President says it will be ‘every bit as good’ as Obamacare 
 
 President Donald Trump said Monday the Republican health-care bill being negotiated in Congress ultimately will protect Americans with pre-existing conditions as well as Obamacare does. 
 
 “I want it to be good for sick people. It’s not in its final form right now," he said during an Oval Office interview Monday with Bloomberg News. "It will be every bit as good on pre-existing conditions as Obamacare." 
 
 The latest version of the House GOP bill, which Republican leaders are trying to figure out whether they have the votes to pass this week, wouldn’t live up to that promise and would weaken those protections. 
 
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 A new amendment aimed at winning over conservative holdouts would allow states to apply for waivers from Obamacare’s requirements to provide certain essential health benefits if they are able to show that the modifications would cut prices. It also would allow states to sidestep the requirement that all consumers in a certain area must be charged the same rate for insurance, which would make plans significantly more expensive for those with pre-existing conditions. 
 
 The Republican bill would hurt protections for people with pre-existing conditions like a history of cancer, said Kirsten Sloan, senior director of policy analysis and legislative support at the American Cancer Society’s Cancer Action Network. 
 
 Obamacare “allowed a person with cancer to both get and keep insurance because of the insurance market protections; it made sure the insurance the kind of person with cancer was purchasing was meaningful,” Sloan said in an interview. The Republican proposal “begins to erode those protections.” 
 
 If states are allowed to use waivers for some protections, Sloan said, “you really are not guaranteeing that a cancer patient could get and afford coverage.” Her group supported the Affordable Care Act and has opposed the GOP bill. 
 
 ‘Continuously Covered’ 
 
 House Speaker Paul Ryan’s office defended the GOP health bill on Monday, saying the measure does protect people with pre-existing conditions. 
 
 “States can’t opt out without a high-risk pool to take care of them. And waivers never apply to anyone who has been continuously covered,” said AshLee Strong, Ryan’s press secretary. “We believe there is more than one way to address this problem.” 
 
 Trump repeated in the interview his contention that the Affordable Care Act is already disintegrating. 
 
 “And Obamacare just so you know, Obamacare’s terrible on preexisting conditions, you know why? Cause you’re not going to have it,” he said. “It’s folding. It’s gone.” 
 
 Reconsidering Floor Vote 
 
 The GOP bill to repeal and replace Obamacare has stalled ever since leaders scrapped a planned floor vote in late March. 
 
 After several embarrassing setbacks, Republican leaders, under pressure from the White House, spent much of last week weighing whether to hold a vote on the measure that included the new amendment, which was negotiated by New Jersey Representative Tom MacArthur and North Carolina Representative Mark Meadows, who chairs the House Freedom Caucus. 
 
 Conservative holdouts endorsed the revised bill but a number of moderate Republicans remained opposed to the measure, making it unclear whether it had enough votes to pass. 
 
 Vice President Mike Pence said in an interview Sunday on NBC’s “Meet the Press” that he hopes the House might act on a health-care bill soon. But he also said a final version from Congress might not be ready “before the end of the year" for Trump to sign. 
 
 Two of Trump’s top aides, Chief of Staff Reince Priebus and National Economic Council director Gary Cohn, in interviews with CBS, both projected confidence Monday that it would. "This is going to be a great week – we’re going to get health care down to the floor of the House. We’re convinced we’ve got the votes," Cohn said. 
 
 House Republicans are far less certain. There is no vote scheduled yet for this week and there are still not enough votes to pass a bill, a congressional aide said after Priebus’s and Cohn’s comments. While the new language won over some conservative holdouts, a number of moderate Republicans remain opposed. 
 
 Leaders are continuing to work to get more votes on board and will schedule a vote for this week if they believe they have enough to pass a bill, the aide added. ||||| House Speaker Paul Ryan, Majority Whip Steve Scalise and House Majority Leader Kevin McCarthy spent the weekend calling reluctant moderates. | Getty GOP suffers surprise defection on Obamacare repeal The scramble for votes is still very much on. 
 
 President Donald Trump dialed up his campaign-trail ally Rep. Billy Long on Monday, after the Missouri Republican announced his decision to vote against the Republican plan to replace Obamacare. The goal was straightforward: Persuade Long to change his mind. 
 
 It didn't work. Though Long hails from a deeply conservative district that overwhelmingly backed Trump over Hillary Clinton in November, and Long supported earlier versions of the legislation, the president's entreaties fell short, GOP insiders said. 
 
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 It was an unexpected blow for House GOP leaders and the White House, who were bullish over the weekend that they were on the cusp of clinching the votes to pass the legislation. Instead, the scramble for support is still very much on. 
 
 “I have always stated that one of the few good things about Obamacare is that people with pre-existing conditions would be covered," Long said in a statement. "The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable,” he added, referring to the last-ditch compromise between conservatives and House moderate Rep. Tom MacArthur (R-N.J.). 
 
