Deirdre Shesgreen

DSHESGREEN@USATODAY.COM

WASHINGTON — Rep. Billy Long reversed his position on the House GOP bill to repeal and replace Obamacare, saying Wednesday he was now on board with the measure after Republican leaders promised to plump it up with $8 billion to help those with pre-existing conditions.

Long, R-Springfield, had said Monday that he would oppose the bill because it would undermine protections for patients with pre-existing conditions.

"I’ve always stated that one of the few good things about Obamacare was pre-existing conditions," Long told the News-Leader on Monday. The new bill "strips away any guarantee that people with pre-existing conditions could be covered at an affordable rate."

Another GOP holdout, Rep. Fred Upton of Michigan, expressed similar concerns, and he spearheaded an amendment to add the extra $8 billion to help sicker patients pay their premiums and other health care bills. Upton and Long both sit on the House Energy and Commerce Committee, which has played a central role in drafting the GOP bill, the American Health Care Act.

Long and Upton were among the GOP lawmakers called to the White House on Wednesday morning for an in-person lobbying session led by President Trump and top White House aides. They emerged with the $8 billion promise, which they said was enough to move them from "no" to "yes" on the bill.

"I support the bill with this amendment," Upton said after the meeting.

Long said he was convinced the extra funds would protect those with pre-existing conditions. The issue hits close to home for the congressman because his daughter is a cancer survivor.

"They need to be covered, period," Long said outside the White House on Wednesday.

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Under the 2010 Affordable Care Act, or Obamacare, insurance companies are barred from discriminating against those with pre-existing conditions. The GOP bill would repeal major elements of the ACA and allow states to opt out of other provisions, including several popular consumer protections.

For example, states could seek a waiver from existing requirements that insurers must cover maternity care, substance abuse and other key health services. States could also seek an exemption of the pre-existing condition protections, allowing insurers to charge such patients more if the state has created a high-risk pool.

Upton's amendment would provide additional funding for those pools, helping sick patients cover their higher health care bills.

In a radio interview on Wednesday, House Speaker Paul Ryan, R-Wis., said with the added money for high-risk pools, “we’re making sure that we have three or four layers of protections for people with pre-existing conditions.” He also said that by promoting high-risk pools and directly subsidizing people with catastrophic illnesses, “you dramatically lower the price of premiums for everyone else buying health insurance.”

At a news conference outside the White House, Long recounted a call from Trump earlier this week, in which the president pressed him to switch his vote to yes — something Long said he initially resisted.

"The president said 'Billy, really need you, we need you man, I said you don’t have me'," Long told reporters. But "with this addition that we brought to the president, and sold him on," Long said he had moved to the "yes" column.

Critics said the Upton provision was still woefully inadequate to protect those with pre-existing conditions, and they noted that high-risk pools have had mixed results in the past. Detractors also pointed to a Congressional Budget Office estimate from earlier this year that predicted the legislation would cause 24 million people to either forgo or lose their health insurance.

“Despite today’s wheeling and dealing, the GOP repeal bill still drops the coverage guarantee for people with pre-existing conditions, strips coverage from millions, and drives up costs for millions more," said Frederick Isasi, executive director of Families USA, a liberal-leaning health advocacy group. "A measly $8 billion handout isn’t going to change that."

One House conservative blasted the latest changes as Washington at its worst.

"The AHCA is like a kidney stone — the House doesn't care what happens to it, as long as they can pass it," Rep. Thomas Massie, R-Ky., said in a tweet on Wednesday.

But the last-minute changes gave House Republicans fresh momentum, and they scheduled the bill for a vote on Thursday.

Democrats are unified against the measure, so GOP leaders can only lose about 22 Republicans and still pass the bill. By multiple news outlets’ counts, roughly 20 lawmakers said they’d vote “no” as of Wednesday and about two dozen others remained undecided.

Ryan said Republicans were getting “extremely close” to having the votes they need in the House.

Contributing: USA TODAY reporters Eliza Collins and David Jackson.