President Trump and House Republican leaders face their first real legislative test on Thursday, when the GOP will try to push through a bill to repeal and replace Obamacare after days of round-the-clock negotiations and personal calls from Trump to squeeze out every possible vote from skeptical conservative lawmakers.
“It’s tomorrow, do or die,” Rep. Chris Collins, R-N.Y., a member of the GOP whip operation, said Wednesday afternoon.
House Speaker Paul Ryan on Wednesday declined to publicly promise passage, and couldn’t deny the possibility that the bill might be pulled at the last minute if it lacks support.
But behind the scenes, confidence is building that Republicans and Trump will score their first big legislative win and fulfill a promise the party has been making since the Affordable Care Act was enacted by Democrats in 2010.
“In the end, we promised to repeal Obamacare,” Rep. Mike Simpson, R-Idaho, a longtime GOP member said, betting the bill will pass.
Republican holdouts include more than two dozen staunch conservatives who want changes to the bill that will ensure lower health insurance costs and no federal mandates.
It’s enough opposition to sink the bill.
If all current members are present, 216 votes would be needed for passage, and with no Democratic support expected, it would take only 22 GOP “no” votes to defeat the legislation. The GOP can fall short a vote or two if a few Democrats are absent, as expected.
The leaders of the opposition, House Freedom Caucus Chairman Mark Meadows, R-N.C., said the group is eager to find a way to support the bill. Meadows pointed out that over recent days opponents have won four of the six changes to the bill they were seeking, including a provision enabling a work requirement for some Medicaid recipients and language permitting states to utilize a less costly Medicaid block grant system.
Hoping for two additional changes, a group of HFC members huddled Vice President Mike Pence in a small room near the House chamber on Wednesday afternoon, while on the House floor, the GOP whip team worked the room.
“We had a great conversation with the vice president,” Meadows told the Washington Examiner after leaving the meeting. “Certainly if anybody can get this to a yes it’s probably the president first and the vice president second. I would characterize the conversation as a back and forth of ideas.”
Meadows said he’s seeking changes to the bill that would end the essential benefits in Obamacare, rather than leaving it up to Health and Human Services Secretary Tom Price to reverse them, as Republican leaders and Trump have promised but which some are dubious can be achieved. Late Wednesday, there were signs those changes were under consideration.
Many conservative Republican opponents site essential benefits, such as allowing adult children to remain on a parent’s insurance policy until age 26, as the reason health insurance premiums do not decrease much under the GOP plan to replace Obamacare. Conservatives want the essential benefits repealed and then added back in one by one, to keep costs lower.
Pence told the group that rather than changing the bill in the House, the Senate could include language ending essential benefits and the mandates when the bill reaches the Senate.
“For most of our members, if not all of our members, that was not enough of a promise,” Meadows said.
But he’s not giving up. Meadows said more talks will continue between GOP holdouts and the White House, including Trump, as the vote nears. Many House Freedom Caucus members interviewed by the Washington Examiner said they were eager to find a way to support the bill.
“At this point I’m a no, but trying to get to a yes,” Rep. Mark Sanford, R-S.C., told the Washington Examiner.
The GOP whip team, eager to score one of the party’s biggest victories, is putting tremendous pressure on GOP holdouts, arguing that a vote against the bill is a vote to keep Obamacare alive after seven years of promising to repeal it.
Collins said the vote could be held open longer than the typical 15 minutes, if that’s what it takes.
“The president is going to have to be on he phone, the Speaker and the Majority Leader are going to have to do some arm twisting,” Collins said.
With only a handful of “no” votes left to ensure victory, Collins said he predicts it will be too hard for GOP opponents to bear responsibility for the failure of the bill or handing President Trump and the party a massive and embarrassing legislative loss.
“I still believe when the president calls someone and says I need you on this, you are the difference between repealing Obamacare or keeping it on the books, which is a disaster for America, it’s very hard to say no to the president,” Collins said.
