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Desperate for any kind of legislative victory, the Trump administration is expressing confidence about a new Republican health care bill that could emerge in the House this week.

During a White House news conference last week, President Donald Trump said progress was being made on a “great plan” for overhauling the nation’s health care system, though he provided no details.

“We have a good chance of getting it soon,” Trump said.

The reason for Trump’s optimism is a deal brokered by leaders of the conservative Freedom Caucus and the moderate Tuesday Group aimed at giving states more flexibility to pull out of “Obamacare” provisions.

The bill would repeal President Barack Obama’s Affordable Care Act and replace it with less generous subsidies and eased insurance requirements.

The bill as reported will provide even less health care coverage than the GOP House bill that was pulled in March for lack of support. The revised proposal is designed to appeal to the more conservative base of the Republican Party.

“Every time they move the scrimmage line, you risk losing other people who were ‘yes’ but this changes them to a ‘no,’” Rep. Dan Donovan (R-N.Y.) said of attempts to win over one end of the GOP spectrum without losing votes from the other side.

Donovan, a centrist, said he remained a no vote, partly because the legislation would increase Medicaid costs for New York City’s five boroughs.

While Trump is expressing confidence about the revised bill, there are signs that it does not have enough votes to succeed, especially among moderates.

The revised bill would be worse than the previous proposal because it would allow states to waive some crucial requirements including covering various preexisting conditions and essential health benefits.

In a bid for conservative support, states could obtain waivers to an Obama prohibition against insurers charging sick customers higher premiums than consumers who are healthy — a change critics argue would make insurance unaffordable for many.

To get those waivers, states would need to have high-risk pools: government-backed insurance for the most seriously ill people and a mechanism that has often failed for lack of sufficient financing.

Trump is anxious to pass legislation quickly, partly because he will likely hit his 100th day in office without having signed a major piece of legislation.

The Trump administration and Republican congressional leaders are eager to dismantle the Obama’s health care law at a time when polls show the existing statute has growing public support.


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