Politics

Health care bill lacks the votes, Meadows says

By Bill Moss, Published: June 23, 2017

The Republican-backed Senate health care bill released on Thursday lacks the votes to pass in either the House or Senate, U.S. Rep. Mark Meadows told reporters in a conference call on Friday.

“We don’t have enough support among conservatives or moderates in either chamber to get it to the president’s desk,” Meadows said.
His main concerns are, “How do we make sure that we bring premiums down substantially, and how do we solidify the insurance markets so that there’s enough insurance to provide coverage,” he said.
The Senate bill provided a little stability, Meadows said, by adding funds for CSR payments, which would help those on Obamacare and reducing the percentage of people that receive subsidies to those at 350 percent of the poverty line.
“That reduction doesn’t affect a great amount of people in terms of the threshold,” he said. “Most people are covered through employer health plans. One of the recommendations is to look at subsidies looking at 400 percent and being able to buy premiums out of a health savings account.”
“A number of us that believe there should be an amendment for people to buy Obamacare plans or other non-compliant plans that would accurately reflect the risk that they have, for example someone in their 50s would have more coverage on certain types of illness than others,” Meadows said. “Having flexibility as a health care provider and insurance provider is important. It’ll have the greatest effect on rates and affordability,” he added.
In terms of Medicaid, because North Carolina isn’t a Medicaid expansion state, the impact here wouldn’t be great, Meadows said. But what is of concern to him is that North Carolina would receive its “fair share” in compensation.
"I’m optimistic that we can improve the bill and get consensus among moderates and ultimately get it to President Trump,” he concluded.
In response to Trump’s calling of the bill “mean”, Meadows isn’t focused on the labels it will receive, and has a different interpretation of Trump’s response.
“I think what he’s responding to is that we not only handle preexisting conditions, but we fund it in a way to not give people anxiety,” he said. “I support him fully in that. They want to make sure we adequately fund it, make sure there is no anxiety for people with preexisting conditions. I see it as a push to get the Senate to increase dollars on some critical areas.”
With regard to preexisting conditions, a heated topic within the bill, Meadows says they need to be covered. “A preexisting conditions provision in the House and Senate bill was never bypassed,” he said. “If I have a preexisting condition and go to an insurance provider I would get the same rate as someone who doesn’t have a preexisting condition.”
The bill looks to decrease government support for Medicaid.
“I would prefer to see greater flexibility for every state to deploy Medicaid dollars in a less prescriptive manner,” Meadows said. “Medicaid today is broken. We somehow think that Medicaid is working the way that it is, Medicaid doesn’t work the way it currently is. The real key is allowing dollars to be deployed by legislature to meet the needs. The trajectory now is not sustainable for the health care provider. They’re getting reimbursed less and less. There’s more work to be done, but it’s a broader Medicaid reform package outside of an ACA repeal and replace measure.”
Meadows would like to see some changes in the bill before it is passed.
“The biggest thing I would like to see in terms of amendments is to have flexibility for consumers where they can buy one of 20 plans that insurance providers are allowed by law to provide those plans and still qualify for subsidies offered by the federal government,” he said. “The second part is to expand the ability of HSAs to allow more people to buy those types of coverage.” Health savings accounts are untaxed, but only those with a high deductible health plan are allowed to have them.
Critics of the bill criticize its process and the nature in which it was made.
“I don’t have a problem with the speed of which it’s being brought forth,” Meadows said. “We’ve (Republicans) talked about repeal and replace for seven years. I do have a concern with trying to make sure legislation has top priority with does it lower premiums and does it stop hardworking tax payers from choosing between putting food on the table and paying premiums. Most people can agree that insurance premiums have continued to skyrocket. We need to do something about that and to make sure preexisting conditions are protected and covered. We will do those two things in a bill that has my approval.” As for the secrecy from the Senate, “I’m for open process and transparency,” he added. “I think the more transparent the deliberation process, the better the product.”
The bill will undergo the voting process next week.
Meadows also briefly discussed tax reform.
“The biggest budget concerns are increasing the amount of money for defense and non-defense discretionary dollars,” Meadows said. “Those numbers right now are to increase defense spending by 75 billion, keep non-defense discretionary at current levels, where most of the consensus is building in the House. If we’re doing tax reform, we have mandatory spending cuts.”
Next week will be critical for settling on a budget and final numbers, he added.
“There is growing pressure to sequester for the military,” he said. “If we did that, it would be a monumental vote that we haven’t seen in the House or Senate in at least the last three congresses. It’s a work in progress in terms of the budget. There are three different camps in the House: fiscal hawks, defense hawks and those that are more moderate in spending habits wanting to increase non-defense spending levels. We need to try to bring those groups together.”