But the Club for Growth sees a path to the bill’s passage: convincing more moderate — or less stridently conservative — Republicans to swallow a proposal favored by the House Freedom Caucus that would allow states to seek waivers of several Affordable Care Act insurance mandates. Those mandates form the core of the ACA’s protections allowing Americans with preexisting medical conditions to buy affordable insurance plans, and numerous lawmakers have balked at the request.
The Club for Growth is betting that the bill could find its way to passage if the mandate waivers win over the vast majority of the Freedom Caucus’s roughly three dozen members, and if other House Republicans who had announced plans to vote for an earlier version of the bill don’t withdraw their support as a result.
The two targets the group announced Monday — Reps. Chris Collins (R-N.Y.) and Adam Kinzinger (R-Ill.) — are both in that latter category: They were prepared to vote for the bill last month before it was pulled from the House floor but have expressed uneasiness last week with the Freedom Caucus’s latest demands.
“There are a few moderates that have worked to thwart these efforts,” David McIntosh, the group’s president, said in a conference call with reporters Monday. “Our message in this ad is: Come on board, keep the promise that you and our party made to finally repeal Obamacare and lower health-care insurance costs for Americans across the board.”
An ad shared with reporters highlights President Trump’s campaign promises to repeal the ACA, and says he has been “working with conservatives on a better bill that lowers premiums, cuts taxes, and repeals Obamacare.”
“Conservatives are working to get it done — a big win for American families, and our economy,” a narrator says. “Tell Congress: Support Trump’s plan to get rid of Obamacare.”
What the ad does not mention is that Trump himself has blamed the Freedom Caucus — not the moderates — for the health bill’s failure so far, and that there is deep concern among both House Republican leaders and the GOP rank and file that rolling back the ACA mandates could easily be cast as a betrayal of Trump and other GOP leaders’ pledges to protect insurance access for those with preexisting conditions.
One provision the Freedom Caucus is proposing to waive, known as community rating, would allow insurers to charge people with preexisting conditions considerably more than healthy people for the same insurance plans. But McIntosh said he was confident that the waivers under consideration would lower premiums in general and that a separate “risk-sharing” provision favored by GOP leaders would help subsidize premiums for the sick.
“I think the message is going to be, for 99.9 percent of the people, your premiums are very likely to go down, and that’s what needs to get through,” he said Monday.
There has yet to be any independent analysis of the conservative mandate-waiver proposal; the Congressional Budget Office had evaluated earlier versions of the legislation and found significant budget savings but major reductions in insurance coverage over the coming decade.
The new ad barrage means moderates are feeling heat from both sides: A liberal advocacy group, Save My Care, also announced Monday that it was targeting seven House Republicans in swing districts urging them to oppose the GOP health-care bill altogether.
It’s unclear to what degree there might be overlap between those GOP members and the ones eyed by the Club for Growth. The latter group’s executives were cagey Monday about who they were planning to target — promising 10 members but naming only Collins and Kinzinger.
“We’re still looking at which moderates need to be targeted,” said Andy Roth, the club’s vice president for government affairs. “But rest assured, there will be 10.”