Upton, key GOP lawmakers flip on health care after Trump meeting

WASHINGTON (CNN) — GOP Reps. Fred Upton and Billy Long say they will now support the Republican plan to repeal and replace Obamacare after meeting with President Donald Trump Wednesday morning.

The House Rules Committee may consider the bill and key amendments Thursday, Upton said at the White House.

The White House is in a full-court press Wednesday to rally GOP support to repeal and replace Obamacare as a key Republican congressman is working on an $8 billion plan that could break the impasse.

Republican Rep. Fred Upton, an influential lawmaker in the health care debate, is finalizing an amendment to the Republican bill to repeal and replace the Affordable Care Act that could move him from a "no" vote to a "yes."

Upton and Republicans Reps. Billy Long, Greg Walden and Michael Burgess met Wednesday morning with Trump at the White House.

Upton rocked Capitol Hill on Tuesday by publicly coming out against the GOP health care bill, for which House Republican leaders still do not have enough votes. But his work on the new amendment looks poised to move the Michigan congressman to the "yes" column at a crucial moment when every vote counts.

The amendment would add $8 billion over five years to fund high-risk pools and go toward patients with pre-existing conditions in states that seek waivers under the Republican legislation, two sources told CNN.

The President called about a dozen wavering Republican lawmakers throughout the day on Tuesday, urging them to back the health care bill, a White House official said.

It's very much an open question, though, how helpful this may be, because the President often is suggesting on some calls he's more open to changing the bill to win over moderates, each call creating a new dynamic.

But he is urging them to pass the bill, declare victory and move on.

Freedom Caucus OK with Upton changes

For now, the conservative House Freedom Caucus would continue to back the bill with the Upton amendment, barring any other major policy changes, a source told CNN.

But the more important question is whether this amendment could bring on board additional "no" Republicans -- and how many.

New Jersey Rep. Leonard Lance, a moderate Republican opposed to the bill, told CNN Wednesday morning that Upton's proposed change would not sway him to support the health care legislation. Lance also noted that he has not heard from Trump or Vice President Mike Pence in several weeks.

The future of the bill "as uncertain as we've seen it," a Republican involved in the health care talks said.

The details of the Upton amendment settled on Tuesday night and the House Energy and Commerce committee is now offering technical drafting guidance so that his idea can become legislative text, a committee source added. The source cautioned, however, that as of Wednesday morning, the amendment had not been finalized.

How to handle coverage for Americans with pre-existing conditions has been a struggle for Republicans seeking to fulfill their longstanding desire to repeal Obamacare. A major pillar of the law is the ban on insurance companies from discriminating against people based on their past medical conditions.

For decades prior to the enactment of the Affordable Care Act, many Americans were unable to even afford or obtain insurance because of their past medical history. As Obamacare has shifted that norm, Republicans have grown increasingly careful in recent years to say they would not repeal protections for people with pre-existing conditions, wary of being branded the party that wants to take that protection away.

High-risk pools

High-risk pools have long been a favorite tool of Republicans, but they have a very checkered past. They were typically severely underfunded, charged participants high premiums, excluded coverage of pre-existing conditions initially and had waiting lists for enrollment.

Some 35 states ran high risk pools prior to Obamacare. In 2011, states had to kick in $1.2 billion to cover 226,000 people enrolled in the programs.

Upton's plan likely wouldn't make much of a difference.

"You just aren't going to cover many people with $8 billion over five years," said Karen Pollitz, senior fellow at the Kaiser Family Foundation.

What's in the bill?

The GOP health care bill would eliminate Obamacare taxes on the wealthy, insurers and others, and get rid of the individual mandate imposed by Obamacare, officially known as the Affordable Care Act. Instead of the Obamacare subsidies that are tied to income and premiums, the GOP plan would provide Americans with refundable tax credits based mainly on age to purchase health insurance.

The legislation would also allow insurers to charge higher premiums to those in their 50s and early 60s, compared to younger consumers.

It would also significantly curtail federal support for Medicaid and allow states to require able-bodied adults to work. After 2020, states that expanded Medicaid would no longer receive enhanced federal funding to cover low-income adults, and those that hadn't expanded would be immediately barred from doing so.

And it would allow states to relax some key Obamacare protections of those with pre-existing conditions, which are among the health reform law's most popular provisions. States could apply for waivers to allow insurers to offer skimpier policies that don't cover the 10 essential health benefits mandated by Obamacare. Also, insurers would be able to charge higher premiums to those with medical issues if they let their coverage lapse. States requesting waivers would have to set up programs -- such as high-risk pools -- to protect insurers from high-cost patients.

However, the GOP bill doesn't touch one another beloved piece of Obamacare -- letting children stay on their parents' insurance plans until the age of 26.

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