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In Major Blow To Trump, GOP Health Care Bill Vote Delayed

The Republican health bill is in jeopardy with resistance from conservative House members. The bill's fate could have big implications for President Trump.

The long-promised Republican bill to repeal and replace the Affordable Care Act, also known as Obamacare, has been delayed, NPR's Susan Davis reports. It was supposed to get a vote Thursday night, but it has been running into trouble — from both the right and the center.

Thursday afternoon, the votes were not there to pass the bill. House Majority Leader Kevin McCarthy tried downplay the task ahead, saying on CNN that leadership just needs to convince "a couple more" lawmakers to give their support. "We'll start the debate [Friday] morning," he said.

But the path forward is still uncertain. The delay is a blow to President Trump, who for all his efforts at deal-making hasn't been able yet to secure the votes.

No consensus was reached during a meeting with the president and the roughly 40 members of the House Freedom Caucus at the White House Thursday afternoon.

Trump is going to try a different tack — at a point a bit more leftward on the spectrum — and meet with the maybe two dozen moderates in the so-called Tuesday Group later Thursday, White House press secretary Sean Spicer said at a White House briefing with reporters.

Spicer had insisted Thursday afternoon, about an hour before the delay, that the vote for Thursday night was still on (though no time was set). He tried to spin the meeting with the Freedom Caucus as a "very positive step."

But that's not the same thing as having the votes.

Republican leadership can lose up to 22 Republican votes and still pass the legislation. (That's if everyone who is supposed to vote does so. With the full 435 House members voting, it takes 218 votes to pass. But there are five vacancies, and Democratic Rep. Bobby Rush of Illinois, who is dealing with the death of his wife, is not expected to vote. That drops the total to 429, a majority of which is 215. That's the magic number if everyone votes. There are 237 Republicans.)

Mark Meadows, a representative from North Carolina and chairman of the Freedom Caucus, emerged after the meeting with the president and said there was still no deal.

"We're certainly trying to get to yes," Meadows said, "but indeed we've made very reasonable requests, and we're hopeful that those reasonable requests will be listened to and ultimately agreed to."

It's a familiar story — Republicans, once again, unable to hold their fractious conference together to get enough votes. It happened continually during the Obama presidency.

John Boehner, when he was speaker of the GOP-controlled House, once likened his job to keeping 218 frogs in a wheelbarrow.

But this is a crucial first test of Trump's and Republicans' ability to govern. It's the first time in a decade that the GOP has control of the House, Senate and White House.

For many members, this is their first time legislating under a Republican president. That has presented opportunity — and complication. Throw into the mix that Trump did well in many of the Freedom Caucus' members' districts in the presidential election, and you have a complex, intertwined political situation.

The Tuesday Group is seen as being steadfast in its objections to the bill — that it would drive up the cost for seniors and increase the rolls of the uninsured.

That puts a lot on the Freedom Caucus. But despite Trump's popularity in their districts, many of those Freedom Caucus members have steadfast ideological objections to this bill, too.

For one thing, it keeps premiums too high, they believe. Dave Brat, a Virginia representative who defeated former Majority Leader Eric Cantor, said he wants to see an "ironclad" document from the White House that shows premiums would be lowered under this bill.

The Congressional Budget Office estimated that the bill would increase premiums as much as 15 to 20 percent in the short run. The caucus believes that to lower those premiums, it's necessary to cut "essential health benefits." Those are types of coverage that insurance companies are required to provide.

Of course, that is a nonstarter with moderates.

Many of those Freedom Caucus members would also like to eliminate popular provisions, like allowing children to stay on their parents' plans until age 26 and requiring insurance companies to provide plans for those with pre-existing conditions. That, however, is seen as nonnegotiable.

And they'd like to see the Medicaid expansion funds to states sunset sooner than 2020, as is proposed in the current bill. The CBO, however, projects 24 million people could lose their health insurance under the Republican health care plan, most of that from the proposed Medicaid rollbacks. That presents Republicans with a potentially very dicey political situation ahead of the midterms and next presidential election.

The clock is ticking, and Trump and House Speaker Paul Ryan appeared to have two more chances Thursday — Trump's meeting with the Tuesday Group and a Ryan news conference. That news conference was supposed to happen at 3:30 p.m. ET, but it was postponed and minutes later, NPR reported the delay of the vote.

Spicer said Trump was working the phones through 11 p.m. ET Wednesday night. If this bill fails, it would mar an essential image Trump has tried to create of himself — of a shrewd businessman who makes the best deals.

The song that seemed to snarkily play in the background at nearly every Trump rally in 2016 was the Rolling Stones' "You Can't Always Get What You Want." The White House seemed to make that its explicit sell to House members who have a problem with the bill.

Spicer chided that GOP members "took free votes" over eight years of the Obama presidency on repealing Obamacare. Now, he said, the party has to "keep our word."

He added, "At the end of the day, we can't make people vote."

But Trump and Ryan have set this bill up as the only vehicle to repeal and replace the Affordable Care Act.

If it doesn't pass, it endangers their entire agenda.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

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