Republican leaders are in a furious last-minute push to wrangle enough House members to pass the GOP’s healthcare bill in a vote expected to be carried out 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 the Affordable Care Act, the healthcare law better known as Obamacare – to conservative members of the House to secure the 218 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.
A representative for the Freedom Caucus tweeted that 25 members were against the AHCA as of Wednesday afternoon in Washington, more than enough to defeat the bill in a House vote.
Additionally, a number of moderate Republicans have begun to state their intention to vote “no” on the bill as well, putting the AHCA even more in jeopardy.
Conservatives remain unconvinced that the AHCA fulfills 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 have 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 fulfill the party’s promise to voters that it would fully repeal the Affordable Care Act.
Meadows said the Freedom Caucus had more than 21 votes against the bill. He also told reporters that changes to positions were 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 of Michigan tweeted Tuesday. “They have seriously miscalculated.”
The Freedom Caucus has not taken an official position against the bill, meaning its members are free to vote how they choose. Alyssa Farah, a representative of the Freedom Caucus, tweeted, however, that this did 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.”
Additionally, it appears that a number of more moderate Republicans are against the bill.
Rep. David Young of Iowa released a statement Wednesday afternoon that he would vote against the AHCA.
“While the American Health Care Act, legislation to repeal and replace Obamacare, is a very good start, it does not yet get it right and therefore I cannot support it in its present form,” said the statement.
Additionally, moderate GOP Rep. Frank LoBiondo of New Jersey tweeted he will also vote against the bill.
“Regrettably, current healthcare proposal falls far short & is not better for #SouthJersey,” tweeted LoBiondo. “I will be voting no on American Health Care Act.”
All in all, it appears that there are not yet enough votes to carry the bill through the House. NBC News estimated on Wednesday that 26 House Republicans had serious reservations or were outwardly against the AHCA. The Huffington Post had the number pegged at 28 for “likely to vote against,” and The New York Times had the most recent tally with 41 members who had said they were opposing the bill or had raised serious concerns (24 solid “no” votes and 17 with concerns).
Given the make-up of the House, only 22 Republicans have to vote against the bill 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 with the House GOP members at a meeting Tuesday morning, threatening that if they did not pass the bill, they risked 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 – the 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 that the president was “bringing them 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,” and he told conservative radio host Mike Gallagher on Tuesday that Trump was “fantastic” at the full House GOP meeting on Tuesday.
The question is whether the late push will be enough.
- Win McNamee/Getty Images
Jitters and a tough path forward
Republicans have insisted that they need to get the healthcare law done before they can move on to other legislative changes, such as tax reform and regulatory cutbacks.
The possibility that the AHCA may not be passed, which would push tax reform to the backburner, may have even given investors jitters. Numerous 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 number 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-to-48 majority. While the AHCA is going through a process called budget reconciliation, meaning it needs only a simply majority, the GOP can only afford to lose three votes in the Senate.
It appears that it has 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 cost many their coverage, according to the nonpartisan Congressional Budget Office analysis. Over 11 million people have gotten onto the Medicaid rolls because of the ACA expansion.
- Alex Wong/Getty Images
Sen. Tom Cotton, a conservative Republican who supported Trump, has repeatedly railed against the bill. Cotton’s fellow senator from Arkansas, John Boozman, and Sen. 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 were similar to the current bill’s.
Sens. Bill Cassidy and Susan Collins, who introduced their own replacement bill, have expressed concerns that the AHCA would cause too many people to lose coverage. Cassidy even said 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,” Trump said. “Working hard!”