Conservative holdouts emerged from a meeting with President Trump on Thursday without a deal to secure their votes for the House Republican healthcare bill, jeopardizing the first major legislation of the new administration.
House Freedom Caucus Chairman Mark Meadows said the GOP still doesn’t have the votes to pass the bill to repeal Obamacare. However, he remained optimistic that a deal could be reached as early as Thursday night that could get the caucus to “yes.”
Still, the possibility of a vote remained very much in doubt. “They had a good meeting but there is no definitive deal,” Rep. Thomas Massie, R-Ky., told reporters. “I think they are in real trouble. If they bring it to the floor and it doesn’t get to 216 quickly, the momentum could go in the other direction quickly.” Another member of the Freedom Caucus, Rep. Mo Brooks, R-Ala., said, “I have not received the assurances that I want.”
As members of the House Freedom Caucus lined up to meet with the president and senior administration staff Thursday morning in an attempt to reach a deal that would ensure the American Health Care Act’s passage, Speaker Paul Ryan delayed a conference meeting and pushed back a scheduled press availability by several hours. The House Rules Committee, which is working on the contents of a manager’s amendment to the legislation, had debated the language of the proposed changes well into Wednesday evening but gave little indication Thursday morning of it when it would reconvene to continue discussions.
North Carolina Rep. Mark Meadows, chairman of the Freedom Caucus, has negotiated directly with Trump this week, earning himself a personal shout-out from the president during a closed-door meeting of the GOP conference on Tuesday. Meadows has indicated that more than 25 members of his conservative voting bloc plan to oppose the healthcare legislation — enough to sink the bill if it heads to the House floor as written.
Lawmakers appeared to be nearing a deal with the White House on Wednesday evening that would give conservative hold-outs more of the policy changes they had expected to see in the Republican healthcare bill. At the heart of their concerns was that the AHCA left too much of Obamacare’s costly regulatory framework intact — including rules that require all health insurance policies to cover an assortment of conditions and a requirement that all insurance companies provide coverage to individuals who have pre-existing conditions.
House leadership also signaled a willingness to add a repeal of “essential health benefits” into the bill, stating that they received new information from the Senate indicating that doing so would not blow up the process in the Senate by which Republicans are planning to pass the legislation with a simple majority.
Conservatives said a bargain with White House that includes a reversal of the “essential health benefits” requirement created by Obamacare did not go far enough, because leaving other regulations intact would further distort the market and leave sicker Americans worse off.
Previously, House leadership had warned that significant policy changes could not be included in the AHCA due to restrictive procedural guidelines in the Senate that could sink the legislation entirely, because Republicans hope to pass the healthcare legislation through budget reconciliation.
That approach will allow GOP lawmakers to send the AHCA to Trump’s desk with a simple majority, but it means the bill must be deficit-reducing and can only include provisions that are primarily related to the budget.
Although Ryan had projected confidence that lawmakers would vote for the healthcare bill on Thursday, the Rules Committee had not yet signaled when it would advance the AHCA to the House floor in the hours before Trump’s meeting with the Freedom Caucus.