 And the task was made even harder by an unforced error from Trump. The president told Bloomberg News in an interview Monday morning that the bill might change to provide more protections to people with preexisting conditions. “It’s not in its final form right now,” he said. Trump's comments frustrated the House whip effort, as some members interpreted them to mean the president was reopening negotiations. 
 
 “I don’t know if there are going to be any kinds of changes,” said Rep. Patrick Meehan (R-Pa.), who opposes the AHCA, as he exited a meeting of Ryan’s whip team. 
 
 By late evening Monday, Trump was calling lawmakers to walk back his comments. 
 
 Even after Trump’s failed attempt to persuade Long, House leaders said they hoped to convince the Missouri lawmaker to change his mind. “I think we just need to sit down with Billy,” said House Majority Leader Kevin McCarthy. “I’d like to see Billy on the bill.” Trump, too, has begun calling around to other members as he and House leaders attempt to shore up enough support for the bill. 
 
 Other House leaders downplayed the significance of Long’s defection, which came as Vice President Mike Pence headed to the Capitol to discuss health care with Republican lawmakers, and members of the GOP whip team met to gauge support for the bill. 
 
 “Billy’s been outside the ‘yes’ column for a while now, [he] just hadn’t been public,” said House Majority Whip Steve Scalise. Asked whether Long’s rejection portended additional defections, Scalise said, “There’s others that have questions that we’re getting them answered on. The work still goes on.” 
 
 Scalise’s assessment follows a similar attempt by the White House to lower expectations after a weekend of making lofty pronouncements of imminent success. 
 
 “We’re not there yet,” White House press secretary Sean Spicer said at a press briefing Monday afternoon, hours after other top White House officials all but predicted an imminent legislative victory for Trump. 
 
 “I think the president has made it clear that he’s not instituting a timeline,” Spicer added. “We have a good whip count, I think we feel good about where we are and where it's headed. But ultimately [Speaker Paul Ryan] and House leadership determine when to call a vote. I think that we know when the vote gets called, we’ll feel confident it will be able to pass.” 
 
 Spicer’s measured tone was markedly more subdued than comments just hours earlier by White House chief economic adviser Gary Cohn and chief of staff Reince Priebus. In separate interviews on “CBS This Morning,” the two senior White House hands drove expectations for House action on health care. 
 
 "Do we have the votes for health care? I think we do," said Cohn. 
 
 Priebus said he expected the vote “this week” and said it would be “one of the fastest pieces of signature legislation to go through for a president since [Franklin] Roosevelt." Trump himself seemed to suggest over the weekend that the House already had enough votes to pass the measure last week. 
 
 "I think they could have voted on Friday," he said in an interview that aired Sunday on CBS’ “Face the Nation.” 
 
 But on Monday, Trump told Bloomberg News that the bill is "not in its final form right now," and said, "It will be every bit as good on pre-existing conditions as Obamacare." That potentially off-the-cuff comment seemed to undercut GOP leaders on the Hill, who have insisted the bill is in its final form. 
 
 Lawmakers return to the Capitol Monday evening where House leaders and vote-counters will once again test the level of support they have for the AHCA. Though the White House has signaled its desire for a vote on the measure by Wednesday, House leaders have insisted they’ll only move the bill when they can guarantee it will garner the 216-vote bare majority it needs to pass. GOP leaders have insisted they’re closer than ever to passing the bill, but wavering support from moderate Republicans and other scattered defections have left little margin for error. 
 
 Underscoring the difficulty House leaders are having securing the votes, a slew of lawmakers tasked by leadership with corralling support for the AHCA say they’re not yet sure how they intend to vote. 
 
 While walking into a vote-counting meeting in the basement of the Capitol Monday evening, half a dozen whips — including Reps. Erik Paulsen (R-Minn.), David Valadao (R-Calif.) and Kevin Yoder (R-Kan.) — said they remained undecided. 
 
 Meanwhile, House Appropriations Chairman Rodney Frelinghuysen, another whip, rushed out of the meeting to avoid reporters. The New Jersey Republican previously opposed the bill, but GOP insiders said leadership and other senior House Republicans had changed his mind. Frelinghuysen refused to say how he intends to vote. 
 
 Rep. Billy Long, left, an ally of President Donald trump, told reporters he opposed the GOP health care bill, known as the American Health Care Act. | Getty 
 
 Ryan, McCarthy, Scalise and Chief Deputy Whip Patrick McHenry spent the weekend calling reluctant moderates and connecting some with Trump’s Health and Human Services secretary, former Rep. Tom Price. Vulnerable Republicans are concerned that the bill would harm people with pre-existing conditions or eliminate insurance coverage for millions on Medicaid. 
 
