Hard-line conservatives told House leaders to delay Thursday’s high-stakes floor showdown on Obamacare, saying the repeal bill doesn’t have enough support to pass — putting them on a collision course with President Trump, who says this is the only chance Republicans will have.
By drawing a line in the sand, members of the House Freedom Caucus set the stage for a dramatic 24 hours of arm-twisting or policy tinkering by Republican leaders and the White House, which is imploring conservatives and centrist holdouts not to stymie Mr. Trump’s agenda with an embarrassing defeat on the floor late Thursday.
As of Wednesday afternoon, there were more than two dozen holdouts among the Freedom Caucus, a spokeswoman for the lawmakers said.
That, combined with unanimous Democratic opposition, is more than enough to sink the bill — to say nothing of centrist Republicans who are firmly opposed or leaning “no.”
Rep. Mark Meadows, North Carolina Republican and Freedom Caucus chairman, said putting off a vote would give leaders a chance to come back with a better version.
“I think everyone wants to be a yes,” he said. “We need changes to the underlying bill before we vote on it in the House.”
But House Speaker Paul D. Ryan, Wisconsin Republican, has shown little appetite for rewriting the bill, saying conservatives are getting 85 percent of what they want. He also is trying to maintain the careful balance struck between conservatives and centrists, and fears a bill that leans too far to the right would be unworkable for the Senate.
Many conservatives want to eliminate Obamacare’s insurance regulations and requirements known as “essential benefits,” which include prescription drugs and maternity care, though leaders worry that doing so would flout budget rules needed to avoid a filibuster in the Senate.
Mr. Meadows told reporters late Wednesday that he was “encouraged” by negotiations and still hoped to strike a deal on the issue, but that their “positions haven’t changed.”
Democrats mocked the last-minute push, saying the effort would violate Senate rules and amounts to desperation.
Earlier Wednesday, the administration had warned conservatives that there is “no Plan B” if they reject the bill.
“This is it,” said White House press secretary Sean Spicer.
Still, Mr. Spicer said the president was confident he would live up to his reputation as “the closer.”
“I’m optimistic in the sense of what we’re seeing and the trajectory that this is going and the number of votes that are flowing our way, not the other way,” Mr. Spicer said.
Mr. Ryan enticed Rep. Lou Barletta of Pennsylvania into the “yes” column by promising a vote on legislation to prevent illegal immigrants from receiving tax credits for health coverage. Rep. Steve King, Iowa Republican, also decided to back the plan, according to the White House.
Yet efforts to bring on conservatives appeared to scare off moderates who are critical to the effort.
Rep. Charlie Dent, Pennsylvania Republican and co-chair of the centrist Tuesday Group, said late Wednesday he couldn’t vote for the plan, saying it wouldn’t make coverage too unaffordable for many Americans.
His major defection, which came after a meeting with Mr. Ryan, compounded defections from earlier in the day. Rep. David Young, Iowa Republican, said the House is rushing, when it should be “deliberate and get this right.”
Rep. Daniel M. Donovan Jr., New York Republican, said he is opposed in part because a tweak designed to rope in upstate votes by axing county contributions to Medicaid exempted New York City. He said it would place a bigger state-tax burden onto his Staten Island and Brooklyn constituents.
Asked about postponing things if the math doesn’t add up Thursday, Mr. Ryan said he wouldn’t get into hypotheticals.
“We’re talking to our members and working toward the goal line here,” he told Fox News. “We’re adding votes by the day. We’re not losing votes — we’re adding votes — and we feel like we’re getting really, really close.”
The strategy is risky for Republican leaders and Mr. Trump, whose seven-year push to dismantle Obamacare could fail on live television despite sweeping victories in November.
The plan repeals most of Obamacare’s taxes and its mandate requiring Americans to hold insurance, replaces its generous subsidies with refundable, age-based tax credits and reins in and caps spending on Medicaid, the insurance program for the poor.
Former Vice President Joseph R. Biden rallied with congressional Democrats in defense of the Affordable Care Act, which extended coverage to more than 20 million Americans.
“This bill was about peace of mind,” Mr. Biden said outside the U.S. Capitol, flanked by lawmakers and advocates.
But Obamacare has also seen soaring premiums and dwindling choices on its web-based insurance exchanges, opening the door to the Republican push for repeal.
“Simply put, Obamacare is collapsing right before the American people’s eyes,” said Rep. Pete Sessions, Texas Republican and chairman of the Rules Committee that spent Wednesday preparing the bill for the floor.
The committee decided to pack it in before midnight and reconvene Thursday morning to issue a same-day rule before the vote, as leaders brokered a path forward.
“Whoever has not been bought off is going to be bought off, or an attempt is going to be made. That’s why you need more time,” Rep. Alcee Hastings, Florida Democrat, said.
Democrats have accused GOP leaders of moving too fast, saying Congress should wait on the Congressional Budget Office’s report on last-minute changes that beef up tax credits for older Americans, or accept a block grant of federal funding for Medicaid.
As written, the CBO estimated that the plan would save more than $300 billion but result in an eye-popping 24 million fewer people being insured a decade from now, while significantly raising costs for Americans ages 50 to 64.
“Sometimes I think my Republican friends have lost their human ability to feel what 24 million people really means,” said Rep. James P. McGovern, Massachusetts Democrat.
Mr. Ryan and his chief aides say the CBO failed to take into account executive actions Mr. Trump would take and bills congressional Republicans would write. There is only do so much they can do in the first phase of their plans because they are trying to meet arcane budget rules that allow them to avoid a Democratic filibuster in the Senate.
Mr. Meadows and other conservatives say that plan is a foolhardy because Senate Democrats will block future legislation.
“The main sticking point is the same that it’s been: If we don’t lower premiums, this bill does not do enough,” Mr. Meadows said. “We’ve got to lower premiums. We’ve got to make sure this bill does that and not hope for a phase-three fix.”
The bill’s backers, though, are losing patience with Republican holdouts, saying failure to repeal Obamacare now will throw the entire year off course.
“We have to call people out with a binary choice. You are voting to repeal Obamacare or you are voting to keep Obamacare,” said Rep. Chris Collins, New York Republican and a staunch Trump ally. “That is what we have to say to the Freedom Caucus and some of the others. If this goes down, we don’t get tax reform, we don’t get infrastructure.”
Rep. Tom Cole, Oklahoma Republican, said the bill is demonstrably better, from a conservative standpoint, than Obamacare.
“Why would you stop something that is better?” he said.
But Rep. Frank A. LoBiondo, New Jersey Republican, applied Mr. Cole’s test and still decided to reject the plan.
“Simply put, this bill does not meet the standards of what was promised; it is not as good as or better than what we currently have,” he said. “Accordingly, I will vote no on this health care plan.”
⦁ Seth McLaughlin, S.A. Miller and David Sherfinski contributed to this report.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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