The turnabout was only more stunning for the way he did it: winning a pledge of support Wednesday from the hard-right House Freedom Caucus, while alienating numerous moderates he is supposed to help lead. It also allows states to opt out of Obamacare's essential health benefits regulations requiring that insurance plans sold in state exchanges cover a laundry list of procedures that not everyone needs, like maternity care.
It's an effort to once again try and bridge the gap between hardline conservatives in the House Freedom Caucus and more moderate Republican members - a divide so wide that that when the compromise first emerged last week, GOP aides remained skeptical that it would be enough to get leadership to the 216 votes it needs to pass the bill.
Rep. Mark Meadows, R-N.C., the chairman of the House Freedom Caucus, backs the new legislation and sources say Republicans anticipate it will pass even with the addition of the MacArthur Amendment.
Rep. Jim Jordan (R-OH) indicated later Wednesday that he and the Freedom Caucus - comprised of very conservative House Republicans - would support a version of the AHCA with the key addition of the so-called "MacArthur Amendment", a proposal from the "Tuesday Group" credited to moderate Rep. Tom MacArthur (R-NJ).
"We know that this bill, in its current form, with or without the amendment, will be gutted in the Senate".
Republicans on Capitol Hill are wrangling over how to revive their health care bill, which is meant to repeal and replace the Affordable Care Act (ACA), known widely as Obamacare.
The amendment would allow insurers to charge higher premiums to people with pre-existing conditions in states that get a waiver.
Much of the renewed optimism stems from support from the House Freedom Caucus, a group of about three dozen staunch conservatives.
In the meantime, Meadows and his Freedom Caucus colleagues may enjoy their time out of the hot seat.
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"I'll have to read the language more closely", Rep. Morgan Griffith (R-VA) admitted in the biggest understatement of the day.
But now the question shifts to how the center will be treated by leadership and the media versus how members of the freedom caucus were when the vote first failed.
Rep. Charlie Dent, an Allentown Republican who co-chairs the same centrist group as MacArthur, called the process "terrible" and complained that his amendment "makes the whole situation worse, not better". "If this is what it takes to get the bill passed", Collins said, "God bless Donald Trump".
The proposed changes would let states get federal waivers to some coverage requirements Obama's law imposed on insurers.
Dent says the changes ignored his concerns that the health care bill would cut too deeply into the Medicaid program for the poor and leave many people unable to afford coverage. "They want to see us move a replacement plan", he said.
Rep. Mike Coffman, R-Colo., who was supportive of the bill last month, said he's now concerned about the changes.
Estimates range greatly depending on the diseases considered, but federal officials said earlier this year that at least 61 million people too young to qualify for Medicare - including 1.2 million in New Jersey - reported chronic health conditions in 2015 that could have made it hard to obtain care if the ACA wasn't in place.
Under MacArthur's proposal, waivers could be granted only to states that participate in a proposed $115 billion risk-sharing pool to help pay medical costs for people with costly pre-existing conditions.
A temporary funding bill expires Friday at midnight, and GOP leaders late Wednesday unveiled another short-term spending bill to prevent a government shutdown this weekend, something Republicans are determined to avoid. President Trump tweeted at them, attacking them for opposing the bill in favor of a more conservative product. MacArthur announced by midday that the exemption would be removed from the final draft of the amendment and members of Congress and their staff would be subject to the same health care rules as other Americans.
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