By Congressman Dave Brat (R, VA-7)
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 behind this decision, so I hope you will take a moment to read through this email and the attached links that explain the AHCA in detail. I also cover some of the myths and facts surrounding the bill. Bottom line, the Freedom Caucus has worked tirelessly to improve the AHCA to make it better for the American people. When we started, only 17% 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.
Excerpt from “Friends of Dave Brat, Inc.” message dated April 30, 2017
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.
For those who want to dive deeper into the numbers, here is a very helpful analysis that shows how premiums can and will go down via use of the MacArthur waiver. Click here to read the analysis.
Myths and Facts Surrounding the AHCA/MacArthur Amendment
The MacArthur Amendment ensures essential health benefits are the federal law of the land and maintains other important protections.
- States have the option to obtain a waiver regarding federal essential health benefits, but the state must publicly attest its purpose for doing so (to reduce the cost of healthcare coverage, increase the number of people with healthcare coverage, etc.), and it must specify the benefits it will require instead of the federal standard.
- NO STATE, under ANY circumstances, may ever obtain a waiver for pre-existing condition protection, prohibition on gender discrimination, for guaranteed issue and renewability, or for the right of dependents to stay on a family plan up to age 26.
- Members of Congress should live by the same rules as everyone else. Period. There will not be a congressional exemption from the AHCA for Members and their staff, and a stand-alone bill has been introduced to ensure this.
There is no misunderstanding; this bill is not a full repeal—and that is a very valid concern, especially given that Republicans campaigned on full repeal. As I stated earlier, this is not the bill that I wanted. However, this is the closest Republicans have come to being able to repeal large portions of Obamacare.
And, this is key: You have to assess what would happen if the vote continued to be held up. The answer would be the same as what we have seen play out in the past with the budget process, where budgets get busted when members cross the aisle to find help from Democrats to pass a bill. The result will not be pretty. Anyone who is not taking that into account has not thought carefully about the process.
I have kept my word to fight for repeal of Obamacare. Please know that I will continue to work with my House colleagues and Senate colleagues to improve the bill, and that work will not end until Obamacare is fully repealed.
Trump’s Tax Reform Plan: Initial Thoughts
Also, last week, President Trump released his much-anticipated tax reform plan. I was on Fox Business Coast to Coast to talk about it with host Neil Cavuto. ICYMI, you can watch it here.
I also talked tax reform, as well as the status of the healthcare bill, with Breitbart Daily News host Alex Marlow on Friday. The key to the Trump tax plan will be finding revenue via repatriation of dollars overseas that will lessen the pain on the deficit side in the short term. Listen to the interview here:
Trump’s First 100 Days
President Trump is not your father’s Oldsmobile—he’s bringing new ideas, as well as a new political realignment and now we all have to work together to keep moving forward on a positive America First agenda that will create jobs and prosperity for Americans across the board. One of the most important things that has come out of the President’s first 100 days is the enormous positive energy. After Obama, the general culture was getting very negative: negative on capitalism, negative on the police, negative on law enforcement, negative on the rule of law. Everyone knows you cannot sustain all of that negativity as culture. And so, giving President Trump a grade for his first 100 days—when it comes to reaffirming the American Spirit, the work ethic, and the idea that business is morally good—all of that is worth an “A” grade in my book.