 Privately, Republicans on the Hill and in the White House realize this week may be their last, best shot to pass the AHCA. That’s because of renewed momentum for the bill after the endorsement of the hard-line House Freedom Caucus as well as procedural constraints. 
 
 GOP lawmakers are relying on arcane Senate budget rules in an attempt to pass their health care plan with a 51-vote majority in the Senate, rather than the typical 60-vote threshold required for most legislation. 
 
 But Republicans can’t move on to their next big priority — tax reform — without launching a new budget process and canceling out their existing authority to pass health reform at the lower threshold. That would effectively kill the measure as Democrats would certainly block any Obamacare repeal bill that requires 60 votes. ||||| Washington (CNN) The White House and congressional Republicans are in serious danger of not having enough votes to pass their health care bill. 
 
 Several Republicans have come out Monday against the current measure to repeal and replace Obamacare, bringing CNN's whip count to 21 Republicans -- mostly moderates -- opposed to the bill with at least 17 lawmakers still undecided. 
 
 There is no vote scheduled and it's unclear if there will be one before the House leaves for a week-long break Friday. There is a lot of talk and significant pressure from the Trump administration to act -- Vice President Mike Pence, who has been working with congressional leaders from the start on the health care effort, headed to Capitol Hill as well to lobby lawmakers. 
 
 Pence will spend much of Tuesday on Capitol Hill as well. He will meet with Senate Republicans for lunch, then meet with lawmakers during the afternoon. 
 
 Yet, President Donald Trump, whose White House was optimistic the House could pass a bill Wednesday, once again muddied the waters by suggesting the measure may still be changed. 
 
 "I want it to be good for sick people. It's not in its final form right now," he said during an Oval Office interview Monday with Bloomberg News . "It will be every bit as good on pre-existing conditions as Obamacare." 
 
 The Republican Party can only afford to lose 22 votes assuming all of the Republicans are able to attend the vote and no Democrats cross over. As they count votes, GOP Rep. Jason Chaffetz, who was expected to be out for three to four weeks after surgery, is returning Monday from Utah and will back the bill, his office said. 
 
 Most notably Monday, Rep. Billy Long, a Republican from Missouri who serves on the Energy and Commerce Committee, announced he was opposed to the legislation. Reps. Brian Fitzpatrick of Pennsylvania, Daniel Webster of Florida and Chris Smith of New Jersey will also vote against the current bill, making their decisions public in succession Monday afternoon. 
 
 Heading into a Republican whip meeting Monday afternoon, some of the members going in still didn't know how they would personally vote for the health care bill: Reps. Kevin Yoder, David Valadao, Erik Paulson, Elise Stefanik, and Adam Kinzinger all were undecided. 
 
 Rep. Patrick McHenry, chief GOP deputy whip, told reporters that he had no predictions on when and if a bill would come up this week. 
 
 But asked how close they were, he said "very." 
 
 The hope is that leadership can sell moderates on the fact that this bill is going over to the Senate where it might be significantly reworked. Rep. Peter King, R-New York, he was already talking to members in the Senate about changes he'd like to see. 
 
 Pushing forward 
 
 As hard as it is, Republican congressional leaders know they can't simply abandon their effort now. 
 
 "I hope we keep going. I don't think we can stop," said Rep. Brett Guthrie, a Republican who serves on the House's Energy and Commerce Committee told CNN last week. 
 
 White House chief economic adviser Gary Cohn sounded optimistic Monday morning when asked if he thought Republicans' plans for health care had enough votes. 
 
 "I think we do," Cohn told CBS. "This is going be a great week. We're going to get health care down to the floor of the House. We're convinced we've got the votes and we're going to keep moving on with our agenda." 
 
 Pre-existing conditions 
 
 The fight over how pre-existing conditions are covered is at the center of the fight. 
 
 Trump said Sunday the White House is pushing forward, and that the GOP plan "guarantees" coverage for Americans with pre-existing conditions. 
 
 "Pre-existing conditions are in the bill. And I mandate it. I said, 'Has to be,'" Trump said on CBS's "Face the Nation" Sunday. 
 
 Pressed further, Trump said that "we actually have a clause that guarantees" coverage for those with pre-existing conditions. Trump also said the health care legislation is "changing." 
 
 Unlike the mandate under Obamacare, however, under the GOP bill insurers could charge them higher rates than others in the plan if they allow their coverage to lapse. 
 
 Republicans might seem stuck in a never ending cycle of trying to please the moderate and conservative wings of their party but pressure from the White House to deliver a legislative win for Trump is real. Also real: the repeated pledges to their constituents over the past seven years to repeal and replace Obamacare if given the chance. 
 
 MacArthur amendment not enough? 
 
 Last week, Republicans seemed to reach a major breakthrough. 
 
