After a humiliating loss on health care reform last month, the White House went back to the negotiating table with House conservatives on a bill to repeal and replace the Affordable Care Act. The result is a proposal to eliminate one of the ACA's most popular provisions: protections for those with pre-existing conditions.
Under the ACA, better known as Obamacare, health insurance providers cannot charge people with pre-existing conditions more than those who are healthy. But the new administration is now considering allowing states to opt out of that rule, according to the Associated Press. It's a change that would allow insurers to charge sick Americans more money for coverage.
The protections for pre-existing conditions consistently polls as one of the most popular provisions of the ACA, with 71% of survey respondents saying the protections should stay, according to a recent Politico poll.
Even the House GOP seemed to recognize this. Bloomberg reporter Steven Dennis pointed out that, as of Monday night, the House Republicans' website said "people should 'never' pay more for health insurance because they're sick."
Trump's White House is also floating the idea of allowing states to opt out of a requirement that insurers offer certain "essential health benefits," according to the New York Times. These include everything from covering prescription drugs to mental health care to maternity coverage.
The new rules would mean health care companies can essentially charge sick Americans more money for plans that may not even cover the services they need.
Trump, for his part, has said he would not get rid of pre-existing condition protections. So if a bill is introduced with these terms, he would be backtracking on a previous pledge.
For now, the proposal is just that: A proposal.
Legislation hasn't been introduced and the bill is not final, with House Speaker Paul Ryan saying talks about changes to Obamacare are still in the "conceptual phase."
It also has not been scored by the Congressional Budget Office, a nonpartisan agency that estimates both the human cost of legislation before Congress and how much bills would add or subtract from the federal deficit.
And with Congress set to go on a two-week recess for the Passover and Easter holidays at the end of the week, and little appetite from House Republicans to eat into that break to negotiate a health care deal, a possible new bill is weeks away.
But nixing some of the most popular provisions in Obamacare would place some Republicans in a precarious political position in the 2018 midterm elections. There are currently 23 House Republicans who represent districts Hillary Clinton carried at the presidential election — and even some Republicans with solidly conservative seats were seeing discontent over efforts to repeal the ACA. Allowing insurance companies to charge sick Americans more money for coverage could imperil Republican House members' re-election bids.
As with the last effort to repeal the, only 21 defections by House Republicans would be necessary to scuttle the bill — potentially handing Trump another embarrassing defeat.
April 4, 2017 10:18 a.m.: This article has been updated.