In his rambling interview with the AP, President Donald Trump said “we’re very close [on health care]. And it’s a great plan, you know, we have to get it approved.”

Last week, congressional Republicans floated the possibility of a new deal to revive the American Health Care Act (AHCA), which died before getting to a vote last month. The big change would allow states to waive the Obamacare provision that stops insurance companies from charging more to people with pre-existing conditions. The deal also reinstated the Obamacare essential health benefits (the federal standards for the benefits that all health plans are required to cover, such as maternity coverage), which the first AHCA had nixed — but again, it allowed states to waive this requirement.


Initial reporting quoted sources from the White House encouraging the notion that a vote on the amended AHCA could come as soon as this week. It became clear, however, that this new plan didn’t have the votes to pass the House, and might have actually lost support compared to AHCA 1.0, since potentially slashing protections for people with pre-existing conditions is not very popular among moderate Republicans. The amended bill might actually lead to an even bigger loss of coverage than the original.

You might recall that last Monday, at a townhall in Little Rock, Sen. Tom Cotton was asked about protections for the 300,000 Arkansans currently covered by the Medicaid expansion if Obamacare was repealed. Cotton responded that part of his problem with the AHCA bill that died last month, which he opposed, was that it failed to protect that population. He said that the repeal of Obamacare didn’t necessarily mean that those 300,000 Arkansans would lose their health care (he offered no details about what he had in mind) — but he said that would have happened under the AHCA, and so he opposed the bill.


Cotton then moved quickly to vague promises and talking points (and though Cotton has generally been positive about the governor’s efforts on the state’s Medicaid expansion program, he made no promise about the Medicaid expansion itself). But he did reiterate this point about the AHCA:

This is one reason I didn’t support the bill [the AHCA] that was originally proposed. My position is that every Arkansan should have access to affordable, quality care. No exceptions, no excuses.

So a question for Cotton: Do the floated amendments to the AHCA change his mind? If a Republican like Cotton won’t vote for it, the bill is almost certainly DOA in the Senate even in the unlikely event that it passes the House.


If Cotton meant what he said about the AHCA at the townhall, it’s hard to imagine that anything in AHCA 2.0 addresses those concerns.