South Jersey’s Rep. Tom MacArthur brokers ‘repeal and replace’ deal, but will it pass?

South Jersey Republican U.S. Rep. Tom MacArthur is the author of the compromise that has breathed new life into the GOP’s effort to repeal and replace the Affordable Care Act. The amended legislation allows states to get waivers for things like covering pre-existing conditions. While it’s won over more conservative members, it hasn’t gained enough support to get a full vote scheduled.

MacArthur is a straightforward Republican. A few reports accused him of running away from reporters’ questions on Wednesday, but normally he’s available and doesn’t dodge questions.  You always know what’s on his mind, likely to the chagrin of party leaders.

It’s only his second term in Congress, so he usually doesn’t garner that much attention. This week was different. After he forged a compromise with members of the conservative House Freedom Caucus on a health care overhaul, he was the hottest ticket in town.

So how did he win over that big voting bloc that had been unwilling to endorse the old version of the bill because it did not go far enough? MacArthur, a former insurance company CEO, said that during Congress’ two-week Easter recess, he kept negotiations going.

“It really came out of those meetings before the break that the vice president was leading, and I think some good ideas came out of that that never coalesced into a proposal,” MacArthur said. “And so I put pen to paper.”

But MacArthur is a moderate and now he’s teamed up with the far right wing of his party to forge ahead on what polls have shown is an unpopular health care effort. Is he putting his seat at risk?

“Well, I’m not looking at this through a political lens,” he said. “We have a health care crisis in this country that has to get solved. And right now, as we speak, 23 million Americans do not have insurance. And millions more are relying on insurance in a system that is slowly collapsing.

“Every day, insurance companies are leaving. My home state had six health insurers 18 months ago, now we have two. One-third of counties have one,” he said. “And, in spite of that, American’s health care insurance costs are skyrocketing.”

MacArthur’s amendment opens the door for states to opt out of things like forcing insurance companies to provide maternity leave and cancer treatment without jacking up the prices for them. They would still be offered coverage, but critics say those offers ring hollow if the premiums are unaffordable.

MacArthur says the amendment is necessary because the current system, with premiums rising for everyone, is unsustainable.

“That’s what my amendment is trying to get at. How do we do these two things? Help those that are in need, make sure every American has insurance, and, at the same time, make sure the costs are under control,” he said.

Other moderate Republicans not on board

Ironically, his plan is not playing well with moderate Republicans in New Jersey and Pennsylvania. U.S. Rep. Leonard Lance represents a district just north of MacArthur’s, which stretches from Hunterdon County east across New Jersey.

“I am opposed to the bill, and I think the Democrats should come to the table on the issue of the exchanges, which I think is an area that needs reform immediately,” Lance said.

Lance says he doesn’t think the bill will work.

“I want to vote for a proposal that lowers premiums for the American people, and I don’t think this bill does that,” he said.

U.S. Rep. Ryan Costello, who represents parts of four counties west of Philadelphia, is not sold either.

“My principles have always been making sure we have affordable access for all Americans, and I believe the pre-existing conditions protection should be without contingency, so it’s for those reasons,” Costello said.

Republican U.S. Rep. Pat Meehan from the neighboring 7th District also opposes the plan.

Still, MacArthur said, he’s actively lobbying his skeptical colleagues to get on board.

“We have a job to do as Congress. Ideally, we should be doing things, both Republicans and Democrats. On this particular bill, it’s going to be an all-Republican effort,” he said. “So I simply am looking at which Republicans can we get to support a compromise that is helpful for moving along health care reform, which is desperately needed.”

At one point, there was talk about a vote on the amended bill this week, but that was delayed. When the original bill was scheduled for a vote and then tabled, it was because both the Freedom Caucus and many moderate Republicans lined up against it.

It’s unclear if the Republicans can get it through the House if one of those camps votes against it.

Regardless of the outcome, MacArthur is now tied to the plan in a way that will likely be part of any Democratic candidate’s campaign against him in 2018.