Special to WorldTribune.com

By Pete Zamplas, Asheville Tribune

Freedom Caucus Chairman U.S. Rep. Mark Meadows sees the health care stalemate unlocked by Easter, easing off from a demand for a full Obamacare repeal that made national waves after he stood toe to toe with President Donald Trump.

But the congressman still firmly seeks to undo two more regulations in order to further lower insurance premiums and boost care quality. “I’m optimistic we’ll find some kind of resolution, in the coming days,” third-term Rep. Meadows told The Tribune Monday, while driving from the 11th House District in western North Carolina back to the nation’s capital.

Meadows remains a Trump supporter. “He’s done more in 65 days than any president in modern history,” with executive orders to roll back regulations to try to spur business growth, Meadows said March 26 as special guest on ABC’s This Week with George Stephanopoulos.

He praised the “master negotiator” as one to be “admired for his negotiating prowess. He is extremely engaging. If a deal is met, it’s because of the president’s personal involvement.”

As for style, true to his sound-bite image, Trump came across to Meadows as wanting to hear succinct arguments with specifics and conclusions. “The more specific I was, the more receptive he was. It worked best keeping it brief and specific.” He said there was “not contentious, but a very rigorous debate.”

Meadows cautioned against rushing too much, especially the first time around on health care, but also on giving up on finding consensus.

“I’ve talked to the White House numerous times in the last 72 hours,” he said Monday. “We’re trying to find some area of compromise, with the more moderate (“Tuesday Group” of about 50) in our (GOP House) conference.”

Speaker Paul Ryan shelved the bill on March 24, the deadline President Trump set for a vote to force congressmen to go on the record. Ryan held off, as there seemed not enough votes from GOP colleagues to pass it.

There was movement even then. The House Freedom Caucus (HFC), which had enough votes to reject a bill not strong enough in its view, pressed for two concessions. Now, the two GOP groups are getting closer this week. Moderates met with executive officials Monday in the White House, and are reportedly warming to letting states opt out of some health care mandates such as with a waiver process.

There was verbal agreement on allowing states to decide whether to scrap requirement of insurers as a basis in all policies covering ten “essential” services. Democrats fear those coverages will be discarded if not mandated, or insurers will offset pricier plans with skimpy insufficient ones.  The areas of coverage include prescription drugs, doctor visits, lab tests, emergency visits and hospitalization which are useful to most people.

But four others are specialized for some, such as pediatrics, maternity care, substance abuse and mental health treatment. By forcing them into everyone’s policies, it spreads out the cost but boosts it for those not needing such services.

Meadows said Obama’s one-size-fits-all approach thus jacks up costs for unneeded coverages, rather than allowing greater choice of which doctor to see and to buy insurance only for what is truly needed and affordable.

He seeks to undo the additional hamper on businesses that wish to employ more than 50 people (the threshold in most states), but do not do so since, if they do, they are then required to insure all of their workers with pricier policies.

The stumbling block is the concession not yet attained, and thus to get the HFC on board. It is to ax the “continuous-coverage” element of community health ratings. These now forbid insurers from charging higher premiums based on one’s health history or gender, thereby punishing healthier people. Meadows’ press secretary Ben Williamson notes it now forces offering “certain policies in a territory, at the same price level without regard to health status. Premiums go up,” for most (healthier) people, more so if they must get pricier comprehensive coverage.

Meadows stated the new health care program needs to be a free “market-driven approach, that brings down costs and provides more choices for the American people.” He added, “some of the provisions in here do not lower health care costs enough. Certainly, not for my constituents. Some have seen their health care premiums go up 30, 35 percent then another 30 percent in North Carolina this year.”

Meadows said the House should stay in session and delay Easter recess until reaching a deal to both repeal and replace the Patient Protection and Affordable Health Care Act (“Obamacare”) of 2010 with what is being called Trumpcare and Ryancare. McCarthy, who has visited Hendersonville, also calls for action soon.

Meadows calls for an “adequate safety net for those most vulnerable.” This includes enabling those with pre-existing conditions to get insured (ideally at reasonable/affordable rates though neither party has instilled price caps), helping lower-income families with aid or at least tax breaks, and enabling youth to stay on their parents’ plans through age 26.

A basic barometer is will it “lower premiums significantly enough, to make a real difference for people that are struggling to pay for health care? I think we have that at the core of where we are.”

Meadows and others of HFC went to Oz — the Oval Office (not Trump Tower) — behind the curtain to see the Wizard of the Deal in action first-hand March 23. This was hours ahead of the planned vote that Thursday night, which was then put off to the next day then called off.

“We both agree we need to cover more people, and (in regulations) do less to hurt mom and pop stores on Main Street,” Meadows said of Trump.

Further, “I let him know this is not about me or the Freedom Caucus. It’s about the American people. It’s about him being able to put together a deal.” Trump initially pressured the HFC to give in, to seal the deal. HFC balked, but Meadows said offered a pending compromise of two more regulatory reversals. Ryan obliged on one, but not yet the other.

President Trump “wants to give in on the other point,” but not lose too much support among GOP moderates and any Democrats needed, Meadows sensed from their discussions.

“His concern is, can he get it through the House and Senate. We’re not at odds over policy — but  rather with what some of his leadership staff tells him is (legislatively) possible and not possible.”

Declaring health care reform dead is “like saying (Super Bowl winning quarterback) Tom Brady lost at halftime,” Meadows said on ABC about the delay on a House vote.

He anticipates the GOP will “get this over the finish line” in the House, after that the more liberal Senate bumps it to conference committee to hammer out a final compromised version. The House now “may be in overtime,” he said in further sports analogy.

“At the end of the day, the most valuable player will be President Trump. Because he will deliver. He’s committed to the American people … to repealing Obamacare, and replacing it with a system that works for American families. I look forward to working with him to do just that.”

The president, after tweeting angrily against HFC members, by Sunday reversed his tone toward conciliation, or at least optimism that he gets his way. He vowed GOP “love and strength” will unify for a health care bill.

Populist President Trump varies across the political spectrum. He is emerging as more moderate and compromising on some budgetary issues than the HFC. Yet true to his Tea Party backing, he is more hawkish on immigration than GOP moderates, still wants to wall  off much of the Mexican border, perhaps even more so than conservative-moderate Republicans led by Speaker Ryan.

Ryan (R-Wisc.), the GOP V.P. candidate in 2012, has taken heat for leading the Trumpcare charge before votes were in place. Meadows said Ryan has worked diligently, and is not for replacing him as Speaker.

But Meadows cautions “we probably need more time to read these bills, and really debate them before they’re rolled out and presented as a binary choice — this way, or no way.”

HFC is depicted as unbending, and indeed has been resolute on many issues. But Meadows points out he has made a huge concession by abandoning the caucus’ earlier stance of a full repeal of Obamacare. Initially after the stalemate March 24, he stated “I promised the people of North Carolina’s 11th District that I would fight for a full repeal of the Affordable Care Act.” But he has since eased off of that insistence, though “many of us ran on full repeal” as he notes.

“We’ve gone from the ideological view for a full appeal, to more pragmatic — what can we accomplish in the Senate, and get for people to lower insurance premiums,” he told The Tribune.

“The original (GOP) bill repealed two of the 12 mandates in Obamacare. In the spirit of compromise, we just asked for an additional two — to make a total of four insurance regulations to be repealed. These two have the most impact, to drive premiums down.”

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