Trying to Revive Health Bill, G.O.P. Adds $15 Billion for Sickest Americans

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Speaker Paul D. Ryan held a news conference with House Republicans on Thursday to discuss health care.

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Gabriella Demczuk for The brand-new York Times

WASHINGTON — Under intense pressure by President Trump, House Republicans took a smaller step Thursday to revive legislation to dismantle the Affordable Care Act, adding a $15 billion fund to help insurers pay claims for their sickest customers.

Speaker Paul D. Ryan orchestrated a broad show of Republican support for the proposal, conceived as an amendment to the repeal bill of which collapsed on the House floor two weeks ago. yet Republicans said they still did not have enough votes to pass the bill, in addition to also with the House currently on a two-week spring break, time will be running out for their planned quick-strike repeal of President Barack Obama’s health care law.

Even so, Republicans said the amendment could help heal divisions in their conference in addition to also show progress to an impatient president, still smarting by a loss in his first showdown with Congress.

By a party-line vote of 9 to 2, the House Rules Committee on Thursday gave its blessing to the proposal, devised by Representatives Gary Palmer of Alabama in addition to also David Schweikert of Arizona, both members of the conservative House Freedom Caucus.

Mr. Palmer said the “risk-sharing program” would certainly lower premiums by sparing insurers some costs. With lower prices, he said, more people would certainly buy insurance.

He estimated of which the idea would certainly reduce the number of uninsured Americans by 1.2 million to 2.2 million. However, those gains would certainly be dwarfed by different parts of the repeal bill, which the nonpartisan Congressional Budget Office says would certainly result in 24 million more uninsured people compared with projections under current law.

Mr. Ryan said the brand-new program would certainly also help stabilize insurance markets. “One of the concerns we have will be of which insurers are leaving left in addition to also right, in addition to also people are down to, like, one choice, in addition to also in some cases no choices,” he said.

inside the latest sign of turmoil, Aetna announced on Thursday of which the idea would certainly leave Iowa’s insurance exchange in 2018 because of “financial risk in addition to also an uncertain outlook for the marketplace.” of which followed Monday’s announcement by Wellmark Blue Cross in addition to also Blue Shield, Iowa’s largest carrier, of which the idea would certainly not sell Affordable Care Act plans there next year.

This particular leaves just one insurer for the bulk of the state. “We’re deeply troubled by the angst in addition to also concern the Affordable Care Act will be causing in Iowa,” the state’s insurance commissioner, Doug Ommen, said in a statement.

Under the latest Republican proposal, patients with high-cost conditions like metastatic cancer in addition to also AIDS would certainly not be segregated in a separate insurance pool, yet their insurers could receive extra payments, as the government would certainly cover a share of claims exceeding a level specified by federal health officials.

Reactions to the proposal showed the political challenges facing Republicans.

Representative Nancy Pelosi of California, the House Democratic leader, said the idea did nothing to improve the legislation, which she called a “horrible, monstrous bill.”

in addition to also Representative Louie Gohmert, Republican of Texas, complained of which the proposal gave “more power to the federal government to dictate what states have to do to get more money.”

yet the White House continues to press for at least the appearance of action. House Republicans took the repeal bill to the floor on March 24 in response to an ultimatum by Mr. Trump, in addition to also the president demanded action again This particular week, just as House members were about to leave town.

“Who’s running This particular place?” Representative Alcee L. Hastings, Democrat of Florida, asked. “will be the idea the speaker, or will be the idea the president? Are we letting the president tell us which amendment to report in addition to also when to report the idea?”

Mr. Palmer said his proposal was modeled on a program in Maine of which reimbursed insurers for 0 percent of certain claims by $7,500 to $32,500 a year, in addition to also the full amount of claims past of which.

Representative Tom MacArthur of brand-new Jersey, a moderate Republican, said “the beauty of This particular proposal” was of which the idea would certainly be invisible to consumers with high-cost conditions. “They would certainly be treated like everyone else, with respect,” he said, “in addition to also the high dollar amount of their claims would certainly not result in premiums going up for everyone else.”

yet the earliest Congress could get to the measure will be April 25, when lawmakers return. in addition to also at of which point, they will have just days to pass legislation to fund the government through September, in addition to also will then begin work on a budget for the fiscal year of which starts Oct. 1.

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