President Trump and House Republican leaders want to take another crack at a health-care reform deal that went up in flames last month.
Except it looks as though they're not really sure how to fix what went wrong — that is, a total implosion of their attempt to build a single-party coalition of moderate Republicans (who thought the original bill would take away too much coverage) and conservative Republicans (who thought it wouldn't go far enough).
The Washington Post's ace congressional team reports that top White House officials — Vice President Pence, Chief of Staff Reince Priebus and budget director Mick Mulvaney — have come to the Capitol this week to talk with Republicans about what an agreeable deal might look like.
So far, it looks as though nobody at the negotiating table has any idea what kind of deal could pass a Republican Congress, a reflection of the fact that there is no easy path to bridging a vast ideological divide in the party. Here's what we know about Republicans' health-care reform 2.0:
It will do this to your health insurance: … Well, we don't know what it would do yet.
“Right now, we’re just at that conceptual stage about how to move forward in a way that can get everybody to 216,” House Speaker Paul D. Ryan (R-Wis.) told reporters Tuesday.
“We're just talking,” Priebus told reporters Monday after leaving a meeting with the influential conservative House Freedom Caucus, whose members mostly opposed the bill.
It will be introduced at this date: … Actually, we don't have details on that, either.
“Now we’re throwing around concepts to improve the bill,” Ryan said. “That’s occurring right now. But that is not to say that we are ready to go.”
It will be this much different from the health-care bill that imploded last month:
Mmm … not sure on that, either.
We don't know how, if at all, the bill will be altered to mitigate an estimated 24 million people who will be without insurance in a decade because of the legislation — an impact that many GOP moderates couldn't get behind.
We also don't know what changes will be made to satisfy conservatives: Should the Affordable Care Act's federal funding for Medicaid expansion be left in place through 2020? Cut in 2018? Cut immediately?
Should insurance companies be allowed to charge healthy and sick people different premiums, something banned by Obamacare and something conservatives badly want?
One proposal that does seem to be gaining traction would allow states to waive an Obamacare requirement that insurance companies selling health insurance on exchanges cover 10 benefits, including ambulance rides, prescription drugs and maternity care.
A last-minute proposal in Republicans' failed bill would have eliminated those requirements, a move that pleased conservatives who consider it government overreach but concerned moderate Republicans who thought vulnerable constituents — like those with preexisting conditions — could lose their health care.
It's going to be a compromise, or nothing at all: Both the White House and Ryan have made clear that they need most, if not all, of the Republican Party on board — something they couldn't do last time.
When they pulled the bill from the House floor, 36 House Republicans and all House Democrats had said they couldn't support it, which was more than enough to kill it.
That means it's unlikely that GOP leaders will introduce a measure that appeases just the conservative Freedom Caucus or just moderate Republicans. They'll have to find a compromise.
Nor are they likely to totally bypass the Freedom Caucus and negotiate with moderate Republicans and Democrats, an idea floated by a frustrated White House officials days after they got burned by conservatives.
A compromise among Republicans isn't out of the question:
“Anything’s possible,” Rep. Tom MacArthur (N.J.), co-chairman of the House GOP moderate Tuesday Group, told reporters.
“We’re certainly encouraged by the progress that we seem to be making,” House Freedom Caucus Chairman Mark Meadows (N.C.) told reporters.
House Freedom Caucus Chairman Mark Meadows (R-N.C.), center, in March. (J. Scott Applewhite/Associated Press)
Democrats already hate it. And they're planning to campaign on how much they hate it. (A Quinnipiac University poll found that just 17 percent of Americans approved of the bill.)
“Republicans are once again meeting in secret to draft a health-care plan that threatens to make insurance more expensive for Americans and undermine coverage for preexisting conditions,” the Democratic Senatorial Campaign Committee, which is defending about 10 Senate Democrats who are up for reelection in Trump states in 2018, warned in a statement Tuesday.
They're coming up on a deadline: On Friday, Congress had planned to break for two weeks. Advocates for a new deal were noncommittal about whether they'd have something in place by then. “I’ve learned that is a recipe for disaster,” Pence replied when asked by reporters if there would be a vote by Friday.
Somewhat oddly, floating the potential for a deal right before a two-week break only ensures Republicans' legislative struggles on health care will be front and center for both conservative voters who want Obamacare gone and moderate voters who were wary of any deal in the first place.
If Congress does go on a break without a vote or even without announcing a deal, it's a safe bet that there is no deal in place yet — and another reminder that there are no easy answers for how to unite a very ideologically divided Republican Party.