Health and Science

House Speaker Ryan says vote on 'new' Obamacare replacement will happen 'when we have the votes'

Key Points
  • The American Health Care Act has so far failed to draw enough Republican support to pass the House.
  • The new version would let states opt out of some key Obamacare rules under certain conditions.
  • The bill likely would face difficulty passing the GOP-controlled Senate in its current form.
House Speaker Paul Ryan speaks to reporters during a news conference on Capitol Hill in Washington, Thursday, April 27, 2017.
Manuel Balce Ceneta | AP

Where have you heard this one before?

House Speaker Paul Ryan said Thursday there was no specific date for a vote on the latest proposal to repeal and replace major parts of Obamacare, saying Republican leaders would call that vote only when they know they will win it.

"We're going to go when we have the votes," the Wisconsin Republican told reporters, echoing a refrain by GOP leaders that has been heard for weeks.

Ryan also said he was not going to be bound by an "artificial deadline" to try to pass the new version of the American Health Care Act.

Ryan, who won support from a key conservative House group on Wednesday for the revised bill, said, "I would argue that this is the bill that moderates would be more likely to vote" for.

He noted that GOP Rep. Tom McArthur, a member of the moderate Tuesday Group, had helped negotiate the new bill with the conservative Freedom Caucus chief Rep. Mark Meadows.

And he said that people with pre-existing health conditions would be protected "even better ... under our plan" than they are now under Obamacare.

That claim was immediately met with scorn from Obamacare supporters.

The new version of the ACHA would allow states under certain conditions to waive Obamacare rules that prevent insurers from charging people with pre-existing conditions more for coverage than healthier people, and that require insurance plans to provide a certain set of minimum essential health benefits.

The speaker and President Donald Trump were badly embarrassed last month when Ryan was forced to cancel a scheduled vote on that bill at the last minute once it became clear the ACHA would fail to pass in a full House vote.

Although Republicans control the House, two dozen or more conservative and moderate GOP members were poised to vote against the bill for various reasons, dooming its chances of passage.

But since then, Republicans have worked to amend the ACHA to alleviate some of those concerns. However, the GOP has avoided bringing amended versions to a vote because the leadership knew it still did not have enough support within the Republican caucus.

On Wednesday, the bill got a big boost when the Freedom Caucus came out in favor of the new bill.

But the changes designed to assuage concerns of conservatives could make it difficult for moderates to support the bill.

Republicans opposed to the bill or uncertain about it are leery of changes to Obamacare that would lead to a sharp increase in insurance premiums and a reduction in the number of people with health-care coverage.

On many of their minds is the fact that every House seat is up for grabs in the mid-term elections in November 2018. The fear among a number of GOP members is that their constituents will blame them for any fallout from a new health-care law.

Asked about the fear of losing seats, Ryan said Thursday: "I think people's seats are at risk if they don't do what they said they were going to do."

Ryan was referring to repeated promises by Republicans to repeal and replace Obamacare.