WASHINGTON — President Donald Trump and House Republican leaders scrambled Wednesday to win enough support from conservatives and some moderate holdouts in their own party to pass a replacement for the Affordable Care Act in a vote scheduled for Thursday.
By day’s end, the vote count to pass legislation that House Speaker Paul Ryan (R-Wis.) has put on a fast track to fulfill a Republican promise to repeal Obamacare appeared to fall short as the hard-line House Freedom Caucus said many of its members remained opposed to the bill.
Trump and Ryan kept pressure on lawmakers into the evening, as the speaker sought to overcome what he called in a radio interview with Hugh Hewitt “the tempest of the legislative process.” The GOP bill can lose the vote of at most 22 of the 237 Republican House members.
A day after going to the Capitol to cajole House Republicans into supporting Ryan’s American Health Care Act, Trump on Wednesday met with 18 of the caucus members for 90 minutes at the White House as the bloc’s top leaders met with Vice President Mike Pence.
Trump responded to reporter questions asking if he will keep pushing the health care overhaul if the House fails to pass the bill by saying, “We’ll see what happens.”
After meeting with Trump, Rep. Mark Meadows (R-N.C.), chairman of the Freedom Caucus, said the pressure and the offers to make some legislative changes was not enough to win over his group, which is demanding a complete repeal of all of the current health law.
“There’s not enough votes to pass it tomorrow,” Meadows said. “Nothing’s changed.”
Meadow’s spokeswoman Alyssa Farrah tweeted on the Freedom Caucus twitter account: “BREAKING: more than 25 Freedom Caucus ‘No’s’ on AHCA — group says ‘start over.’ ”
Meanwhile, three moderates, including Rep. Dan Donovan (R-Staten Island), announced that they also oppose the bill, but for very different reasons than their conservative colleagues.
A key reason Donovan cited was this week’s Medicaid amendment to win over upstate Republicans, which effectively exempts counties from contributing to the New York State’s Medicaid coffers, but excludes New York City.
Rep. Peter King (R-Seaford) remained on the fence, but Rep. Lee Zeldin (R-Shirley) said he supports several of the bill’s provisions, according to his spokeswoman.
Trump spokesman Sean Spicer wouldn’t share the White House’s count of Republican votes for the legislation but sought to project confidence it would pass, saying Trump is a “closer” and doesn’t need a Plan B.
“There’s Plan A and Plan A. We’re going to get this done,” Spicer said.
The House Rules Committee moved ahead to set the conditions for the vote Thursday, and was expected to let the chamber vote on changes to the legislation that Republican leadership devised to win votes.
As Trump and Ryan offer concessions in the bill to win votes, they are running into a quandary because moderates oppose what conservatives demand, and conservatives reject the changes moderates seek.
Many conservatives demand a complete and clean repeal of Obamacare, including its requirements to cover pre-existing conditions and to cover maternity care, and oppose tax credits to help lower-income people pay for health insurance.
Some moderates, meanwhile, are concerned that the Congressional Budget Office has determined that 24 million people will lose health insurance coverage under the Ryan bill.
Meanwhile, Democrats remain unified in opposition.
Dozens of Democratic lawmakers, joined by former Vice President Joe Biden, rallied on the House steps to mark the seventh anniversary of the signing of the Affordable Care Act while urging their Republican colleagues to reject repeal efforts.
Biden said Obamacare gives “peace of mind” to Americans, several of whom spoke at the event about how the coverage benefited them. He said it can be modified. “We know, just like when Social Security was passed, there’d have to be improvements made,” he said.