really explain it."