MacArthur’s plan on Obamacare faces make-or-break moment

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WASHINGTON — Tom MacArthur went out on a limb.

The next 48 hours could determine if it snaps beneath him.

The Republican Congressman from South Jersey took a steep risk last month, becoming the face of a plan to roll back one of the most popular patient protections in the Affordable Care Act. His amendment is part of an effort to woo House conservatives and, he hopes, finally advance an overhaul of the law often called “Obamacare.”

After appearing on the brink of failure Tuesday, it gained new momentum Wednesday when two prominent opponents negotiated a deal with President Trump and reversed their positions.

The plan still remains in a precarious position, even as the White House and House leaders desperately push for a vote this week. With the House scheduled to leave town Friday for a week-long recess and one failed repeal effort already in the books, many Republicans believe it’s now or never on their longheld promise to tear up the law.

If it fails, MacArthur might be looking at the worst of all worlds: He would be the author of an idea — dubbed “the MacArthur amendment” — attacked for undercutting a well-liked safeguard, but without any tangible results to show for it.

The 56-year-old, two-term congressman from Toms River acknowledged the challenge Tuesday.

“Although you can’t escape the politics of this, I try to focus on the actual effect on people, and after 30 years in insurance I read a lot of things that are simply not true about what this bill does and doesn’t do,” he said off the House floor, surrounded by a horde of reporters. “It does protect people with pre-existing conditions, but it does it in a way that doesn’t everyone else’s premiums going through the roof.”

His critics, including some Republicans, sharply dispute his assertions about a proposal that has dominated Capitol Hill.

One influential opponent of the measure, Rep. Fred Upton (R., Mich.), tried to revive its chances Wednesday with a proposal that would add $8 billion over five years to help cover people with pre-existing conditions. That change moved Upton and another opponent to the ‘yes’ column, Politico reported.

Upton is a former chairman of the committee that oversees health policy. MacArthur, by contrast, has gained heft in this debate due to his private background, said Rep. Tom Cole (R., Okla.).

“He has obviously a profesional expertise that far surprasses almost anybody in our Congress,” Cole said.

MacArthur founded an insurance company called York Risk Services that made him wealthy before he sold it in 2010 for around $500 million. He also had a daughter, Gracie, who was born with severe health problems and died, nearly 20 years ago, at age 11.

“If I didn’t have insurance, I would be bankrupt, because I also had a child with serious issues and massive medical bills,” MacArthur said. “Those are real issues and we have to protect those situations. I believe the bill does that.”

MacArthur has explained his compromise pragmatically: His proposal would advance the only vehicle now available to roll back Obamacare and, in his view, save the health insurance market.

If Republicans can’t find the votes before recess, he said, “how many times are we going to go through this?”

The amendment, whether or not it passes, has already made MacArthur into a prime political target. A group called “Save My Care” has launched television ads attacking him and on Tuesday the liberal New Jersey Citizen Action delivered a 34,139-signature petition to his South Jersey office urging him to stop his effort.

Facing reelection in a swing district next year, MacArthur has not shied away. He has scheduled a town hall meeting for next week.

His plan required defying the Republican centrists he normally aligns with and cutting a deal with the hard-right Freedom Caucus.

The deal would allow states to opt out of Obamacare’s restriction against charging higher rates to people who have pre-existing medical conditions, such as cancer, asthma or heart disease.

Groups like the AARP and American Medical Association say it could lead to steep spikes in prices for those people, effectively putting insurance out of reach for people who need it most. They say MacArthur’s proposed safeguards would be inadequate.

MacArthur says his plan would reduce costs for healthy people and provide fall-back options for those with pre-existing conditions — though he has failed to convince any other Republicans from the Philadelphia area, who all oppose the measure.

Late-night comedy host Jimmy Kimmel drew national attention to the issue this week with a tearful monologue describing how his son had been born with heart disease and needed surgery to live. Without protections for pre-existing conditions, his son might never be able to obtain health insurance, Kimmel said.

Some Republicans say they should vote for MacArthur’s amendment simply to advance the repeal process, hoping the Senate improves the measure.

“If you kill it in the cradle, you basically are ratifying Obamacare,” Cole said.  

He said the biggest danger for fellow Republicans is not backing the MacArthur plan, but failing to deliver the promised repeal that has energized the GOP base.

“If you think voting ‘no’ is going to save you in the next election, it’s not,” Cole said. “We have to do two things: Number one, pass something. Number two: the guys that are designing it … better be right.”

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