 A new amendment sponsored by moderate leader Rep. Tom MacArthur of New Jersey gave states the ability to opt out of more Obamacare regulations. The amendment was also enough to finally bring the conservative House Freedom Caucus on board. 
 
 But the amendment, which experts noted could drive up the cost of insurance for older Americans and those with pre-existing conditions, spooked moderates and left some -- who had been supportive of the legislation before -- scrambling to publicly voice their discontentment. All of a sudden, it was moderates in the hot seat. 
 
 It seemed that even though leadership may have gained upwards of 30 new votes from the Freedom Caucus, they were suffering significant enough losses from the other side of the party that they still couldn't bring a bill up to the floor for a vote in order to mark Trump's first 100 days in office. 
 
 This week, leadership's focus remains trying to help those moderates get comfortable with the new MacArthur amendment. Over the weekend, House leaders, as well as Pence and Health and Human Services Secretary Tom Price, spoke with members hoping to flip enough votes to move the bill forward. Leadership aides emphasize that there isn't much room to change the proposal at this point, but many deputy whips are trying to get members to keep the process in perspective. 
 
 "You remind them there is a United States Senate, and it will change things. What we send over there isn't going over there on stone tablets," said Rep. Tom Cole, R-Oklahoma. 
 
 "Going back to the drawing board would be death to repeal and replace," one aide said. 
 
 After last week, though, many moderates are frustrated with the process. Some say they see their party making the same kind of mistakes Republicans criticized Democrats for making back in 2010. 
 
 "We didn't learn anything from their mistakes," said Rep. Mark Amodei, a moderate Republican from Nevada told CNN. "We learned nothing from their mistakes." 
 
 As to promises the bill will be changed once it's in the Senate? 
 
 "Seriously, you want me to go back and tell the people in my fourth of Nevada 'the Senate will make it better?'" Amodei said. "What the hell?" ||||| This week is witnessing what must count as at least the third round of the House GOP’s peculiar, staccato legislative process on health care. In some ways, it resembles the prior rounds: An idea has emerged that seems like it could address the daunting political problems that bedevil any significant Republican health reform advanced through reconciliation, and so it is being held up as the end-all proposal. There is a rush to vote. The overall bill remains unfinished in key respects. And a great deal of incoherence and dysfunction has been driven by the House Republican moderates yet blamed on the conservatives. 
 
 All of that we have seen for two or three months. But this round does feel different, and to me at least it seems reasonably likely to end in the passage of a bill through the House. 
 
 For one thing, the substantive idea itself—embodied in the MacArthur Amendment—is a real step in the right direction. As I suggested around here a few weeks ago, state waivers from federal insurance regulations are (unlike much of what Republicans have tried so far this year) an idea native to the actual circumstances Republicans now face: the uneven (at best) commitment of some Republican members to actually doing anything about Obamacare, the constraints of the budget reconciliation process, and the sheer multiplicity of problems now confronting the individual insurance market in different parts of the country. 
 
 It is also responsive to what House Republicans have learned about the priorities of different factions within their coalition in the course of the prior rounds of this internal debate. The Freedom Caucus prioritizes deregulation of the individual insurance market to lower costs and constrain the federal role. The moderates prioritize coverage levels and protection for people with pre-existing conditions. These are both very worthwhile sets of causes to prioritize, and they are in some important respects compatible. But rather than try to arrive at a single overall balance between them, the approach House Republicans are now pursuing says to state governments that they can have relief from the rules that drive up costs and make their insurance markets unsustainable if they themselves propose alternative rules that would still protect people with pre-existing conditions and make coverage accessible. This course recognizes that different states will approach the tense balance between these priorities differently, and allows them to do that—thereby perhaps also enabling congressional Republicans to achieve the precarious political balance they require. 
 
 The extent of the waivers is constrained, in light of the political pressures involved, though it would allow for some meaningful variation and experimentation with insurance rules. If they show that their proposed alternative rules would reduce premiums, increase coverage, or otherwise strengthen insurance markets, states can request to waive the age bands on premiums starting next year. They can set their own essential health benefits (and therefore can recover the right to define insurance coverage in their jurisdictions to a significant degree) starting in 2020. And, if a state has established a high-risk pool or similar mechanism for covering people with pre-existing conditions, it can allow insurers to consider health status when pricing coverage for people who have not been continuously insured. 
 
 The waivers approach may also help the bill survive the reconciliation process in the Senate. Because it explicitly connects state regulatory waivers to effects on premiums and other factors that would influence the cost of a federal insurance subsidy, it creates a link between insurance-rule changes and federal spending that might not otherwise be clear. This at least is the theory behind the argument that this approach could make it through reconciliation in the Senate. I see no reason to consider that any more than a theory, but it’s probably a better theory than Republicans have had so far. 
 
