Seth A. Richardson

Reno Gazette-Journal

5 p.m. Thursday update:

U.S. Rep. Mark Amodei, R-Nev., became a late addition to the Republican effort to repeal several key components of President Barack Obama’s health care law on Thursday when he flipped his vote from ‘no’ to ‘yes.’

Amodei was originally against the bill pushed by Republican House Speaker Paul Ryan, R-Wis., and President Donald Trump in its first incarnation in March and remained so through several revisions as of April 28.

Republicans successfully passed the bill, known as the American Health Care Act or AHCA, moving it to the Senate where it faces a tougher road.

The flip in the vote comes after Amodei met with Vice President Mike Pence, Ryan and Secretary of Health and Human Services Tom Price on Wednesday. Amodei said in a Thursday statement he did not think the bill would harm the state with cuts to Medicaid or alterations to insurance company’s abilities to refuse or raise the cost of coverage to people with preexisting conditions.

"Accordingly, I have concluded that the potential for Nevada deficits or expanded Medicaid enrollees being kicked off of Medicaid will be avoided," he said.

House Republican leadership and Trump made several attempts to jam the legislation through Congress before the end of May before successfully doing so Thursday to use a process known as reconciliation. A reconciliation vote is able to bypass the filibuster in the Senate, requiring only 51 votes, with Pence able to cast the tiebreaker.

The latest draft of the bill to replace Obamacare includes most of the previous provisions – cutting Medicaid and ending the mandate that people purchase insurance, among others – but would also repeal one of the most popular provisions: barring companies from discriminating against patients with pre-existing conditions.

The new bill allows for companies to alter the price of customers with pre-existing conditions – anything from cancer to pregnancy. A provision was added to help offset some of the costs by including $8 billion to subsidize sick people’s coverage, but analysts have said that is short of what is needed.

High-risk pools would also be promoted under the new bill, lumping already sick people into a group for insurance purposes, which Republicans say will lower the cost of insurance for healthy people. Critics say that creates a two-tier system and raises costs on people with pre-existing conditions.

Amodei originally chastised leadership for the hurried process of trying to replace Obamacare.

“The problem is there aren’t any witnesses,” Amodei said before a joint session of the Nevada Legislature in March. “You know, folks who are sometimes considered shareholders? People who have views whether they’re with yours or against yours.”

“How can I have a serious discussion about health care when I can’t go back to any record whatsoever?” Amodei said during a later press gaggle that same day. “That’s a problem for me.”

Congress hasn’t held any hearings and is slated to vote Thursday without obtaining an updated report from the Congressional Budget Office, a nonpartisan entity that determines the anticipated effects of the bill. The original score from the CBO estimated 24 million people would lose health coverage by 2026.

Amodei also had initial concerns about cuts to Medicaid funding for the state that could push newly-eligible people off the rolls. A significant reduction in funding could lead to a massive budget deficit for the state Legislature to deal with.

Current law allows anyone who is earns 138 percent of the poverty line or below to enroll in the Medicaid expansion program, provided the state in which they reside accepted the expansion. Nevada was one of those states.

Even with Democrats united against the bill and several Republican holdouts, the House is likely to pass the bill on Thursday, pushing it to the Senate. However, it could face problems there from a more moderate bloc of Republican senators, including U.S. Sen. Dean Heller, R-Nev.

Heller said Thursday following the House vote that he would not support the bill in its current form.

Whatever swayed Amodei also was not enough to convince Gov. Brian Sandoval that the bill would work for the state. He said in a statement Thursday his opposition to AHCA was unchanged.

9:45 a.m. Thursday update:

U.S. Rep. Mark Amodei, R-Nev., confirmed he was switching his vote on the plan to repeal and replace Obamacare from 'no' to 'yes' in a lengthy statement on Thursday.

Amodei said his concerns were alleviated after concerns about cuts to Medicaid funding for the state that could push newly-eligible people off the rolls.

Current law allows anyone who is earns 138 percent of the poverty line or below to enroll in the Medicaid expansion program, provided the state in which they reside accepted the expansion. Nevada was one of those states.

"Accordingly, I have concluded that the potential for Nevada deficits or expanded Medicaid enrollees being kicked off of Medicaid will be avoided," he said.

One of Amodei's original criticisms was the hurried pace of passing the legislation. He did not address that issue in his statement.

Original story:

U.S. Rep. Mark Amodei, R-Nev., has reportedly flipped his vote from no to yes on the rushed package to repeal and replace President Barack Obama’s health care law.

Amodei was originally against the bill pushed by Republican House Speaker Paul Ryan, R-Wis., and President Donald Trump in its first incarnation in March and remained so through several revisions as of April 28.

Matt Fuller of the Huffington Post reported Thursday on Twitter that Amodei – originally a no vote on the bill – had changed his mind.

The flip in the vote comes after Amodei met with Vice President Mike Pence, Ryan and Secretary of Health and Human Services Tom Price on Wednesday. Amodei’s office did not respond to a request for comment.

House Republican leadership and Trump have made several attempts to jam the legislation through Congress before the end of May to use a process known as reconciliation. A reconciliation vote is able to bypass the filibuster in the Senate, requiring only 51 votes, with Pence able to cast the tiebreaker.

MORE:Obamacare repeal: Republicans scramble in 11th hour with new health plan

The latest draft of the bill to replace Obamacare includes most of the previous provisions – cutting Medicaid and ending the mandate that people purchase insurance, among others – but would also repeal one of the most popular provisions: barring companies from discriminating against patients with pre-existing conditions.

The new bill allows for companies to alter the price of customers with pre-existing conditions – anything from cancer to pregnancy. A provision was added to help offset some of the costs by including $8 billion to subsidize sick people’s coverage, but analysts have said that is short of what is needed.

High-risk pools would also be promoted under the new bill, lumping already sick people into a group for insurance purposes, which Republicans say will lower the cost of insurance for healthy people. Critics say that creates a two-tier system and raises costs on people with pre-existing conditions.

Amodei originally chastised leadership for the hurried process of trying to replace Obamacare.

“The problem is there aren’t any witnesses,” Amodei said before a joint session of the Nevada Legislature in March. “You know, folks who are sometimes considered shareholders? People who have views whether they’re with yours or against yours.”

“How can I have a serious discussion about health care when I can’t go back to any record whatsoever?” Amodei said during a later press gaggle that same day. “That’s a problem for me.”

Congress hasn’t held any hearings and is slated to vote Thursday without obtaining an updated report from the Congressional Budget Office, a nonpartisan entity that determines the anticipated effects of the bill. The original score from the CBO estimated 24 million people would lose health coverage by 2026.

Even with Democrats united against the bill and several Republican holdouts, the House is likely to pass the bill on Thursday, pushing it to the Senate. However, it could face problems there from a more moderate bloc of Republican senators, including U.S. Sen. Dean Heller, R-Nev.

Heller stated in March he would not vote for the original version of AHCA. His office did not immediately respond to a request for comment on Thursday.

Seth A. Richardson covers politics for the Reno Gazette-Journal. Like him on Facebook here or follow him on Twitter at @SethARichardson.