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After the withdrawal of the American Health Care Act in late March in the face of defeat, Republicans have continued to work on a healthcare bill that can pass Congressional muster. Earlier this week an amendment to the AHCA was negotiated between Tom MacArthur, moderate Republican and leader of the “Tuesday Group,” and House conservative Freedom Caucus Chairman Mark Meadows.

The amendment would allow states to seek waivers from ACA provisions that guarantee “essential health benefits” and prohibit charging higher rates to less healthy consumers. Opponents argue this amendment weakens several key Obamacare insurance reforms that protect those with pre-existing conditions, including the benefits insurers must cover in their policies and the ban on allowing carriers to charge more based on a person’s health background.  The AHCA would rely on so-called high-risk pools to serve the sickest Americans, aiming to keep costs and premiums down in the larger pool that serves most consumers.

While conservatives have now largely signed on to the AHCA, many moderates are still balking. It’s an effort to bridge the gap between hardline conservatives in the House Freedom Caucus and more moderate Republican members.

Major health care groups have reacted, saying the newly announced changes do not strengthen the bill and may actually weaken it.

GOP leaders will need the support of at least 216 of the 238 House Republicans, assuming total Democratic opposition. No vote is reportedly likely until later this week at the earliest.