The details are still emerging, but the White House and Republicans are discussing a plan that would allow states to apply for waivers on some of Obamacare’s requirements, while still preserving its ban on excluding coverage of those with pre-existing conditions. States would have to show that their waiver “would improve coverage and reduce costs,” Collins said.

Democratic National Committee Chairman Tom Perez on Tuesday called the Republican leadership “heartless” in how they are dealing with a law that extended health care to 24 million people.

“I believe anyone who wants to vote to repeal the Affordable Care Act should be required to spend five hours in an emergency room watching what the Affordable Care Act has done in their community and the country,” Perez said on MSNBC.

Varying Premiums

Meadows said that Obamacare’s community rating system, which prevents insurers from varying premiums within a geographic area based on age, gender, health status or other factors, would be eligible for the waivers. Such a change would allow insurers to charge sick people more for coverage.

The plan would rely on risk-sharing pools to be the “backstop” for people with pre-existing conditions who could be subject to higher premiums if the requirement on community rating were to be removed, Meadows said. “Marginally sick people” would pay the “risk cost associated with their coverage.”

“Those that have premiums that would be driven up because of catastrophic illness or long-term illnesses, we’ve been dealing with that for a long time with high-risk pools, so we believe in doing that is a way to keep premiums down for everybody to ensure everybody’s covered and ultimately where you don’t get priced out of the market,” he added.

Meadows said lifetime and annual caps weren’t discussed explicitly, because they aren’t the main drivers of insurance premium costs.

‘Hope’ for a Vote

When asked if the changes Pence offered would lose moderate votes, Meadows said it was his understanding that the administration had met with moderate members and were working to shore up support in the center.