GOP rules proposal could snarl health care plans

If conservative Republicans succeed in an attempt to revamp some GOP conference rules, it could scramble some Republican health care plans — including who chairs one of the primary committees.

Driving the news: The changes — first reported by Punchbowl News this morning — include a Republican Conference vote on each bill before it’s brought to the House floor and allowing committee members to elect committee chairs, rather than leadership.

• Another proposal would bar omnibus spending packages — a tool for avoiding fatal fights over controversial policy items and a frequent vehicle for health care legislation.

Between the lines: Who knows how successful the Freedom Caucus and their friends will be in securing any of these asks, but there are two huge health care implications if they succeed, according to former GOP Hill aides and analysts:

1. Any significant health care policy that doesn't happen in the lame duck session may not happen at all. The rule proposals — especially the one requiring a majority of the GOP conference to sign off on any legislation — create even more incentive to cram in everything humanly possible over the next few weeks.

• "I think whatever happens in the lame duck is by far the most important question, and maybe the last chance to do anything meaningfully if they do do a rules change," one former GOP aide told Axios.

2. Adrian Smith may pull ahead in the competitive race for Ways and Means chair if committee members get to choose their leader.

• Smith has been seen as the third-place candidate, but he’s known as the policy wonk among the three contestants. That could give him the edge in a secret ballot election, another former House GOP leadership aide said.

• But another former GOP aide said members could also go the seniority route and vote for Vern Buchanan.

Reality check: All this hinges on Republicans getting a majority in the House. Pollsters and pundits still predict a slim GOP majority, but it’s not yet solidified.