The White House takes aim at ObamaCare's pre-existing condition ban in new health-care proposals

Rep. Mark Meadows is still negotiating the health-care bill

(Image credit: NICHOLAS KAMM/AFP/Getty Images)

published 4 April 2017

Vice President Mike Pence, White House Chief of Staff Reince Priebus, and White House budget director Mick Mulvaney met behind closed doors with members of the House Freedom Caucus on Monday night, after meeting with more moderate House GOP members earlier in the day, in the latest sign that President Trump hasn't given up on House Speaker Paul Ryan's health-care bill. Rep. Mark Meadows (R-N.C.), the Freedom Caucus leader, told The Associated Press that the White House made an informal offer but "there is no deal in principle" yet and his group is waiting to see details, in writing, before committing support.

The changes, Meadows said, center on allowing governors to apply for waivers to some big ObamaCare requirements, including that all health-care plans offer a set of essential health benefits and that insurers have to charge the same prices to everybody in the same age group, a mechanism called community rating. Scrapping both requirements, but especially community rating, would effectively negate ObamaCare's ban on discriminating against sick people and those with pre-existing conditions, Margot Sanger-Katz explains at The New York Times:

A patient with cancer might, for example, still be allowed to buy a plan, but it wouldn't do her much good if that plan was not required to cover chemotherapy drugs.... Technically, the deal would still prevent insurers from denying coverage to people with a history of illness. But without community rating, health plans would be free to charge those patients as much as they wanted. If both of the ObamaCare provisions went away, the hypothetical cancer patient might be able to buy only a plan, without chemotherapy coverage, that costs many times more than a similar plan costs a healthy customer. Only cancer patients with extraordinary financial resources and little interest in the fine print would sign up. [The New York Times]

Trump ally Rep. Chris Collins (R-N.Y.) told Politico that the moderates said they would tentatively be fine with the changes if the Freedom Caucus signed on, and White House legislative liaison Marc Short reportedly told attendees at Ryan's donor retreat late last week that outside conservative groups that opposed the AHCA have indicated a willingness to negotiate. Ryan pulled the deeply unpopular bill two weeks ago when it became clear it wouldn't pass, and it still faces long odds in the Senate if it manages to pass in the House.

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Peter has worked as a news and culture writer and editor at The Week since the site's launch in 2008. He covers politics, world affairs, religion and cultural currents. His journalism career began as a copy editor at a financial newswire and has included editorial positions at The New York Times Magazine, Facts on File, and Oregon State University.