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House votes on GOP health care bill Friday after Trump ultimatum

White House budget director Mick Mulvaney relayed President

White House budget director Mick Mulvaney relayed President Donald Trump's ultimatum that the House approve the GOP health care bill on Friday, March 24, 2017 -- or else keep Obamacare in place. Mulvaney, right, White House Chief of Staff Reince Priebus, center, and White House chief strategist Steve Bannon, behind Priebus, leave the U.S. Capitol after a House Republican caucus meeting on Thursday. Credit: AP

WASHINGTON — The House will hold a showdown vote on a bill to replace the Affordable Care Act Friday afternoon, a dramatic step Republican leaders took after President Donald Trump late Thursday demanded a vote — and said if it fails, he’ll leave Obamacare in place.

Trump’s ultimatum was delivered by his budget director, Mick Mulvaney, to a meeting of House Republicans convened Thursday evening to pull the divided Republicans together so they can deliver on their seven years of promises to end Obamacare, lawmakers said afterward.

House Speaker Paul Ryan (R-Wis.) and other House Republican leaders are still trying to assemble the support needed to pass the legislation, which means they can lose the backing of only 22 of their 237 party members in the House.

Trump’s demand, and Ryan’s decision to go ahead with Friday’s vote, followed the postponement of a planned Thursday evening vote on the Obamacare repeal after Trump failed to close a deal with the hard-line conservatives in the House Freedom Caucus.

For the past several days, Trump’s skills as a negotiator have been put to test as he has been pressuring and wooing members of the Freedom Caucus and wavering GOP moderates to support the bill. He has met continued resistance that has prevented the bill’s passage.

Trump’s vote demand came after he decided he would no longer negotiate, lawmakers said. It echoes his assertion that the best gambit is to do nothing and let the insurance market collapse — though the nonpartisan Congressional Budget Office said the market would remain stable.

In a short House session late Thursday, Rules Committee Chairman Pete Sessions (R-Texas) said the House would reconvene at 10 a.m. Friday for a debate and an afternoon vote on the modified version of Ryan’s American Health Care Act.

Thursday’s postponement dealt a setback to Trump and Ryan, who had hoped for a powerful symbolic victory by the House voting to repeal Obamacare on the seventh anniversary of it being signed into law by then-President Barack Obama.

Still, passage of the Republican bill remains up in the air.

Many Freedom Caucus members remain dug in against it, while support among moderate Republican lawmakers slipped some. Ryan can lose just 22 of his members’ votes, because Democrats are unified in opposition to the bill.

Rep. Mark Meadows (R-N.C.), the Freedom Caucus chairman, said he will reconvene his members to discuss the concessions Trump has offered and decide how to vote.

Earlier Thursday, Meadows said, “At this point we are trying to get another 30 to 40 votes that are now in the ‘no’ category to ‘yes.’ ”

The caucus insists the bill must strip benefit requirements for health insurance, saying these would raise health costs and premiums. Those benefit requirements include pregnancy, maternity and newborn care; birth control; mental health and substance abuse services; laboratory work; preventive and wellness services; outpatient care; emergency services, and hospitalization.

“We believe some of the text and some of the things we’re being asked to consider at this point are not in enough of a form to make a good informed decision,” Meadows said. “Even some of the language that we believe moves it in a right direction still is ambiguous.”

Rep. Peter King (R-Seaford) said he remains undecided.

Rep. Lee Zeldin (R-Shirley) “is likely voting yes pending possible changes,” his spokeswoman Jennifer DiSiena said.

Hanging over the revisions to the legislation is a question of whether making concessions on insurance mandates will run afoul of the so-called Byrd rule, which requires that only provisions that lower the deficit can be included in a reconciliation bill. Democrats say such concessions would violate the Byrd rule.

Senate Republicans, who hold a majority of just 52 members, need that parliamentary procedure to avoid a filibuster that requires 60 votes to pass the legislation. Senate Republicans cannot reach the required vote total without Democratic support, which Democrats already have said will not be coming.

Obama issued a statement defending his signature legislative achievement. “America is stronger because of the Affordable Care Act,” he said. “There will always be work to do to reduce costs, stabilize markets, improve quality and help the millions . . . who remain uninsured.”

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