 The practical implications of this amendment would depend heavily on how many states actually seek waivers, and of what sort. It’s possible that few states will want to play ball. But given the very real problems states are seeing in their individual insurance markets, there is reason to think that different states—both red and blue—would seek and find different ways to maximize their options under the waiver regime given their particular circumstances. They could well be under pressure from insurers and providers to find such ways, and they would have help too: I’d expect that a fair amount of model waiver language would be out there next year if something like this passes—language from insurers, providers, and activists on the left and right intended to help states pick up the pieces of their individual markets and put them back together in different arrangements to suit different needs, interests, and preferences. This would be a good thing. And the political pressures involved would likely drive states to prioritize coverage—even in the reddest states, the constituencies governors face are much more diverse and complicated than those of most Republican House members. 
 
 There are certainly some peculiarities in the amendment. For instance, allowing some waivers to take effect in the 2018 plan year seems to introduce some needless complications into an already horribly complicated transitional challenge for insurers. It also seems to me (as it has to others) that on its face section (a)(5)(A)(ii) of the amendment exempts members of Congress from the amendment’s effects, which would be truly just insane and inexcusable. Word is that this provision will now be removed (through a separate amendment), but that it was ever there is pretty staggering. 
 
 There is also no question that this bill, even with the MacArthur Amendment, is no one’s idea of an ideal solution. It retains Obamacare’s regulatory architecture as a default from which states can opt out, and only in restricted ways. But as a compromise that takes account of the fact that a full replacement is beyond Republicans’ reach given their numbers and the rules of the Senate, it does look like a meaningful step. 
 
 This would be an amendment to the broader AHCA that has, and would still have, some significant further problems. But with this amendment, the bill would reach the Senate in a form that could be made into a workable partial repeal and replacement of Obamacare, and might be reasonably close to the most that congressional Republicans can do about Obamacare at this point that would also be worth doing. 
 
 There would be some significant work for the Senate to do if this passes the House, and we should hope there is a real legislative process in the Senate and not a rushed vote on the House product as it is. The premium tax credit in the bill will need to be rethought so as to be more useful to more of the uninsured, and this could be done in ways that also make the bill more likely to survive reconciliation rules. That could involve something like Avik Roy’s very constructive proposals or it might even involve a move away from a tax credit toward a benefit more suitable for a state-waiver approach (which might also assuage concerns about reconciliation and the Hyde Amendment that otherwise could easily still kill the whole process in the Senate). Some ideas on how to proceed are out there, and Senators and staff are already chewing them over. And of course some fundamental questions about spending levels will need to be resolved, and ought to be resolved in ways that prioritize protecting the vulnerable. Essentially punting these questions to the Senate offers some hope that this could happen, but it will not be a simple matter. 
 
 Still, it does now look as though the rough, frustrating, unruly process House Republicans have been going through, with its multiple near-death experiences, has actually enabled some learning about their own priorities, the nature of the substantive policy challenges they face, and the difficulties involved with bringing their conference together. In the end, if this is the end of this stage of the process, what has worked best on the latter front has been direct negotiation between the different factions of the House Republicans, rather than leadership efforts at preventive mediation to assuage them all while keeping their substantive differences below the surface. There is surely a lesson in that for everything else Republicans imagine they can achieve this year. Republicans are divided, this president is not likely to play the role presidents usually play in overcoming internal divisions in their parties, and that means differences will need to get worked out through frank bargaining. Face to face discussions between different flavors of Republicans—not finished products from above, let alone “now or never” dictates and cheap twitter bravado from down the street—is how reconciliation bills might work in this Congress. And for other bills, some frank bargaining with actual human Democrats might be required too. 
 
 Even if the House does pass this amended bill, much work and time will remain before they get near any final product on health care. That is as it should be. It makes no sense to rush this effort, especially now that Republicans are exploring a relatively novel set of approaches—rooted in federalism and responsive to the distinct political and substantive constraints they face. There are lots of needles left to thread. But progress is something, and this looks like progress. ||||| A number of states would likely pursue waivers in the House Republican health plan enabling them to charge higher premiums to people with pre-existing conditions who let their coverage lapse, health analysts said. 
 
 The waivers are the latest twist to the House GOP proposal that would topple most of the Affordable Care Act and replace it with a new plan that would bring steep Medicaid cuts and refundable tax credits to help people... ||||| Jimmy Kimmel. 
 
 After weeks of negotiations, last week House Republicans reached a compromise that they said could finally allow them to repeal and replace Obamacare. It involves letting states opt out of certain Obamacare provisions, which would allow insurers to once again charge people with preexisting conditions exorbitant fees. 
 
 Protecting people with preexisting conditions may be Obamcare’s most popular provision. A recent Kaiser poll found that even among the 26 percent of Americans who want Obamacare repealed, 38 percent changed their mind when told that would hurt people with preexisting conditions. 
 
