Republican leaders are in a furious last minute push to wrangle enough House members to vote for the GOP’s healthcare bill in an attempt to save it from a potentially disastrous failed vote on Thursday.
President Donald Trump, members of his administration, and House GOP leaders have continued to put the hard sell on the American Health Care Act — the GOP’s bid to repeal and replace Obamacare — to conservative members of the House to secure the votes needed for the bill to pass.
As of Wednesday afternoon, they remained unsuccessful.
“Currently there are not enough votes to pass the legislation,” Rep. Mark Meadows, the chair of the conservative House Freedom Caucus, said after a meeting at the White House.
Conservatives remain unconvinced that the AHCA fulfils their promises and have reiterated that they have enough votes necessary to block the bill from passing the House. Conservative-leaning groups have remained steadfast in opposition, as well.
If the bill does not pass, it would be a serious setback for the legislative agenda of Trump less than 70 days into his presidency.
The importance and uncertainty of the vote, expected Thursday, has created the biggest opportunity yet for Trump to attempt to do what he says he does best: Deal.
‘They have seriously miscalculated’
The biggest blockade has become the House Freedom Caucus. The collection of roughly 35 House members grew out of the Tea Party movement and has pledged to uphold conservative ideals in the legislature.
The Freedom Caucus has opposed the AHCA from the outset, saying the bill does not fulfil the party’s promise to voters that they would fully repeal the Affordable Care Act, also known as Obamacare.
Rep. Mark Meadows, head of the Freedom Caucus, said that the administration and GOP leaders do not have the votes they need to pass the bill and that there are over 21 votes against the bill from the Freedom Caucus. He also told reporters that changes to positions are unlikely to come unless the Republican leaders budge.
“I certainly think that the president is the best guy to bring this home and close this deal out,” Meadows told reporters. “Hopefully, we’ll be able to do that, but if everyone’s entrenched at this particular point it’s going to be a very difficult 48 hours.”
Other Freedom Caucus members have also reiterated that the bill does not have enough support.
“They don’t have the votes to pass it,” Rep. Justin Amash tweeted Tuesday. “They have seriously miscalculated.”
The Freedom Caucus has not taken an official position against the bill so, meaning that its members are free to vote how they choose. Alyssa Farah, a spokesperson for the Freedom Caucus, tweeted, however, that this does not mean the group would split votes on the bill.
“Reports the Freedom Caucus won’t oppose AHCA are incorrect,” Farah said Tuesday. “No position was announced last night — doesn’t mean they won’t vote as bloc.”
All in all, it appears that there are not yet enough votes to carry the bill through the House. NBC News estimated that 26 members have serious reservations or are outwardly against the AHCA. The Huffington Post also has the number pegged at 27 for “likely to vote against,” and The New York Times has a tally of 45 members that have said they are opposing the bill or have raised serious concerns.
Given the make up of the House, only 22 Republicans have to vote against the bill in order for it to fail.
Over the weekend, reports indicated that members of Trump’s administration — such as Health and Human Services Secretary Tom Price and Office of Management and Budget Director Mick Mulvaney, a former Freedom Caucus member — were taking the lead on calling representatives to earn their support. Trump, reports said, was providing little assistance.
Over the past few days, however, Trump has increased his sales push for the AHCA. The president spoke to the House GOP members at a meeting Tuesday morning, threatening that if they do not pass the bill they risk losing reelection in 2018. He even called out Meadows for his opposition, having him stand up and predicting he’d come around.
Trump followed it up by speaking at the National Republican Congressional Conference on Tuesday night, reiterating the need to pass the bill.
On Wednesday, Rep. Patrick McHenry — deputy House whip for the GOP — told reporters at the White House that Trump was meeting with 10 House members who had “myriad concerns” with the bill and the president was “bringing them to the closer.”
As part of the final push to win over conservatives, Trump will meet with the entire House Freedom Caucus at the White House on Wednesday to try to pick off their votes.
House Speaker Ryan has repeatedly called Trump “a great closer” an told conservative radio host Mike Gallagher on Tuesday that Trump was a “fantastic” at the full House GOP meeting on Tuesday.
The question is whether the late push will be enough.
Jitters and a tough path forward
Republicans have insisted that they need to get the healthcare law done before they can move onto other legislative changes, such as tax reform and regulatory cutbacks.
The possibility of the AHCA’s may not get done, which would push tax reform to the backburner, may have even given investors jitters. A number of market analysts and investors have cited the possible delay in Trump’s agenda as the reason for the Dow Jones industrial average’s 237-point fall on Tuesday.
It is clear that a large amount of Trump’s promises to make big changes hinge on the passage of the bill.
And while the heat is increasing in the House, the effort may all be for naught when the bill hits the Senate.
The Republicans hold an even slimmer margin in the chamber, with just a 52-seat majority. While the AHCA is going through a process called budget reconciliation, meaning it only needs a simply majority, the GOP can only afford to lose three votes in the Senate.
It appears they have far more defectors than that.
A large concern seems to be the changes to Medicaid in the AHCA. The rollback of funding for the ACA’s Medicaid expansion could leave many currently on the program without coverage according to the CBO analysis. Over 11 million people have gotten onto the Medicaid rolls due to the ACA expansion.
Sen. Tom Cotton, a conservative Republican that supported Trump, has repeatedly railed against the bill for its harmful impact. Cotton’s fellow Senator from Arkansas John Boozman and Dean Heller of Nevada have also said the Medicaid cuts have caused them to question the bill.
Four senators wrote a letter to Senate Majority Leader Mitch McConnell hours before the AHCA was first released expressing concerns about a leaked draft’s cuts to Medicaid funding that are similar to the current bill’s.
Sens. Bill Cassidy and Susan Collins, who introduced their own replacement bill, have expressed concerns that the AHCA causes too many people to lose their coverage. Cassidy even said that the CBO score of the AHCA was “awful.”
Additionally, conservative members such as Sens. Rand Paul, Mike Lee, and Ted Cruz have all suggested the bill does not go far enough — similar to the Freedom Caucus.
With obvious knowledge of the large stakes, Trump took to his usual Twitter platform on Wednesday and previewed his day working on the AHCA.
“Big day for healthcare,” said Trump. “Working hard!”
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