Health Care Bill Still Not Certain Of Passage

The Washington Post

Washington — The Republican health-care overhaul spearheaded by House Speaker Paul Ryan (Wis.) and backed by President Trump hung in the balance on Wednesday, as the White House signaled at the 11th hour a willingness to rework the measure to mollify conservatives.

After insisting for weeks that the changes sought by hard-right members would render the bill unable to pass the Senate, White House officials and GOP House leaders appeared to shift their thinking — and opponents agreed to keep working on a deal with the goal of holding a floor vote in the House by Thursday night.

Rep. Mark Meadows, R-N.C., chairman of the conservative House Freedom Caucus, said he had taken personal calls on Wednesday from Trump seeking a resolution, though he said no formal offer had been extended by the White House.

“We are working very diligently tonight to try and get there,” Meadows said on Wednesday.

“The president has been profoundly engaged,” said Rep. Trent Franks, R-Ariz. “I think things are going in a very good direction right now.”

More than two dozen House conservatives remained opposed or leaning against the effort to revise the Affordable Care Act, even as a handful of moderates decried the current proposal as harming the elderly and poor. Both the president and vice president made personal appeals throughout the day to secure the votes needed to pass the House.

Pence huddled with members of the Freedom Caucus in his Eisenhower Executive Office Building office early in the day, while Trump met with 18 House Republicans at the White House, but these efforts appeared to produce just one definitive aye vote from the conservative camp: Rep. Steve King, R-Iowa.

GOP leaders can afford only 22 defections, given that one Democrat is expected to be absent Thursday. A Freedom Caucus spokeswoman said that “more than 25” members of the group oppose the bill.

The day’s events laid bare party leaders’ struggle to muster enough votes for one of their defining goals: to roll back the 2010 health-care law that helped galvanize conservatives in the years since to wrest control of both the legislative and executive branches from Democrats.

If Republicans fail this initial test of their ability to govern, Trump and Capitol Hill Republicans may face a harder time advancing high-priority initiatives on infrastructure, tax reform and immigration. They might also find themselves navigating strained relationships among themselves.

For much of Wednesday, the Freedom Caucus’s message, spokeswoman Alyssa Farah tweeted, was: “start over.”

At the same time, three more Republican moderates — Reps. Frank LoBiondo (N.J.), Daniel Donovan (N.Y.) and David Young (Iowa) — announced their opposition Wednesday, increasing pressure on leaders to win over the conservatives.

Ryan summoned more than a dozen members of the moderate Tuesday Group to his office late Wednesday evening in an apparent bid to curb further defections.

“There’s not enough votes to pass this,” Meadows said. “Nothing’s changed.”

Conservatives are seeking to eliminate more of the ACA’s insurance mandates, known as “essential benefits,” which require plans to cover specific medical benefits, such as mental health care, prescription drugs and preventive care. That, conservatives argue, is the only reliable way to force down premiums.

Ryan warned in an interview Wednesday with conservative radio host Hugh Hewitt that fulfilling those GOP demands would violate Senate budget rules and leave the bill vulnerable to a blockade by Democrats.

“Our whole thing is we don’t want to load up our bill in such a way that it doesn’t even get considered in the Senate,” the speaker said. “Then we’ve lost our one chance with this one tool we have.”

That stance appeared to soften later on Wednesday, as White House officials and House leaders tried to negotiate changes to the bill that would get closer to conservatives’ goal of eliminating more of the Affordable Care Act’s insurance mandates.

“We’re not there yet,” Meadows said on Wednesday, “but we’re very optimistic that if we work around the clock between now and noon tomorrow that we’re going to be able to find some common ground. Tonight is an encouraging night, and yet I don’t want to be so optimistic to say that the deal is done, but I do think that there is a framework to work with our leadership and the leadership in the Senate and certainly the administration to find some common ground.”

He continued: “The overall impression of the Freedom Caucus is we’re willing to jump through unbelievable hurdles to hopefully get to a point where this bill is better for the American people.”

Even if the House approves the package, the legislation faces an uphill battle in the Senate — and the new negotiations late Wednesday raised the possibility that the challenge would only grow at the other end of the Capitol. There are at least a dozen skeptics of the bill among Senate Republicans.