 The original vote on the American Health Care Act in March was canceled, in part, because opponents of the bill — which only had the support of 17 percent of Americans — called their representatives and protested at town hall meetings. Now Republicans say they may vote this week on a version of the bill that’s even worse for the sick, the elderly, and the poor — yet there’s been less organized resistance to the latest health-care push. 
 
 Two possible reasons: It’s been hard to keep track of GOP efforts to revive Zombie Trumpcare, and Republicans aren’t advertising that the latest version would weaken protections for people with preexisting conditions. President Trump added to the confusion in recent days when he appeared to offer false information about the contents and status of the GOP health plan. 
 
 “I want it to be good for sick people. It’s not in its final form right now,” he told Bloomberg News on Monday. “It will be every bit as good on pre-existing conditions as Obamacare.” 
 
 In Trump’s defense, the Republican plan to get AHCA passed by making it crueler doesn’t make any sense — unless your real aim is to shift the blame for the GOP’s failure to make good on seven years’ of promises to replace Obamacare with something better. The Post reported on Monday that House GOP leaders are now focused on one political goal: “Pass a bill they can say repeals Obamacare — even if it has no hope of survival in the Senate — to shield their members in next year’s elections.” 
 
 This time around, the House Freedom Caucus would prefer not to take the brunt of the blame for AHCA’s failure, and they’ve successfully pushed the legislation to the right. They frame reducing Obamacare’s protections for people with preexisting conditions as cutting costs and making the U.S. health system freer. 
 
 But GOP Representative Mo Brooks slipped on Monday, admitting that he doesn’t think we should punish healthy people for being “good” by forcing them to pay for people who don’t take care of themselves. 
 
 “It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy,” explained Brooks. “And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.” 
 
 Watch Alabama Rep. Mo Brooks make the case for Trumpcare on CNN. 
 
 Twitter quickly filled up with people asking Brooks what moral failing gave them thyroid cancer, or how their poor choices at age 3 ended in a car accident. But the most vivid counterpoint to the GOP’s entire health-care push came later on Monday night from, of all people, a late-night comedian. 
 
 In a heart-wrenching 13-minute monologue, Jimmy Kimmel opened up about his son’s heart condition, which was discovered just hours after his birth ten days ago. With tears in his eyes, the host described the harrowing ordeal, which started with a nurse noticing baby William John Kimmel’s color was off and ended with him being rushed into open-heart surgery. 
 
 Baby Billy is doing well, though he’ll need several more surgeries. Kimmel closed with a plea for politicians to make sure others have a similarly happy outcome, even if they aren’t born to wealthy parents. 
 
 We were brought up to believe that we live in the greatest country in the world, but until a few years ago, millions and millions of us had no access to health insurance at all. You know, before 2014, if you were born with congenital heart disease, like my son was, there’s a good chance you’d never be able to get health insurance, because you had a pre-existing condition. You were born with a preexisting condition. And if your parents didn’t have insurance, you may not even live long enough to get denied because of a preexisting condition. 
 
 
 
 If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make. I think that’s something that whether you’re a Republican or a Democrat or something else, we all agree on that, right? 
 
 Kimmel said that regardless of party, “We need to make sure that the people who are supposed to represent us, people who are meeting about this right now in Washington, understand that very clearly.” 
 
 The GOP’s Obamacare repeal effort appeared to be hanging by a thread before Kimmel’s monologue aired. Republicans reportedly see this week as their last opportunity to pass a version of AHCA, and on Monday several Trump officials claimed they’re close to the 216 votes needed to pass the bill. However, by the Wall Street Journal’s count, they can only afford a few defections: 
 
 At least 19 House Republicans are currently opposed to the bill, with at least 17 undecided, according to a Wall Street Journal survey of the lawmakers. The GOP can only afford to lose about 22 votes, depending on absences. 
 
 On Monday afternoon, Representative Billy Long, a Trump ally who supported a previous version of the bill, said he’ll vote against the current measure, citing its lack of protections for people with preexisting conditions. 
 
 “I have always stated that one of the few good things about Obamacare is that people with preexisting conditions would be covered,” Long said. “The MacArthur amendment strips away any guarantee that preexisting conditions would be covered and affordable.” 
 
 Around 2 million people watch Kimmel’s show each night, and his name was trending on Twitter following his moving monologue about his son. Kimmel succinctly explained what tinkering with protections for preexisting conditions could do to an innocent baby, and pointed out that’s what the GOP is trying to do this week. What wavering House Republican is going to decide now is the time to come out in favor of the bill? ||||| Says of the GOP health care proposal, "pre-existing conditions are in the bill." 
 
 President Donald Trump remains hopeful that he can deliver on his promise to repeal the Affordable Care Act and replace it with a plan from the Republican Party. 
 
 In an interview with CBS’ Face the Nation, Trump argued that the GOP’s health care plan covers pre-existing conditions, despite what news reports have said. 
 
