Update: Why the Freedom Caucus is backing the revised healthcare bill

Special to WorldTribune.com

By Congressman Dave Brat (R, VA-7), Fairfax Free Citizen

Last week, the House Freedom Caucus endorsed the revised version of the GOP’s healthcare bill. I wanted to take some time to lay out the reasoning that explains the The American Health Care Act of 2017 (AHCA) in detail. Bottom line, the Freedom Caucus has worked tirelessly to improve the AHCA to make it better for the American people.

Freedom Caucus member Rep. Dave Brat, R-VA, at the White House on March 23. / AP

When we started, only 17 percent of Americans supported the GOP healthcare bill because it had virtually no mechanism to bring down costs for consumers. When the bill passes, as we think that it will, our efforts will have made the bill better and provided lower premiums and greater choice — and that has been the top priority throughout this process.

First, it’s important to reiterate that I have always been for a full repeal of Obamacare. My position has not wavered on repeal at any point. In fact, earlier this year, the Freedom Caucus asked for a vote on the repeal bill that already passed the House and the Senate and went to Obama’s desk in early 2016. But, after discussions with both House Leadership and the White House, it became clear that a vote on full repeal was not going to happen and that conservatives would have to work to try to improve the AHCA, as it was the only bill that would be considered and brought up for a vote in the House.

Given that, over the past weeks, we fought for needed changes to reduce premiums, and that would help open up the market for people to purchase a health care plan that best fit their own needs. We worked tirelessly to find creative solutions, a new set of approaches rooted in federalism that would grant greater control and decision making ability to the states, rather than the federal government.

The efforts of the Freedom Caucus have now moved this legislation as far as possible in the free market direction, without losing votes. This is not a full repeal of Obamacare, but, ultimately, forty members within the Republican conference can block a bill but cannot write a bill and get it to the floor. Taking into consideration the political dynamics of a diverse Republican conference, this bill is the best path forward for conservatives to get any real and beneficial health care reform passed and to bring some relief for individuals and families struggling to pay sky-high health care premiums.

Here is a general overview of the AHCA as it stands today:

  • Dismantles the Obamacare taxes that have hurt job creators, increased premium costs, and limited options for patients and health care providers—including taxes on prescription drugs, over-the-counter medications, health-insurance premiums, and medical devices.
  • Eliminates the individual and employer mandate penalties, which forced millions of workers, families, and job creators into expensive, Obamacare plans that they don’t want and cannot afford.
  • Helps young adults access health insurance and stabilize the marketplace by allowing dependents to continue staying on their parents’ plan until they are 26.
  • Guarantees coverage to Americans with pre-existing conditions and bans health insurers from charging a patient with pre-existing conditions higher premiums as long as they maintain continuous coverage, or sign up for new coverage within 63 days of exiting a previous insurance plan.
  • Establishes a Patient and State Stability Fund and Federal Invisible Risk Sharing Program, which provides states with $130 billion to design programs that meet the unique needs of their patient populations, help low-income Americans afford health care, and provide a backstop safety net for Americans with pre-existing conditions. This includes $15 billion specifically toward mental health and substance abuse and newborn care.
  • Modernizes and strengthens Medicaid by transitioning to a “per capita allotment” so states can better serve the patients most in need. The Medicaid reform represents the biggest entitlement reform in a generation and puts the program on a sustainable fiscal path.
  • Protects current Medicaid beneficiaries receiving health care under the expansion by honoring the enhanced state match they have been receiving, while working to redirect able-bodied adults to private health care so Medicaid can be refocused on helping the most vulnerable.
  • Empowers individuals and families to spend their health care dollars the way they want and need by enhancing and expanding Health Savings Accounts (HSAs)—nearly doubling the amount of money people can contribute and broadening how people can use it.
  • Helps Americans access affordable, quality health care by providing a monthly tax credit— between $2,000 and $14,000 a year—for low- and middle-income individuals and families who don’t receive insurance through work or a government program. Americans can use this tax credit to purchase private, quality coverage of their choice.

One of the amendments that the Freedom Caucus fought for is the MacArthur Amendment, an important part of the proposed plan. This amendment keeps our promises of lowering costs and protecting high-risk patients by giving states greater flexibility and more control over local insurance markets, by providing states the option to apply for waivers from certain federal insurance regulations that increase insurance premiums. This new flexibility will allow states to design insurance frameworks that are right for their unique populations. Ultimately, this strategy — which proved successful in Maine—will lower insurance premiums, ensure coverage for pre-existing conditions, and expand coverage.