States could also seek waivers to opt out of the ACA's community rating rule, which prohibits insurers from charging enrollees different premiums based on factors such as age, gender or health status. These pools existed before Obamacare, and research showed they often failed to make coverage affordable and accessible.
The plan was crafted by MacArthur along with Rep. Mark Meadows, R-N.C., head of the House Freedom Caucus. But the new plan isn't a completely new AHCA; it's an amendment meant to appease the ultra-conservative House Freedom Caucus, whose opposition to the original plan ultimately tanked the vote.
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. The story will be that the bill was changed to placate extremists who want to hang sick people out to dry - and that these members went along with it.
Obamacare's protections for those with pre-existing conditions are among the law's most popular measures. MacArthur is a leader of the roughly 50-member moderate House Tuesday Group, but it is unclear that he has won over many of their votes and he conceded that some lawmakers "are struggling to get to yes".
The conservative House Freedom Caucus came out in support of a reworked US healthcare overhaul bill even though it would not fully repeal Democratic former President Barack Obama's signature healthcare law, the group said in a statement on Wednesday.
Meadows said the plan "has real merits worthy of consideration for all the Freedom Caucus folks" and that he is optimistic they will reach a deal. "We think it's constructive". He said the provision would lower premiums and give states more flexibility.
The latest Republican plan to replace Obamacare exempts members of Congress and their staff from key changes to the health care system the GOP is trying to unravel.
Ryan told reporters that leaders were making progress but added, "We're going to go when we have the votes". As always, I'll let you know if they get back to me on this or anything else ever.
Assuming all Democrats are present, GOP leaders can't afford to lose more than 21 Republicans and still pass a new health care bill.
Rep. Tom MacArthur (R-NJ) said today that he's seen the problems with the USA health care system through tragedies in his own life.
The hospital groups - the American Hospital Association and America's Essential Hospitals - both voiced concerns that the amendment would not lessen the number of people expected to be left uninsured under the Republican bill. "I urge the Speaker and Majority Leader to keep their TrumpCare bill off the House Floor".
At least 21 Republicans, as of Thursday afternoon, had said they would vote no on the latest version of the bill that could come to a vote in the House of Representatives next week, The Hill reported.
Republican leaders have not scheduled a vote on the bill.
President Donald Trump himself campaigned hard on repeal, saying it would be "easy" and warning that if the law wasn't repealed, it "will destroy health care in America".