 "Pre-existing conditions are in the bill," Trump said April 30. "And I just watched another network than yours, and they were saying, ‘Pre-existing is not covered.’ Pre-existing conditions are in the bill. And I mandate it. I said, ‘Has to be.’ " 
 
 Trump was more than likely referring to the most recent version of the GOP health care overhaul, an amendment by U.S. Rep. Tom MacArthur, R-N.J., introduced in late April. 
 
 "This bill is much different than it was a little while ago, okay? This bill has evolved," Trump said. "But we have now pre-existing conditions in the bill. We've set up a pool for the pre-existing conditions so that the premiums can be allowed to fall." 
 
 When CBS’ John Dickerson pressed Trump on whether everyone with pre-existing conditions would be covered, Trump said, "We actually have a clause that guarantees." 
 
 White House spokesman Sean Spicer said at the May 1 news briefing that Trump was referring to the MacArthur amendment and that Trump is ensuring that "coverage of pre-existing conditions is at the core" of the legislation. 
 
 But the reality of how the bill addresses pre-existing conditions -- which are health problems patients have before new insurance kicks in -- is much more complicated than Trump makes it sound. 
 
 What the amendment says on pre-existing conditions 
 
 In March, the Republican’s American Health Care Act died without a vote when Republicans couldn’t agree on the bill designed to replace the Affordable Care Act. Under the new bill, called ACHA, insurers had to cover pre-existing conditions, but they could have charged more for people who are recently uninsured. 
 
 The MacArthur amendment would allow states to obtain waivers to some requirements of the Affordable Care Act, including the "essential health benefits" provision that requires maternity care or mental health services. 
 
 The amendment has language that appears to protect those with pre-existing conditions stating that "nothing in this Act shall be construed as permitting insurers to limit access to health coverage for individuals with pre-existing conditions." 
 
 But experts say other parts of the amendment suggest that those with pre-existing conditions could struggle to maintain affordable health insurance. 
 
 The amendment permits insurers to set premiums based on the "health status" of an individual by looking at their current and past health status and make predictions about how much an individual will use medical care in the future, said Linda Blumberg, senior fellow in the Health Policy Center at the Urban Institute. 
 
 That’s where pre-existing conditions could come into play, because it would mean that the costs rise for consumers who are sicker, said Timothy Jost, Washington and Lee University School of Law emeritus professor. 
 
 "Health status underwriting is literally charging a higher (possibly much, unaffordably, higher) premium to people with pre-existing conditions," Jost said. "Under the MacArthur amendment, they could not be refused coverage, but insurers could impose high enough premiums that coverage would be unaffordable." 
 
 The amendment says that the waiver would allow states to set up a high-risk pool or participate in a new federal invisible risk-sharing program to help states reimburse insurers for covering high-risk consumers. 
 
 "No state may obtain a waiver for health status unless it has taken these efforts to protect those who might be affected," stated a MacArthur press release. "In states with a waiver, individuals who maintain continuous coverage could not be rated based on health status." 
 
 That means people who stay insured without any lapses can’t be charged more by insurance companies if they get sick. 
 
 But experts said that many low-income people aren’t able to stay covered without breaks, and that questions remain about the effectiveness of the high-risk pools. 
 
 The American Medical Association, which opposes the amendment, said in a statement that it "could make coverage unaffordable for people with pre-existing conditions." The AMA raised questions about whether the high-risk pool would be "sufficient to provide for affordable health insurance or prevent discrimination against individuals with certain high-cost medical conditions." 
 
 Our ruling 
 
 Trump said of the GOP health care amendment, "Pre-existing conditions are in the bill." 
 
 The amendment says that health insurers can’t limit access to coverage for people with pre-existing conditions, but that insurers can charge people more if states agree. In some states, health insurers would be able to charge sicker people more. And experts warn that high-risk pools -- the mechanisms meant to keep premiums lower for sick people -- might not be effective. 
 
 Overall, the latest proposal seems to weaken existing protections for people with pre-existing conditions, not strengthen them. 
 
 We rate the statement Mostly False. ||||| President Trump says the revised House GOP health care bill would protect people with pre-existing conditions, but a multitude of experts and advocates beg to differ. 
 
 The latest change to the bill, called the MacArthur amendment after its author, Republican House member Tom MacArthur, would allow states to opt out of several key Obamacare insurance regulations. Two of these are critical for protecting those with health care issues obtain policies that are affordable and cover their treatments. 
 
 Related: Trump: GOP health care bill 'guarantees' coverage for pre-existing conditions 
 
 Obamacare revolutionized health insurance for people with pre-existing conditions who buy policies on the individual market. Prior to the health reform law, consumers with a medical issue -- even if it were years earlier and completely resolved -- could be denied coverage or charged much more in premiums. 
 
