Eliza Collins

USA TODAY

WASHINGTON — The House Freedom Caucus announced Wednesday that with new changes to the Republican Obamacare repeal bill, the conservative lawmakers are now willing to support the bill and are urging the rest of their party to get behind it as well. The group was critical to sinking the Obamacare repeal bill last month.

“Due to improvements to the (American Health Care Act) and the addition of Rep. Tom MacArthur’s proposed amendment, the House Freedom Caucus has taken an official position in support of the current proposal,” the group said in a statement Wednesday.

MacArthur, the New Jersey Republican who co-chairs the moderate Tuesday Group, negotiated new language with Freedom Caucus Chairman Mark Meadows, R-N.C., to address Freedom Caucus concerns that the original bill did not go far enough in repealing the Affordable Care Act's mandates on the coverage insurers are required to provide.

The amendment leaves many of the mandates from Obamacare in place, in an attempt to keep or get moderate support, but it also gives states the option to apply for waivers that would get rid of the minimum insurance requirements, like coverage of maternity care and mental health treatment.

States will be granted waivers if they can prove one or more of the following: Premiums will go down, more people will get insurance, the insurance markets or premiums will be stabilized, or there will be more health options in the state.

The amendment does say that even with waivers, insurance companies cannot discriminate in their rates based on gender. They also must provide coverage to people with pre-existing conditions, though it is not clear whether costs will go up for people with pre-existing conditions.

“The MacArthur amendment will grant states the ability to repeal cost driving aspects of Obamacare left in place under the original AHCA,” the Freedom Caucus said. “While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower healthcare costs. We look forward to working with our Senate colleagues to improve the bill."

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Conservative interest groups — which had previously come out against the bill and said Republicans would be held accountable for their votes — indicated support for the amendment, too.

"This latest agreement would give states the chance to opt out of some of Obamacare’s costliest regulations, opening the way to greater choice and lower insurance premiums," Club for Growth President David McIntosh said in a statement.

Heritage Action stopped short of a full endorsement but said it would not attack members who vote for the legislation.

“To be clear, this is not full repeal and it is not what Republicans campaigned on," said Heritage Action CEO Michael Needham. "The amendment does, however, represent important progress in what has been a disastrous process."

But even with the amendment, not all conservatives were on board. Arizona Rep. Andy Biggs, a member of the Freedom Caucus, remained against the bill despite the change.

"As amended, the American Health Care Act (AHCA) would not be the clean repeal of Obamacare I promised and would not lower premiums to pre-ACA levels," Biggs said.

While the Freedom Caucus’ endorsement of the amendment will bring on a significant number of votes, it was not immediately clear whether it would gain support of moderates. With no Democratic support for an Obamacare repeal, the bill will not pass if two dozen Republicans vote against it.

Speaker Paul Ryan, R-Wis., has not yet scheduled a vote on the amended bill, but he praised the new language Wednesday. "We think the MacArthur amendment is a great way to lower premiums, and give states flexibility while protecting people with pre-existing conditions," Ryan said. "Those are the three things we want to achieve ... And I think it helps us get to consensus."

Rep. Dan Donovan, R-N.Y., told USA TODAY he was a “no” on the original bill and as of now that hasn't changed.

“The MacArthur-Meadows amendment does give states some choices, I believe states should have choices in what health care benefits are best for their residents. But it doesn’t address the things that hurt me in New York,” Donovan said. For Donovan and other moderates, there is significant concern that elderly and infirm constituents will see higher insurance premiums and reduced coverage.

“I was opposed to it before, I’m still opposed,” Rep. Charlie Dent, R-Pa., who co-chairs the Tuesday Group along with MacArthur, told reporters.

Rep. Mario Diaz-Balart, R-Fla., told reporters he had gotten to a “yes” on the last bill but wasn’t sure whether he was still there with the new amendment because he had concerns about his constituents with pre-existing conditions.

MacArthur met with a group of reporters in his office late Wednesday and defended his legislation against criticism from moderates.

“My goal in offering the amendment was to bridge a divide not in one part of our conference or another part, it was to try to get people that were against the bill before to favor it from wherever they come from. And it has set some movement in the conference overall,” said MacArthur, who is an insurance executive. “Whether people are coming from one group or another, to me, is less the issue.”

When asked whether he was concerned about "bleeding" moderate votes in order to bring on conservatives, MacArthur avoided the question and said it was important to get the votes to repeal Obamacare.

But later in the conversation, he acknowledged that the new amendment flipped the narrative from the Freedom Caucus being obstructionists to moderates being the ones who could hold up the bill.

“Anybody who is wavering feels some pressure,” he said.

The Freedom Caucus endorsed the changes with the understanding that one provision of the amendment will be removed, according to spokeswoman Alyssa Farah. A provision stuck into the bill, first reported by Vox, would group members of Congress and their staff together in an insurance plan that would not be affected by the amendment’s terms.

“We don’t believe that members of Congress should be treated differently so we’re already working on that particular issue,” Meadows told reporters. “We understand the optics and we’re working to make sure it gets fixed."

The progressive super PAC Priorities USA announced that it was spending six figures to run digital ads against the updated legislation. The ads will run in nine states that have will have close House and Senate races in 2018.

House Minority Whip Steny Hoyer pointed at the stop-and-go efforts of House Republicans to repeal Obamacare as cause for insurance market destabilization.

“This latest change would still allow discrimination against Americans with pre-existing conditions, making it substantially the same bill that House Republican leaders could not secure the votes to pass last month," the Maryland lawmaker said in a statement. "These stop-and-go legislative efforts by Republicans to repeal and undermine the Affordable Care Act are destabilizing our health care markets, leading insurers to exit the marketplaces and consider raising premiums."