BY ERIN MERSHON AND LINDSEY McPHERSON

Former House Energy and Commerce Chairman Fred Upton of Michigan switched his position to support the Republican health care bill after President Donald Trump agreed Wednesday morning to a policy change that could provide $8 billion in funding to some states to help lower costs for sick people and those with pre-existing conditions whom insurance companies could charge more in premiums under the measure.

Upton met at the White House with Trump, Energy and Commerce Chairman Greg Walden of Oregon, Health Subcommittee Chairman Michael C. Burgess of Texas, and fellow holdout Rep. Billy Long of Missouri, according to Majority Whip Steve Scalise of Louisiana and several GOP aides.

“We’ve been working with them and a number of other members to continue growing the vote, and we’ve been successful so far,” Scalise said before the White House meeting.

Winning over Upton, a leader on the party’s health care policies, and Long, a key Trump ally, has broader significance for House GOP leaders’ efforts to pass the GOP health care package this week. The House voted Tuesday to allow lawmakers to pass legislation until Friday under same-day authority.

Their defections just earlier this week swelled the ranks of “no” votes to at least 21. Republicans can only lose 22 votes and still pass the measure. A dozen other members have told CQ Roll Call they remain undecided.

Earlier this week, Upton and Long balked at supporting the Republican package under consideration because they said it did not go far enough to protect people with pre-existing conditions, a concern shared by many other holdouts.

Republican leaders had argued that the $115 billion over 10 years in the package for state and federal high-risk pools will help insurers offset the costs of covering sicker Americans who could be charged higher prices for insurance under the current bill.

“We’re getting really close,” Speaker Paul D. Ryan said when asked on WCLO’s “Your Talk Show with Tim Bremel” if the House will vote on the GOP health care bill this week. “We haven’t made that decision but we’re getting really close.”

Ryan said Republicans have been working to refine the bill. “We’re making sure that we have three or four layers of protections for people with preexisting conditions in the bill,” he said.

The Upton proposal would include more money for that effort.

“We think by directly subsidizing people who have catastrophic illnesses … you dramatically lower” premiums for more healthy individuals, Ryan said. The GOP’s high-risk pools proposal is effectively “reinsurance of insurance,” he said.

“We’re trying to find what I call the consensus on how to achieve this goal and we’re getting really close,” he said.

The extra $8 billion, which a House GOP aide said would be provided over five years, would supplement the funding for programs for sick people.
The $8 billion in funding would help reduce premiums or out-of-pocket costs for individuals with pre-existing conditions in states that receive waivers under an amendment proposed by Tom MacArthur of New Jersey, the House Republican aide said.

It would be available to help only those individuals who could be charged higher premiums under that amendment because they had a lapse in coverage, the aide said.

Democrats reacted to the news by reviving one of the most infamous rhetorical devices of the health care debate: death panels. Use of the term “death panels” was used as a GOP rallying cry during the 2009 health care debate. 

“The proposed Upton amendment is like administering cough medicine to someone with stage 4 cancer. This Republican amendment leaves Americans with preexisting conditions as vulnerable as they were before under this bill. High-risk pools are the real death panels: they mean waiting forever in line for unaffordable health insurance,” Senate Minority Leader Charles E. Schumer of New York said in a statement. 

John T. Bennett contributed to this story.