 The MacArthur amendment keeps Obamacare's guaranteed access clause, which requires insurers to provide policies to those with pre-existing conditions. MacArthur and other politicians cite this part of the bill to say that the sick and formerly sick would continue to be protected. 
 
 But the bill would allow states to apply for waivers that could greatly change the cost and quality of their coverage. 
 
 States could opt out of the law's essential health benefits measure, which requires insurers to cover 10 main benefits, including hospitalization, prescription drugs and other services. 
 
 Insurers in those states would likely offer skimpier policies that don't cover all the treatments and medications that those with medical issues need. Carriers would be hesitant to offer more comprehensive policies because they would attract consumers with costly conditions. 
 
 Related: First 100 Days: What Trump has done to Obamacare 
 
 The amendment would also allow states to change Obamacare's community rating provision, which bans insurers from charging enrollees more based on their medical history. Under the revised bill, insurers could charge higher premiums to those with pre-existing conditions who let their coverage lapse. 
 
 States that apply for this waiver would have to set up high-risk pools or other programs aimed at minimizing insurers' exposure to costly policyholders. This could offset some of the price hikes carriers would levy on those with pre-existing conditions. 
 
 But experts say the $130 billion that Republicans would set aside to fund these programs through 2026 is woefully inadequate. High risk pools existed before Obamacare, but most were underfunded, charged policyholders high premiums and had waiting lists. 
 
 Health policy experts, consumer advocates, provider groups and even some Republican lawmakers have voiced concerns about how the amendment would affect those with medical issues. Several have come out strongly opposing the revised bill. 
 
 Related: Republicans continue to work on health care. They can't afford not to. 
 
 "The individuals and families we represent cannot go back to a time when people with pre-existing conditions could be denied coverage or forced to choose between purchasing basic necessities and affording their health care coverage," said a coalition of 10 patient advocacy groups, including the American Diabetes Association, the American Cancer Society and the National MS Society. 
 
 Also, many lower-income people could get caught by this amendment if the bill becomes law, noted Sabrina Corlette, research professor at Georgetown University's Health Policy Institute. A Congressional Budget Office analysis of an earlier version of the bill found 24 million more people would be uninsured under the GOP legislation, and experts say that number could grow as a result of the recent changes. 
 
 Related: AMA, AARP oppose latest Obamacare repeal effort 
 
 These uninsured folks could encounter higher premiums when they try to return because insurers would be allowed to set rates based on their health backgrounds. 
 
 "If they try to go back in, they will face insurers that could price them out of the market if they have a pre-existing condition," she said.
– The Republicans' new attempt to repeal and replace ObamaCare is suddenly in serious trouble, reports CNN, with the White House engaging in a furious push to win over wavering lawmakers. One sticking point is coverage of pre-existing conditions, with one blogger arguing that Jimmy Kimmel's emotional plea on Monday night's show may have effectively killed the GOP bill. Here's what's happening, much of which revolves around an amendment offered by Republican Tom MacArthur of New Jersey: President Trump insists the GOP bill will cover people with pre-existing conditions in its final form. In fact, "it will be every bit as good on pre-existing conditions as ObamaCare," he told Bloomberg, echoing comments he made over the weekend. He's basing that on the MacArthur amendment, which states explicitly that "nothing in this act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with pre-existing conditions.” (The full amendment is here.) But that's not true, say critics, because the amendment allows states to grant waivers to insurers to set rates based on people's "health status." The New York Times explains it this way: "Rates for a person with cancer, diabetes or multiple sclerosis could be far higher than the standard rate, effectively pricing the sick out of the market without technically blocking coverage, critics say." The American Medical Association says that "health status underwriting could effectively make coverage completely unaffordable to people with pre-existing conditions." PolitiFact digs into the nuances and concludes that Trump's statement is "mostly false." (CNN has more particulars on the waivers.) Politico takes note of a key GOP defector, Rep. Billy Long of Missouri. He's voting no, explaining that he thinks coverage of pre-existing conditions is one of the few things ObamaCare got right. "The MacArthur amendment strips away any guarantee that pre-existing conditions would be covered and affordable." Defenders of the waivers say they give states necessary flexibility that will result in lower rates. "People with pre-existing conditions today can’t access health care because the premiums and deductibles are so high," says Rep. Richard Hudson of North Carolina, per the Wall Street Journal. A National Review columnist also backs them. The vote count is razor-thin at the moment, and Margaret Hartmann at New York suggests that Kimmel's monologue may have doomed the GOP bill. Kimmel spoke of his infant's heart condition and the need for insurance to be available to people with pre-existing conditions, and he urged people to make sure lawmakers know that. He's got an audience of 2 million, and the clip is going viral. "What wavering House Republican is going to decide now is the time to come out in favor of the bill?" she writes.